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  • Title: Vas deferens obstruction due to fibrosis after plug hernioplasty.
    Author: Valenti G, Baldassarre E, Torino G.
    Journal: Am Surg; 2006 Feb; 72(2):137-8. PubMed ID: 16536243.
    Abstract:
    The positioning of mesh and plug is routinely performed in hernioplasty, but knowledge about the long-term side effects of plug-induced fibrosis on the vas is incomplete. This is the first case of a documented fibrotic vas deferens obstruction resulting from compression of the plug that was in direct contact with the vas. During subsequent repair for a recurrent hernia, the cord and the plug appeared enveloped in dense fibrous tissue. Microscopy confirmed gross surgical findings. To reduce this morbidity, we suggest a cremaster sparing surgery, avoiding the positioning of bioprosthesis in direct contact with the vas deferens. We also found that positioning of a flat mesh over the transversalis fascia will avoid the unnecessary contact between mesh and bare vas below the transversalis fascia.
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