Estudo ultrassonográfico prospectivo do fluxo arterial e do volume testicular em doentes submetidos à correção cirúrgica de hérnia inguinal sem utilização de prótese.

• Autor(a) principal: David, Claudio de Saboya [UNIFESP]
• Data de Publicação: 2018
• Tipo de documento: Dissertação
• Idioma: por
• Título da fonte: Repositório Institucional da UNIFESP
• Texto Completo: https://sucupira.capes.gov.br/sucupira/public/consultas/coleta/trabalhoConclusao/viewTrabalhoConclusao.jsf?popup=true&id_trabalho=6446162; https://repositorio.unifesp.br/handle/11600/52457
• topic: Inguinal hernia; Testis; Arterial flow; Doppler ultrasound; Hérnia inguinal; Testículo; Fluxo arterial; Ultrassom doppler

Introduction: Inguinal hernia is a highly prevalent condition and its treatment represents one of the most common surgical interventions performed by the general surgeon. In an attempt to find low recurrence rates, the operative approach has undergone changes over time. The polypropylene mesh, used indiscriminately today, has reduced the rate of relapse, but is not free of complications. Surgery for correction of inguinal hernia can produce changes in spermatogenesis or obstruct the vas deferens, although it is not always possible to establish exactly the limits of the adverse effects caused by the mesh or by surgical manipulation. Objective: To evaluate the behavior of arterial circulation and testicular volume in patients submitted to conventional inguinal hernia repair without the use of a synthetic prosthesis to reinforce the posterior wall. Method: A prospective observational clinical trial was performed on 26 male patients with unilateral inguinal hernia types I and II by the Nyhus classification, who underwent surgical correction using the modified Bassini technique. Bilateral Doppler ultrasonography was performed preoperatively, at the third and at the sixth postoperative month. The studied variables were: systolic velocity, diastolic velocity, resistance index, pulsatility index and testicular volume. Results: There were no statistically significant changes over time in the variables studied on the operated side: systolic peak velocity (p = 0.916), diastolic peak velocity (p = 0.304), resistance index (p = 0.879), pulsatility (p = 0.475), and testicular volume (p = 0.100). The variables on the control side also did not change statistically until the sixth postoperative month: systolic peak velocity (p = 0.784), diastolic peak velocity (p = 0.446), resistance index (p = 0.672), pulsatility index (p = 0.607), and testicular volume (p = 0.413). Conclusion: Surgical correction of the inguinal hernia without the use of a prosthesis does not cause alterations in arterial circulation and testicular volume in the first six months postoperatively.