Testicular volume after inguinal hernia repair at childhood. Explorative study.

Testicular atrophy is a complication after inguinal herniotomy in children.
Percentage described in the literature varies from 1 to 38% [1-4].
It is imaginable inguinal operation at childhood has his long-term effects. The
funniculus, with spermatic fascia, cremaster muscle, ductus deferens, spermatic
artery and vein, can be damaged. This can cause a reduce in growth -and
function [5]- of the testicle.
The Leung et al. [6] studied the precize volumina of the testicles after
herniotomy at childhood [6]. They documented in 0.58 and 10% of the boys a
respectively more than 50 en 25% decrease in testicular volume on the operated
side when compared with the non-operated side.
An important limitation of this study is -as described in their discussion-
'the testicular volumes of the operated and normal sides of the same patient
were compared since we believe it is very difficult, if not impossible, to
obtain a 'normal range' of testicular volume in a specific age group.
Because our research group recently created this 'normal ranges', we hope to
improve the study of testicular volume after inguinal herniotomy at childhood.


1. Friedman, D., Schwartzbard, A., Velcek, F. T. et al.: The government and the
inguinal hernia. J Pediatr Surg, 14: 356, 1979
2. McGregor, D. B., Halverson, K., and McVay, C. B.: The unilateral pediatric
inguinal hernia: Should the contralateral side by explored? J Pediatr Surg, 15:
313, 1980
3. Puri, P., Guiney, E. J., and O'Donnell, B.: Inguinal hernia in infants: the
fate of the testis following incarceration. J Pediatr Surg, 19: 44, 1984
4. Surana, R. and Puri, P.: Is contralateral exploration necessary in infants
with unilateral inguinal hernia? J Pediatr Surg, 28: 1026, 1993
5. Takihara, H., Cosentino, M. J., Sakatoku, J. et al.: Significance of
testicular size measurement in andrology: II. Correlation of testicular size
with testicular function. J Urol, 137: 416, 1987
6. Leung, W. Y., Poon, M., Fan, T. W. et al.: Testicular volume of boys after
inguinal herniotomy: combined clinical and radiological follow-up. Pediatr Surg
Int, 15: 40, 1999

to study testicular volumes after inguinal herniotomy at childhood.

study population
inclusion:
- boys who underwent inguinal herniotomy between 1999-2008 - acute or elective-
before the age of 16 years in the Medical Centre Alkmaar.
- age at follow-up 9-13 years.

exclusion:
- abnormalities at scrotum / testis (eg torsio testis)
- chromosomal abnormalities

Ca. 200 boys will reach the inclusion criteria. With a response of 50% we will
include ca. 100 boys.

clinical examination
* position of the testes
* testicular volume
- prader orchidometer
- ultrasound

data will be analysed by SPSS

One visit to the outpatient clinic for a pain-free clinical examination without
any risk.