“Comparative study of the effect of prosthetic mesh on spermatogenesis in laparoscopic transabdominal preperitoneal versus lichtenstein inguinal hernia repair”

Background and aim Groin hernia is a common condition, with mesh repair now used in most cases due to its lower recurrence rate. The Lichtenstein technique remains the standard approach for its simplicity and effectiveness this study aimed to compare the impact of laparoscopic transabdominal preperitoneal (TAPP) versus open (Lichtenstein) inguinal hernia repair on ipsilateral testicular volume and spermatogenesis. Patients and methods This prospective research involved 80 inguinal hernia cases treated at Al-Azhar University Hospitals, Assiut, between January 2024 and 2025. They were randomized into two groups: group A (open Lichtenstein, n =40) and group B (laparoscopic transabdominal preperitoneal, n =40). All have been discharged on the first postoperative day. Results Time of the operation and blood loss were higher in the open group (72 min, 40 ml) than in the laparoscopic group (65 min, 15 ml). Hospital stay was shorter (1 vs. 2 days), and return to work was faster (3–7 vs. ∼7 days) with laparoscopy. Scrotal edema was more common in the open group (30 vs. 10%), while subcutaneous emphysema occurred only in laparoscopic cases (10%). Testicular volume showed a slight, nonsignificant postoperative decrease, more in the open group. Resistive index remained stable (∼0.6) in both. Semen parameters and hormones were unchanged, except for a mild, clinically insignificant rise in luteinizing hormone (LH) (5.4–6.2 IU/L). Both techniques were safe, with a slight functional advantage for laparoscopy. Conclusion Laparoscopic repair offers quicker recovery but is costlier. No gold standard exists; Lichtenstein remains a safe alternative when laparoscopy is not available.