Nouvelles perspectives dans l'étiologie des hernies de l'aine

Abstract

Aim of the study

To explore new etiological hypotheses of groin hernias, using a biomechanical and histochemical study of the transversalis fascia and of the rectus sheath.

Patients and methods

The samples were collected from 63 patients with uni- or bilateral hernias and from 30 control subjects without hernia. The biomechanical properties were assessed using a computerized-suction device (Cutometer ^®). Sections were stained with hematoxylin and eosin, Masson-trichrome and double-stained with sirius red and orcein.

Results

There was no major biomechanical and histological difference between the control and patient aponeuroses. The patient fascias from the non-herniated sides presented an increased extensibility and elasticity, as compared with the control fascias. Those fascias also showed a collagen framework with disorganized areas and an increased number of isolated fibers.

Conclusion

The transversalis fascia from the non-herniated side appears to be a pathological fascia. Therefore, a connective tissue pathology seems to be involved in the genesis of groin hernias, with a preferential manifestation in the inguinal region which affects mainly the collagen fibers.