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Child has umbilical hernia from birth, done surgery. Will he become impotent in future?

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Answered by

Practicing since : 1995
Answered : 527 Questions
Hi Doctor,
I have couple of questions.
1. My elder son is born in Jun 2008. He was diagnosed with bilateral inguinal hernia (when he was 6 months old). He also had umbilical hernia from birth which got fine later. Pediatric hernia surgery was performed by a pediatric surgeon for inguinal hernia (both sides) and he got fine. My question is that I read in the forums and websites that inguinal hernia surgery may cause infertility or impotence in future since the surgery takes place near Vas deferens. Is it true? Will my son have a problem to father a child in future?

2. My younger son was tested for reflux in kidneys when he was 2 months old (It was found that he doesn't have reflux). At that time nurse put catheter in his penis and it started bleeding after trying for some time. So she took it out and used catheter of smaller size to proceed ahead. My question is does this bleeding was caused due to any damage? Do I have to be worried? Will it cause any issues for him in future?

Posted Fri, 24 Aug 2012 in Child Health
Answered by Dr. V. Sasanka 5 hours later
The chances of vas deferens injury do exist when any inguinal surgery is being done, but the chances of such an event happening are very minimal, and there is no way you can recognize if there has been an injury unless the sperm in adults is analyzed. The chances of such an injury happening on both sides, especially if the surgery has been performed by a paediatric surgeon or urologist who handle these type of cases very frequently and quite well is quite remote. So I sincerely suggest that you stop worrying about it.
There might have been some urethral injury when your second child was being catheterized for testing for reflux, but if he has no reflux, and if he is now passing urine comfortably with a good stream, you need not worry about it. However, rarely even minor urethral injuries can lead to what we term urethral narrowings known as strictures and so if the stream of urine becomes slow to be in drops, or if he develops recurrent urinary tract infections in the future, please do get checked up by a urologist / paediatric surgeon again.
Hope I have been able to help you.
Above answer was peer-reviewed by
Follow-up: Child has umbilical hernia from birth, done surgery. Will he become impotent in future? 3 hours later
Thanks a lot doctor for your response. I'm feeling lot better after reading your response. I have a couple of questions/updates in my earlier questions.

1. Thanks for confirming that the chances of vas deferens injury is remote. I want to check the scenario where one side of the vas deferens is injured in the surgery. In that case where one side (Vas deferens) is injured in the pediatric hernia surgery and other side is not affected, still one can have healthy sperms / sperm count to father a child when they become adult?

2. My second son has no reflux or urinary track infections. He was diagnosed to have a renal dilation in one of the kidneys. The doctor told me that the dilation is very small and there is no treatment required and it will not cause any harm in his future (He told me the possibility of surgery in future in 1%). The reflux test was done more than 4-5 months back and initially right after the test he had some very slight pink color in the urine and after that he is urinating normally (with good flow initially and drops at the end) and with good flow without any uncomfortability. Please let me know if it is fine. Please let me know if you think there is a chance he might develop strictures.

Thank You!!!
Answered by Dr. V. Sasanka 1 hour later
Hi again,
In instances where one vas is injured while other is normal, usually there should not be trouble in being able to father a child in the future. In fact, on several occasions in patients with congenitally undescended testes, we do remove testes which appear non-viable, and yet these patients have a normal adolescence and adulthood. There are rare occasions when anti-sperm antibodies do develop if one side only is affected, but these are instances where the injury has occured post-puberty.
Regarding your second child, as I mentioned earlier, as long there is a good stream, you needn't worry. You should consult a urologist if he develops high grade fever with stuttering urinary stream.
Hope that has answered your question.
Above answer was peer-reviewed by
Follow-up: Child has umbilical hernia from birth, done surgery. Will he become impotent in future? 2 days later
Thanks a lot Doctor. I can't express in words that your reply meant to me. I now understand that I should not have worried about these things in the first place. But I read some articles in the internet and worried without knowing the complete details. After your response I understand that I don't need to be worried at all for any of these things. THANK YOU!!!
Answered by Dr. V. Sasanka 7 hours later
You are welcome.
Above answer was peer-reviewed by
Follow-up: Child has umbilical hernia from birth, done surgery. Will he become impotent in future? 16 hours later
Hi Doctor,

I'm really sorry for these big questions. I want to confirm for sure for my peace of mind. I apologize for the inconvenience. I'm not from medical field. I read few websites and had been confused and worried for last few years. Then I saw the XXXXXXX website and finally thought I will ask all the questions to clear up everything. I apologize if my questions are very silly.

During the initial time when I was going through websites about Hernia surgery I came across this article in the below website.


It states that

"Few complications result from operative repair of an inguinal hernia. Possible consequences of hernia repair include decreased testicular size (≤ 20% of patients), testicular atrophy (1-2%), vas injury (< 1%), and development of sperm-agglutinating antibodies XXXXXXX

My questions are

1.They have mentioned about the decreased testicular size. Is it true? Does the reduced testicle size causes any issues in future? Does this affect the fertility or sperm count? My son goes for a yearly checkup with pediatrician. Doctor checks the testicles along with the normal checkup and told me everything looks good. If testicle sizes are decreased, then I assume the pediatrician would have mentioned it. Please let me know if my assumption is correct. I was worried since they are saying about 20% of the patients. Please let me know if it is a true concern?

2. Do I have to be concerned about any of these other complications like testicular atrophy or sperm - agglutinating antibodies? As a person not from medical field, I don't understand these terms.Please let me know if I need to be concerned?

3. Bottom line I wanted to check with you on my sons. My elder son had hernia surgery done in 6 months. Other than that he didn't have any issues and he is healthy. My second son has slight renal dilation in one of kidneys. Otherwise he is healthy. I wanted to check with you, having said these problems, do I need to be worried about anything on their health issues. I want to check on this question for my peace of mind. Even though it is silly, after I read about hernia surgery I started relating every small things to their future ability to have children. Please let me know if I don't need to be concerned about any of these things?

Answered by Dr. V. Sasanka 3 hours later
Hi Again,
I will try and answer your questions one by one.
As the article mentioned, the complications are 'possible' - I have seen two cases of vas injury in over 300 cases of hernia repair in children - so it is not impossible, obviously, but the odds are there for you to see. 298 patients went home with their vas normal.
The testicular size becoming smaller - hmmm. ... I do not think it is as much as 20% - definitely overestimated, but anyway if clinically the paediatrician says everything is okay on their physical examination front, then indeed things must be normal.
Sperm agglutinating antibodies do come into the picture if an injury has happened to one of the vas, but usually in patients who have had surgeries after adolescence. So please do not fret unnecessarily. You also are not looking at the other side of the picture - If you do not have surgery performed for inguinal hernia in a child, the possibility of intestinal obstruction and other complications do go up significantly, and that is a more sinister occurrence than a theoretical vas injury, and anyway the surgery is done with, you have taken the correct decision, the paediatrician says everything is alright, and there is no way you can do anything to know if there has been an injury till they are adults.
I do not know if this is the correct forum t tell you this, but my own son had an inguinal hernia surgery performed by a XXXXXXX colleague when he was 2 years old, and though the theoretical risk of vas injury fleetingly crossed my mind, I had no second thoughts about the need for surgery, and I certainly do not worry about it now. It is 4 years since the operation, and I think the testes are normal but I do not keep getting them checked.
Regarding the renal dilatation of your 2nd child - reflux in achild can cause kidney scarring and damage, and if the MCUG study which was performed is normal, you can rest assured things are Ok. In fact probably once a year screening ultrasound for kidney size and dilatation should probably be sufficient or if develops a abdomen, earlier.
Hope I have addressed your concerns.
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