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Forum Name: Surgery Topics

Question: Loss of ejaculate after laparoscopic bilateral inguinal surg


 aliou.smith - Sat Jul 24, 2010 5:35 am

Hi,

I am a healthy 26 year old concerned about the diminished force and amount of ejaculate that has occurred since my hernia operation 5 weeks ago. I have zero pain and am back to normal in terms of daily activities. Could this lower level of ejaculate return to normal at some time, or even worsen?

thanks
 Dr.M.Aroon kamath - Sun Jul 25, 2010 2:33 am

User avatar Hi,

Several types of sexual dysfunctions have been reported infrequently following inguinal hernia repairs(both the traditional "open" as well as the laparoscopic repairs).

One study indicated erectile dysfunction in just over 1%, pain related erections in 2% and shooting pains during ejaculation (dysejaculation) in 1.5% of cases. Overall sexual activity was allegedly affected in 4% of patients. As many hernia patients are younger men this is a particularly problematic situation following hernia surgery.
http://www.ncbi.nlm.nih.gov/pmc/article ... 846/?page=

The cause of the painful ejaculation is not clear. Also, reduced quantity of the ejaculate is difficult to explain- even in bilateral repairs( by an injury or entrapment of the vasa deferentia), as the major part of the total seminal volume is made up of the seminal vesicular and prostatic secretions which are not transported via the vasa [approximately, seminal vesicles (65% by volume) and prostate (35% by volume) and 5% via the vasa].

Apart from the aforesaid complications, ischemic orchitis can arise if the blood vessels which travel within the spermatic cord are injured. This results in a painful testicle on the side of the hernia repair. Eventually the testicle may shrink in size and become nonfunctional. Fertility is generally not affected in unilateral involvement, as the remaining testicle compensates for the loss of the other.

As the other causes for male sexual dysfunctions among men in the general population are very much more common than post-hernia repair related ones, to attribute the surgical procedure as the definite cause becomes immensely difficult.

As you have no pain associated with ejaculation, this could well be a temporary setback and should recover soon.
Best wishes!

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