article · BMC Urology
Inguinal hernia repair is a frequent surgical procedure, but fear of postoperative erectile problems can deter men from undergoing treatment. This prospective cohort study examined sexual function and quality of life four months after surgery, comparing open nylon darn repairs with open mesh repairs in 104 adult men with normal baseline erectile function. Overall, postoperative erectile problems occurred in 12.1 percent of patients, affecting 11.1 percent of the nylon darn cohort and 13.0 percent of the open mesh cohort. No statistically significant difference in erectile dysfunction rates was identified between the two techniques. Furthermore, 95.8 percent of participants experienced a notable improvement in quality of life after surgery, with the nylon darn group showing better numerical gains. These results indicate that nylon darn repairs carry a risk of sexual dysfunction comparable to mesh repairs, supporting equivalent pre-operative patient counselling for both approaches.
Concerns regarding sexual health after surgery often discourage men from seeking necessary treatment for inguinal hernias. By showing that nylon darn repair does not carry a higher risk of erectile dysfunction than open mesh repair, this research offers clinical clarity. It helps clinicians reassure patients, standardise surgical counselling, and support informed decision-making without fears of adverse sexual outcomes driving technique selection.
This clinical study evaluates established surgical techniques rather than introducing a proprietary medical device or commercial product. Its direct application lies in clinical practice, informing surgical guidelines, patient consenting protocols, and pre-operative counselling programmes used by surgeons and hospital departments. Because the procedures are already applied and tested in routine clinical environments, these findings can be integrated directly into current surgical decision-making without further commercial development.
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Inguinal hernia (IH) is a common surgical pathology worldwide. Even though nylon darn repair is commonly used, little is known about the incidence of erectile problems post darn despite the perceived occurrence being a major deterrent of surgical intervention. This study was conducted to determine the rate, patients and hernia factors that could predict the occurrence of erectile function and quality of life post nylon darn repairs. Consecutive adult male participants with normal erection who underwent open hernia repair for primary unilateral inguinal hernia was included in the study. Data on sociodemographic, nature of hernia, complications and overall quality of life post repair was collected, analysed using Statistical Package for the Social Sciences (SPSS) version 25 and associations with erectile dysfunction determined. A total of 104, 48 (46.2%) nylon darn and 56 (53.8%) open mesh repaired participants with a mean age of 50.0 ± 15.9 years completed the study and were included in the analysis. Erectile problems were reported by 11(12.1%) [nylon darn 5(11.1%) and mesh 6(13.0%)] participants. Majority (95.8%) of participants reported a significant improvement in their quality-of-life post-surgery. Erectile dysfunction occurring after nylon darn hernia repairs in this study was comparable to those with open mesh repair with no significant difference between the choice of methods. Nylon darn appeared to have a better numerical overall improvement of the quality of life. The Nylon darn technique of inguinal hernia repair was not associated with increased erectile dysfunction compared to the open mesh inguinal repairs. Patients for nylon darn should follow the same counselling as open mesh repairs do on the possibility of ED.
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DOI: 10.1186/s12894-026-02337-5
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