Significance of oxidative endotoxemia and hypoxia in the pathogenesis of testicular insufficiency in patients with inguinal hernia

Abstract

Aim. To determine the level of “oxidative stress” and hypoxia markers in the blood and venous blood flowing from the testicle in inguinal hernias and the postoperative period after inguinal hernioplasty.Materials and Methods. 34 patients with inguinal hernias were under the observation in Istiqlol health complex of Dushanbe. The age of patients ranged from 18 to 30 years old. The patients were divided into 3 groups: 14 patients with long (5 or more years) inguinal hernia combined with varicocele, 12 patients with infertility, and 8 patients with inguinal herniotomy. The content of LPO products and hypoxia markers in the blood flowing from the testicle was studied in 34 patients with various groups of inguinal hernias.Results and discussion. An analysis of the level of “oxidative” toxemia and hypoxia indices in the studied groups of patients showed their increased levels in the peripheral blood. The levels of DA and MDA in peripheral blood in Group I patients reached 1.3±0.02 units pg/ml and 2.4±0.09 nmol/ml, which was caused by prolonged compression of the spermatic cord elements by the hernial sac; the presence of ischemia was confirmed by increased blood lactate level. Marked pathophysiological changes result in the disturbance of hormonal background and spermatogenesis disorder.Conclusion. Increased content of LPO products in the testicular parenchyma further results in the branching of chain reactions and final LPO products with high damaging activity followed by the development of systemic damage to cellular structures of the contralateral testis with subsequent progression and development of testicular insufficiency.