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16.04.2020 | original article | Ausgabe 5/2020

European Surgery 5/2020

Phthalates and infertility: an issue in hernia meshes?

European Surgery > Ausgabe 5/2020
Nele Van De Winkel, Yagmur Yurtkap, Vicky Dhooghe, Shengyun Huang, Govindan Malarvannan, Guy Van den Mooter, Adrian Covaci, Ann Van Schepdael, Marc Miserez
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Based on recent data that sperm motility in humans might be (temporarily) affected when lightweight meshes are used for laparoscopic inguinal hernia repair, the aim of this study was to identify the plasticizers present in meshes used for hernia repair.


Mesh samples (n = 13) were cut into small pieces (1 cm × 1 cm), and, after the addition of internal standard, plasticizers were extracted with hexane:acetone (1:1; v:v) by vortex and ultrasonication. The analysis was performed by gas chromatography and mass spectrometry (GC-MS) in electron ionization mode (EI) with full scan acquisition. The identification of compounds was done by injection of reference standards and using the Wiley mass spectral library.


None of the targeted plasticizers, including phthalates, were present in the analyzed mesh samples. In particular, di-(2-ethylhexyl) phthalate (DEHP), a major phthalate plasticizer frequently used in medical devices in the past, was not detected in any of the samples.


The implantation of mesh materials affecting male fertility, whether temporarily or not, cannot be explained by the presence of the targeted plasticizers, since none of them were found in the wide range of commonly used meshes that were tested in our study.

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