Skip to main content
Erschienen in: European Surgery 5/2020

16.04.2020 | original article

Phthalates and infertility: an issue in hernia meshes?

verfasst von: Nele Van De Winkel, Yagmur Yurtkap, Vicky Dhooghe, Shengyun Huang, Govindan Malarvannan, Guy Van den Mooter, Adrian Covaci, Ann Van Schepdael, Marc Miserez

Erschienen in: European Surgery | Ausgabe 5/2020

Einloggen, um Zugang zu erhalten

Summary

Background

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.

Methods

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.

Results

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.

Conclusion

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.
Literatur
1.
Zurück zum Zitat Simons MP, Smietanski M, Bonjer HJ, et al. International guidelines for groin hernia management. Hernia. 2018;22(1):1–165.CrossRef Simons MP, Smietanski M, Bonjer HJ, et al. International guidelines for groin hernia management. Hernia. 2018;22(1):1–165.CrossRef
2.
Zurück zum Zitat Baylón K, Rodríguez-Camarillo P, Elías-Zúñiga A, Díaz-Elizondo JA, Gilkerson R, Lozano K. Past, present and future of surgical meshes: a review. Membranes (Basel). 2017;7(3):E47.CrossRef Baylón K, Rodríguez-Camarillo P, Elías-Zúñiga A, Díaz-Elizondo JA, Gilkerson R, Lozano K. Past, present and future of surgical meshes: a review. Membranes (Basel). 2017;7(3):E47.CrossRef
3.
Zurück zum Zitat Brown CN, Finch JG. Which mesh for hernia repair? Ann R Coll Surg Engl. 2010;92(4):272–8.CrossRef Brown CN, Finch JG. Which mesh for hernia repair? Ann R Coll Surg Engl. 2010;92(4):272–8.CrossRef
4.
Zurück zum Zitat Zhu LM, Schuster P, Klinge U. Mesh implants: an overview of crucial mesh parameters. World J Gastrointest Surg. 2015;7(10):226–36.CrossRef Zhu LM, Schuster P, Klinge U. Mesh implants: an overview of crucial mesh parameters. World J Gastrointest Surg. 2015;7(10):226–36.CrossRef
5.
Zurück zum Zitat Sajid MS, Kalra L, Parampalli U, Sains PS, Baig MK. A systematic review and meta-analysis evaluating the effectiveness of lightweight mesh against heavyweight mesh in influencing the incidence of chronic groin pain following laparoscopic inguinal hernia repair. Am J Surg. 2013;205(6):726–36.CrossRef Sajid MS, Kalra L, Parampalli U, Sains PS, Baig MK. A systematic review and meta-analysis evaluating the effectiveness of lightweight mesh against heavyweight mesh in influencing the incidence of chronic groin pain following laparoscopic inguinal hernia repair. Am J Surg. 2013;205(6):726–36.CrossRef
6.
Zurück zum Zitat Sajid MS, Leaver C, Baig MK, Sains P. Systematic review and meta-analysis of the use of lightweight versus heavyweight mesh in open inguinal hernia repair. Br J Surg. 2012;99(1):29–37.CrossRef Sajid MS, Leaver C, Baig MK, Sains P. Systematic review and meta-analysis of the use of lightweight versus heavyweight mesh in open inguinal hernia repair. Br J Surg. 2012;99(1):29–37.CrossRef
7.
Zurück zum Zitat Currie A, Andrew H, Tonsi A, Hurley PR, Taribagil S. Lightweight versus heavyweight mesh in laparoscopic inguinal hernia repair: a meta-analysis. Surg Endosc. 2012;26(8):2126–33.CrossRef Currie A, Andrew H, Tonsi A, Hurley PR, Taribagil S. Lightweight versus heavyweight mesh in laparoscopic inguinal hernia repair: a meta-analysis. Surg Endosc. 2012;26(8):2126–33.CrossRef
8.
Zurück zum Zitat Peeters E, Spiessens C, Oyen R, et al. Laparoscopic inguinal hernia repair in men with lightweight meshes may significantly impair sperm motility: a randomized controlled trial. Ann Surg. 2010;252(2):240–6.CrossRef Peeters E, Spiessens C, Oyen R, et al. Laparoscopic inguinal hernia repair in men with lightweight meshes may significantly impair sperm motility: a randomized controlled trial. Ann Surg. 2010;252(2):240–6.CrossRef
9.
Zurück zum Zitat Peeters E, Spiessens C, Oyen R, et al. Sperm motility after laparoscopic inguinal hernia repair with lightweight meshes: 3‑year follow-up of a randomised clinical trial. Hernia. 2014;18(3):361–7.PubMed Peeters E, Spiessens C, Oyen R, et al. Sperm motility after laparoscopic inguinal hernia repair with lightweight meshes: 3‑year follow-up of a randomised clinical trial. Hernia. 2014;18(3):361–7.PubMed
10.
Zurück zum Zitat Pant N, Pant A, Shukla M, Mathur N, Gupta Y, Saxena D. Environmental and experimental exposure of phthalate esters: the toxicological consequence on human sperm. Hum Exp Toxicol. 2011;30(6):507–14.CrossRef Pant N, Pant A, Shukla M, Mathur N, Gupta Y, Saxena D. Environmental and experimental exposure of phthalate esters: the toxicological consequence on human sperm. Hum Exp Toxicol. 2011;30(6):507–14.CrossRef
11.
Zurück zum Zitat Todros S, Pavan PG, Natali AN. Synthetic surgical meshes used in abdominal wall surgery: part I – materials and structural conformation. J Biomed Mater Res Part B Appl Biomater. 2017;105(3):689–99.CrossRef Todros S, Pavan PG, Natali AN. Synthetic surgical meshes used in abdominal wall surgery: part I – materials and structural conformation. J Biomed Mater Res Part B Appl Biomater. 2017;105(3):689–99.CrossRef
12.
Zurück zum Zitat Bilsel Y, Abci I. The search for ideal hernia repair; mesh materials and types. Int J Surg. 2012;10(6):317–21.CrossRef Bilsel Y, Abci I. The search for ideal hernia repair; mesh materials and types. Int J Surg. 2012;10(6):317–21.CrossRef
13.
Zurück zum Zitat Elango S, Perumalsamy S, Ramachandran K, Vadodaria K. Mesh materials and hernia repair. Biomedicine. 2017;7(3):16.CrossRef Elango S, Perumalsamy S, Ramachandran K, Vadodaria K. Mesh materials and hernia repair. Biomedicine. 2017;7(3):16.CrossRef
14.
Zurück zum Zitat Deeken CR, Lake SP. Mechanical properties of the abdominal wall and biomaterials utilized for hernia repair. J Mech Behav Biomed Mater. 2017;74:411–27.CrossRef Deeken CR, Lake SP. Mechanical properties of the abdominal wall and biomaterials utilized for hernia repair. J Mech Behav Biomed Mater. 2017;74:411–27.CrossRef
15.
Zurück zum Zitat Onghena M, van Hoeck E, Vervliet P, et al. Development and application of a non-targeted extraction method for the analysis of migrating compounds from plastic baby bottles by GC-MS. Food Addit Contam Part A Chem Anal Control Expo Risk Assess. 2014;31(12):2090–102.CrossRef Onghena M, van Hoeck E, Vervliet P, et al. Development and application of a non-targeted extraction method for the analysis of migrating compounds from plastic baby bottles by GC-MS. Food Addit Contam Part A Chem Anal Control Expo Risk Assess. 2014;31(12):2090–102.CrossRef
16.
Zurück zum Zitat Onghena M, Van Hoeck E, Van Loco J, et al. Identification of substances migrating from plastic baby bottles using a combination of low-resolution and high-resolution mass spectrometric analysers coupled to gas and liquid chromatography. Mass Spectrom. 2015;50(11):1234–44.CrossRef Onghena M, Van Hoeck E, Van Loco J, et al. Identification of substances migrating from plastic baby bottles using a combination of low-resolution and high-resolution mass spectrometric analysers coupled to gas and liquid chromatography. Mass Spectrom. 2015;50(11):1234–44.CrossRef
17.
Zurück zum Zitat Gimeno P, Thomas S, Bousquet C, et al. Identification and quantification of 14 phthalates and 5 non-phthalate plasticizers in PVC medical devices by GC-MS. J Chromatogr B Analyt Technol Biomed Life Sci. 2014;949–950:99–108.CrossRef Gimeno P, Thomas S, Bousquet C, et al. Identification and quantification of 14 phthalates and 5 non-phthalate plasticizers in PVC medical devices by GC-MS. J Chromatogr B Analyt Technol Biomed Life Sci. 2014;949–950:99–108.CrossRef
18.
Zurück zum Zitat Tekatli H, Schouten N, van Dalen T, Burgmans I, Smakman N. Mechanism, assessment, and incidence of male infertility after inguinal hernia surgery: a review of the preclinical and clinical literature. Am J Surg. 2012;204(4):503–9.CrossRef Tekatli H, Schouten N, van Dalen T, Burgmans I, Smakman N. Mechanism, assessment, and incidence of male infertility after inguinal hernia surgery: a review of the preclinical and clinical literature. Am J Surg. 2012;204(4):503–9.CrossRef
19.
Zurück zum Zitat Marie C, Vendittelli F, Sauvant-Rochat MP. Obstetrical outcomes and biomarkers to assess exposure to phthalates: a review. Environ Int. 2015;83:116–36.CrossRef Marie C, Vendittelli F, Sauvant-Rochat MP. Obstetrical outcomes and biomarkers to assess exposure to phthalates: a review. Environ Int. 2015;83:116–36.CrossRef
20.
Zurück zum Zitat Pant N, Shukla M, Kumar Patel D, et al. Correlation of phthalate exposures with semen quality. Toxicol Appl Pharmacol. 2008;231(1):112–6.CrossRef Pant N, Shukla M, Kumar Patel D, et al. Correlation of phthalate exposures with semen quality. Toxicol Appl Pharmacol. 2008;231(1):112–6.CrossRef
21.
Zurück zum Zitat Silva MJ, Reidy JA, Preau JL, Samandar E, Needham LL, Calafat AM. Measurement of eight urinary metabolites of di(2-ethylhexyl) phthalate as biomarkers for human exposure assessment. Biomarkers. 2006;11(1):1–13.CrossRef Silva MJ, Reidy JA, Preau JL, Samandar E, Needham LL, Calafat AM. Measurement of eight urinary metabolites of di(2-ethylhexyl) phthalate as biomarkers for human exposure assessment. Biomarkers. 2006;11(1):1–13.CrossRef
22.
23.
Zurück zum Zitat Koch HM, Preuss R, Angerer J. Di(2-ethylhexyl)phthalate (DEHP): human metabolism and internal exposure—an update and latest results. Int J Androl. 2006;29(1):155–65.CrossRef Koch HM, Preuss R, Angerer J. Di(2-ethylhexyl)phthalate (DEHP): human metabolism and internal exposure—an update and latest results. Int J Androl. 2006;29(1):155–65.CrossRef
24.
Zurück zum Zitat Wittassek M, Koch HM, Angerer J, Brüning T. Assessing exposure to phthalates—the human biomonitoring approach. Mol Nutr Food Res. 2011;55(1):7–31.CrossRef Wittassek M, Koch HM, Angerer J, Brüning T. Assessing exposure to phthalates—the human biomonitoring approach. Mol Nutr Food Res. 2011;55(1):7–31.CrossRef
25.
Zurück zum Zitat Thurston SW, Mendiola J, Bellamy AR, et al. Phthalate exposure and semen quality in fertile US men. Andrology. 2016;4(4):632–8.CrossRef Thurston SW, Mendiola J, Bellamy AR, et al. Phthalate exposure and semen quality in fertile US men. Andrology. 2016;4(4):632–8.CrossRef
26.
Zurück zum Zitat Jenardhanan P, Panneerselvam M, Mathur PP. Effect of environmental contaminants on spermatogenesis. Semin Cell Dev Biol. 2016;59:126–40.CrossRef Jenardhanan P, Panneerselvam M, Mathur PP. Effect of environmental contaminants on spermatogenesis. Semin Cell Dev Biol. 2016;59:126–40.CrossRef
27.
Zurück zum Zitat Jones HB, Garside DA, Liu R, Roberts JC. The influence of phthalate esters on Leydig cell structure and function in vitro and in vivo. Exp Mol Pathol. 1993;58(3):179–93.CrossRef Jones HB, Garside DA, Liu R, Roberts JC. The influence of phthalate esters on Leydig cell structure and function in vitro and in vivo. Exp Mol Pathol. 1993;58(3):179–93.CrossRef
28.
Zurück zum Zitat Wirth JJ, Rossano MG, Potter R, et al. A pilot study associating urinary concentrations of phthalate metabolites and semen quality. Syst Biol Reprod Med. 2008;54(3):143–54.CrossRef Wirth JJ, Rossano MG, Potter R, et al. A pilot study associating urinary concentrations of phthalate metabolites and semen quality. Syst Biol Reprod Med. 2008;54(3):143–54.CrossRef
29.
Zurück zum Zitat Verstraete S, Vanhorebeek I, Covaci A, et al. Circulating phthalates during critical illness in children are associated with long-term attention deficit: a study of a development and a validation cohort. Intensive Care Med. 2016;42(3):379–92.CrossRef Verstraete S, Vanhorebeek I, Covaci A, et al. Circulating phthalates during critical illness in children are associated with long-term attention deficit: a study of a development and a validation cohort. Intensive Care Med. 2016;42(3):379–92.CrossRef
Metadaten
Titel
Phthalates and infertility: an issue in hernia meshes?
verfasst von
Nele Van De Winkel
Yagmur Yurtkap
Vicky Dhooghe
Shengyun Huang
Govindan Malarvannan
Guy Van den Mooter
Adrian Covaci
Ann Van Schepdael
Marc Miserez
Publikationsdatum
16.04.2020
Verlag
Springer Vienna
Erschienen in
European Surgery / Ausgabe 5/2020
Print ISSN: 1682-8631
Elektronische ISSN: 1682-4016
DOI
https://doi.org/10.1007/s10353-020-00636-1

Weitere Artikel der Ausgabe 5/2020

European Surgery 5/2020 Zur Ausgabe

letter to the editor

Coronavirus and surgery