Does Inguinal Hernia Repair Impair Male Fertility?

Albert B. Lowenfels, MD


August 24, 2018

Does herniorrhaphy impair male fertility? In a paper recently published in Annals of Surgery ,[1] the authors studied fertility outcomes in 32,621 Danish male inguinal hernia patients operated with mesh repair and 97,805 matched men who had not undergone herniorrhaphy.

The main outcome measure was the number of offspring per 1000 men, with follow-up time ranging from 0 to 14.3 years. The variables included in the analysis were unilateral versus bilateral herniorrhaphy, type of procedure (Lichtenstein technique or laparoscopic approach), and patient age.

After adjusting for the large number of potential subgroups, patients who had the unilateral Lichtenstein technique had slightly more children (161 vs 151 per 1000 patients; P = .009). No group of patients experienced a decreased fertility rate.

Rest Assured That Patients Did Not Father Fewer Children

Herniorrhaphy is a common operation performed by general surgeons, so any information about decreased fertility after this procedure is important.[2] The results of this report are reassuringly negative.

The study's strengths include its large sample size (which includes data from nearly all men operated on in a single country), the accuracy of the data sources, and the availability of excellent follow-up statistics for fatherhood. On the basis of this study, surgeons can reassure patients that having a hernia operation will not reduce their chances of having children.

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