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

Abstract

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.