What Happens to the Cremasteric Muscle During Non-Mesh Hernia Repair Surgery?
Perhaps your surgeon mentioned the cremasteric muscle when discussing your hernia repair surgery. The cremaster muscle surrounds the spermatic cord and runs from the internal inguinal ring to the testicle. The cremasteric muscle has two important jobs:
- It pulls the testicles closer to the body when they are exposed to cold.
- It brings the testicles closer to the body during sexual intercourse.
However, since it is a muscle, it has the potential to add volume around the spermatic cord and thereby make it more difficult to get a tight hernia repair.
Options for Addressing the Cremasteric Muscle
Removing it: There are surgeons who routinely remove the cremasteric muscle during hernia repair surgery, which results in a tighter repair. However, removing this muscle means it can no longer do its job of pulling the testicles closer to the body in cold conditions or during sex. Another consideration is that removing the cremasteric muscle may also cut some of the blood supply and nerves to the testicle.
Leave it intact: Some surgeons routinely leave the cremasteric intact. This can make getting a tight hernia repair more difficult. But it must be done wherever there is any concern about the blood supply to the testicle.
What Dr. William Brown does: Dr. Brown evaluates the anatomy and the situation and proceeds accordingly. If cremasteric muscle will interfere with the hernia repair, then as little of the muscle is removed as possible to get a good repair. Care is taken to preserve the blood vessels and nerves. In most situations Dr. Brown prefers to leave the cremasteric muscle intact.