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Desarda hernia surgery: what about sexual complications?
Question to men who have done the Desarda repair for an inguinal hernia: did any of you experience sexual pain or dysfunction that persisted long-term as the result of the repair? I know there some people on this forum who’ve done Desarda.
I’m considering the Desarda repair for my inguinal hernia here in the US. The Desarda repair is reported to have lower chronic pain rates, but there is no information specifically on sexual complications. Apparently, other repair types can cause long-term sexual complications, including pain during sex or ejaculation (link at the bottom, and it was previously discussed on this forum). The mesh is implicated to impact the sexual structures in some people. I’ve also searched Reddit and saw numerous reports of sexual pain after a hernia surgery, but nothing from Desarda patients. I understand that there is a lower volume of Desarda repairs, I’m still concerned that there is no mention of any sexual issues anywhere. Could it be really that good…?
More detail, if you care: I’m not an expert so I’m just quoting some thoughts I saw in the studies (the referenced study is based on 12 other studies). The articles discuss that in some cases long-term sexual complications are due to the scar tissue around the mesh (fibrosis) engulfing the nerves and spermatic cord structures (vas deference, nerves, vessels). The pressures and torsion created by the rigid mesh can create various degrees of symptoms that interfere with the sexual function. Desarda uses natural tissue, however per Desarda’s own website: “…This will result in closure effects of both these flaps when the external oblique muscle contracts during cough. Due to this closure effect the entire canal and the spermatic cord will get compressed giving protection against the recurrence of hernia again.”. This sounds good for recurrence prevention, but it’s not clear what kind of compression forces this repair creates – normal forces similar to the original tissues, or something more forceful created by the muscle reconfiguration which could impact the spermatic structures.
link to the main study:
https://pubmed.ncbi.nlm.nih.gov/31733327/
pubmed.ncbi.nlm.nih.gov
Sexual dysfunction and PSA are not rare after inguinal hernia repair. They should be included in preoperative discussions and as standard metrics in reporting outcomes of repair in large cohorts or trials.
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