HISTOLOGICAL FINDINGS IN THE TESTICLES AND SPERMATIC CORD AFTER VARIOUS TYPES OF SURGERY WITH USAGE OF DIFFERENT TYPES OF BIOPROSTHESIS (MESHES)(EXPERIMENTAL STUDY)

Аннотация

The goal of study is estimation of the degree of influence of various types of operations (with the subcutaneous trans- position of spermatic cord, its contact with various types of meshes or their separation with host tissue interposition) on the spermatic cord and testicles in 12 male rabbits.Methods. The I series of experiments (4 rabbits): Reconstruction of the inguinal canal was performed according to Archvadze’s  I method and the contralateral side was left intact.The II series of experiments (4 rabbits): The Prolene mesh was implanted on one side, and the Vypro mesh was implanted on the other side as it is done during Lichtenstein’s operation.The III series of experiments (4 rabbits): The spermatic cord and the polypropylene mesh were isolated by the help of the interposition of the aponeurosis of external oblique muscle between the mesh and the spermatic cord. On the other side of the inguinal region the operation was done according to Lichtenstein’s technique.Results and conclusions:  Three series of experiments (models of pure-tissue repair according to Archvadze’s I method, Lichtenstein’s method and Archvadze’s II method) showed significant differences in histologic changes between those groups and correlation of the type of operation with changes in the spermatic cord and testicles.In the first series of the experiment it was difficult to make the border between the aponeurosis of external oblique and Poupart’s ligament, because of the ingrowth of collagenic fibers in those structures, the muscles and collagen fibers have parallel direction. It is difficult to identify transverse muscle at the site of the internal ring because of ingrowth of collagenic fibers. The posterior wall of the inguinal canal thickened because of the growth of the connective tissue. Investigation shows that implantation of the mesh affects the function of the spermatic cord, vas deferens, causes the deformation and impairment of spermatogenesis and function of epididymis. There is a damage of spermatogenesis caused by the Prolene implantation with the reduction of the spermatic epithelium, Sertoli and Laidigi’s cells. The proximal part of the vas deferens is atonic, dilated with stasis of secret. Excessive growth of the fibrotic tissue causes the dilation of the proximal part of the vas deferens.The similar changes but less pronounces are found at the site of the Vypro implantation without damage of spermatogenesis but with some problems of excretion, what causes the retention of sperm in the ductus deferens and necrobiosis and necrosis of the spermatozoids.Thus we think that the obligate usage of the alloplastic material is not preferable and we must create protection for the spermatic cord with the placement of aponeurosis of external oblique between it and mesh, in order to cover spermatic cord with host tissues.