观点｜腹股沟疝使用补片对男性生育有影响吗？
在Pubmed上，用Mesh hernia repair and male infertilit检索（注意，这里用了 and 限制了关键词，即检索必须满足疝补片修补和男性不育两个条件），共检索到27篇相关的文献。
总体上，疝的补片修补与男性的不育只还是个假说，有人在动物实验上发现了用聚丙烯补片可影响输精管，但在临床观查上没有发现这方面的证据。
首先看一下这方面的文献综述：Am J Surg. 2012 204(4):503-9.
小产权房屋买卖合同>会计教育题目：Mechanism, asssment, and incidence of male infertility after inguinal hernia surgery: a review of the preclinical and clinical literature.（综述临床前期和临床的有关文献）
Tekatli H1, Schouten N, van Dalen T, Burgmans I, Smakman N.
BACKGROUND: 婚姻的真相
英文生日祝福The treatment of inguinal hernia has changed considerably over the past 15 years. We revi
ewed the preclinical and clinical literature to find out the effect of inguinal hernia surgery on male fertility becau it has been suggested that hernia surgery may impair testicular function and male fertility.
DATA SOURCES:
A arch on Emba, MEDLINE, and the Cochrane Library was performed to find related articles.
CONCLUSIONS:
糯米肉丸Animal models show substantial effects of hernia repair on the structures in the spermatic cord, which is more pronounced in meshrepairs. Although the number of studies and the included numbers of patients were limited, clinical studies indicate that the potential adver effects do not em to have a clinical impact on male fertility in humans with inguinal hernias. Future clinical studies, preferably with bilateral patients, are necessary to investigate the clinical relevance of the effects of inguinal hernia and hernia surgery on male fertility.
还有一篇更早一点文章，说的是：双侧TEP术后的男性生育的影响，（双侧可能更靠谱，因为人有两个睾丸，两条输精管）作者对58例双侧TEP术后随访超过3年，认为：只要是标准的TEP手术（补片不管是轻量还是重片，都不会对生殖功能造成影响。World J Surg. 2011 Jul;35(7):1643-8..
Bilateral endoscopic total extraperitoneal (TEP) inguinal hernia repair does not induce obstructive azoospermia: data of a retrospective and prospective trial.
Skawran S1, Weyhe D, Schmitz B, Belyaev O, Bauer KH.
Author information
Abstract
茂密的花
BACKGROUND:
The endoscopic totally extraperitoneal (TEP) mesh repair is nowadays a well-established tension-free method for inguinal hernia repair. Mainly bad on animal studies and ca reports, a concern about the risk of postoperative infertility was expresd. This clinical study aimed to evaluate the risk of infertility due to obstructive azoospermia in men of fertile age who underwent a bilateral hernia repair.
METHODS:
Over 3 years (2005-2008) 59 male patients, 18-60 years of age, underwent a bilateral TEP repair. Twenty-one of them were prospectively ('light mesh') and 38 retrospectively ('
heavy mesh') evaluated for testicular volume and perfusion, rum levels of xual hormones, ejaculate volume, and number of spermatic cells. Tho parameters were determined preoperatively (prospective group) and not earlier than 3 months postoperatively (both groups).
RESULTS:
No significant difference between pre- and postoperative values was detected in the prospectively studied group. All postoperative parameters were within the normal range in the retrospective group. There was no evidence of impaired fertility in any patient due to the operation.
CONCLUSION（结论）:
The standardized TEP technique for simultaneous bilateral inguinal hernia repair in male patients was not associated with a higher risk for postoperative infertility after mesh implantation. The u of heavy-weight meshes had no
negative effect on fertility.（双侧男性的腹股沟疝，以标准的TEP技术，与术后男性不育无关连）
小编，今天要重点介绍以下这篇文章
刊登在《Surgery 》杂志上，2012;151:94-98)
题目Mesh hernia repair and male infertility: A retrospective register study
（疝补片修补和男性不育：一项登记的随访研究）
小编先要解释一下有关的背景：在北欧，补片是市场是开放的，上百种的补片，什么是最好的，Ｎ多种术式，到底用什么最好，最安全有效？为此，北欧的一些国家政府建立疝病的国家数据库，即政府出钱，对疝病人进行随访登记（每登记一个病人，国家付25欧），
所以，在此基础上建立的国家数据，以便为国家的医疗政策方针服务。小编再讲一下作者单位，即瑞典Karolinska医学院，Karolinska医学院是什么大学，那是发诺贝尓奖的单位，所以，信誉很高。
蒴果
以下的文章就是瑞典的国家数据：
所有的入组男性患者出生年份在1950至1989年之间，同时查阅瑞典的国家不育疾病数据库系统，两数据库交叉，分析腹股沟疝补片修补术后不育的累计发病率等指标。
应该说这种数据也算大数据了，共有34,267名男性患者，这些患者至少接受过1次腹股沟疝修补手术，其中233例（0.7%）患者在接受第一次腹股沟疝无张力修补术后被确诊为不育症。与同年龄人不育症的发病没有统计学差别。（在普通的正常人中也有不育症）白花图片
结论：腹股沟疝修补使用补片，术后不会增加男性不育症风险。
Mesh hernia repair and male infertility: A retrospective register study
《Surgery 》2012;151:94-98
英文摘要Abstract：
BACKGROUND:
Previous studies have suggested that the u of mesh in groin hernia repair may be associated with an incread risk for male infertility as a result of inflammatory obliteration of structures in the spermatic cord. In a recent study, we could not find an incread incidence of involuntary childlessness. The aim of this study was to evaluate this issue further.
