Collagen in the transversalis fascia of patients with indirect inguinal hernia: a case-control study

BACKGROUND: The aim of this study was to analyze the constituents of total and types I and III collagen fibers in the transversalis fascias of patients with indirect inguinal hernias, compared with samples removed from nonherniated cadavers. METHODS: Biopsy samples from 26 patients and 26 cadavers were analyzed. Hematoxylin-eosin and picrosirius staining techniques were used. The images obtained were analyzed using a video morphometric technique to determine the constituents of total collagen and-types I and III collagen in the transversalis fascia. The picrosirius-stained tissues were submitted to observation under polarized-light microscopy. RESULTS: The results showed 17.3% less total collagen in patients with hernias compared with the control group (P <.01). Type I collagen in patients with indirect inguinal hernias was 23.7% less than the control group (P <.01), type III collagen was 6.4% less in the controls (P <.01). CONCLUSION: The lower percentages of total collagen and type I collagen in the transversalis fascias of patients with indirect inguinal hernias could be a factor in hernia formation. (C) 2009 Published by Elsevier Inc.