[Several ultrastructural peculiarities of the fascia transversalis in direct inguinal hernias of senile men].

Fascia transversalis of the dorsal wall of the inguinal canal in direct hernias in senile men was studied by transmission electron microscopy. Collagen microfibrils (CMF) were unevenly arranged and rarely formed compact fibres. Dysplastic CMF with variable diameters and nonuniform profiles were also encountered. There was a marked collagenophagy: in some fibroblasts we observed collagen-containing vacuoles in different stages of microfibrillar degradation. Among CMF matrix vesicles were also detected. These ultrastructural findings are discussed as a morphological substrate leading to supportive and mechanical insufficiency of the fascia transversalis causing herniation. It is concluded also that because of the structural defects of the fascial sheath there is a need of alloplastic reconstruction where Bulgarian-made AMPOXEN tissue can successfully be applied.