Myofibroblasts defined by electron microscopy suggest the dedifferentiation of smooth muscle within the sac walls associated with congenital inguinal hernia

Tanyel, Feridun Cahit; Müftüoğlu, Sevda; Dağdevıren, Attıla; Kaymaz, Figen; Büyükpamukçu, Nebìl

doi:10.1046/j.1464-410x.2001.02028.x

Cited by 34 publications

(36 citation statements)

References 11 publications

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“…Tanyel et al [7], [8] showed that childhood inguinal hernia is related to smooth muscle within the wall of the sac. The smooth muscle bundles may have an important role both in prevention of obliteration and clinical outcome.…”

Section: Discussionmentioning

confidence: 99%

Orchidopexy Without Ligation of Hernia Sac: Our Experience

Gajbhiye¹,

Singh²,

Singh³

et al. 2015

jemds

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AIMS:To confirm that, the ligation of hernial sac during orchiopexy is not mandatory to prevent postoperative development of hernia. METHODS: This prospective study was conducted in 40 children with an age range of six months to 12 years with a diagnosis of undescended testis. Of the 40 cases, 30 were unilateral and 10 bilateral cases. Of the 30 unilateral undescended testis, 18 were right-sided and 12 left-sided. All children underwent standard orchiopexy without the ligation of the hernia sac. RESULTS: All the patients were followed up regularly up to a period ranging from 18 months to 24 months. No inguinal hernia was detected during the regular follow-up in any child. CONCLUSION: Ligation of herinal sac is not mandatory during orchipexy. KEYWORDS: Undesended testes, inguinal hernia, orchidopexy. INTRODUCTION:Herniotomy is performed along with orchidopexy for the closure of associated patent processus vaginalis. The conventional technique for undesended testis repair is high ligation of the hernial sac after proper dissection upto the deep ring, Mohta et al. [1] Observed that there is no untoward effect on the early complications and recurrence rate, if hernia sac is not ligated during herniotomy. During laparoscopic orchidopexy performed for contralateral testicle it was found that despite nonligation, the previous de peritonalized site got reperitonalized by itself and the sac which is dissected and left open deep to deep ring is not having hernia later in life. This is probably due to the closer of peritoneal defect within 24 hours by metamorphosis of the in situ mesodermal cells. [2] We done a study on non-ligation of hernia sac during conventional orchiopexy in our institute to see the results and it's long term untowards effects and advantages over standard orchiopexy.

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Section: Discussionmentioning

confidence: 99%

Orchidopexy Without Ligation of Hernia Sac: Our Experience

Gajbhiye¹,

Singh²,

Singh³

et al. 2015

jemds

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“…While the sacs presenting smooth muscle have invariably disclosed myofibroblasts, some sacs have only included myofibroblasts without any additional smooth muscle [4]. Therefore, the apoptosis of smooth muscle in PV has been suggested to be a continuous process, which also involves the dedifferentiation into myofibroblasts [5]. The close correlation among the amounts of presenting smooth muscle and myofibroblasts [4], and the possibility of failed obliteration even in the presence of only myofibroblasts suggest interactions during the process.…”

Section: Discussionmentioning

confidence: 99%

“…It has recently been reported that incomplete obliteration of PV contains a layer composed of smooth muscle and myofibroblasts that is not encountered in obliterated PV [3][4][5]. Since smooth muscle develops within the gubernaculum around the PV and it is not found in obliterated PV, it should present temporarily during a time period compatible with the descent of testis.…”

Section: Introductionmentioning

confidence: 98%

“…The failed descent of testis has been described to result through an impairment of the propulsive activity [7]. The smooth muscle layer has been suggested to disappear through dedifferentiating into myofibroblasts after the descent [4,5]. Incomplete obliteration, which gives rise to either hydrocele or inguinal hernia, has been proposed to be the reflection of abnormal persistence of smooth muscle and myofibroblast, and the amount of persisting structures has been suggested to define the clinical outcome to be a hernia or hydrocele [8,9].…”

Section: Introductionmentioning

confidence: 99%

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Smooth Muscle within Incomplete Obliterations of Processus vaginalis Lacks Apoptotic Nuclei

et al. 2002

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Introduction: Incomplete obliteration of processus vaginalis (PV) has been suggested to result from the persistence of smooth muscle, which should normally disappear after taking part in the descent of testis. Since apoptosis is the mechanism of disappearance, the presence or absence of apoptotic nuclei was evaluated within sacs that result from failed obliteration of PV. Materials and Methods: Twenty sacs associated with female inguinal hernia (n = 5), male inguinal hernia (n = 6), hydrocele (n = 5), hydrocele of the cord (n = 2), and undescended testis (n = 2) were evaluated. 10-µm sections were cut from the snap-frozen samples and stained for nuclear DNA fragmentation. Results: Apoptotic nuclei were detected within the vascular structures and mesothelium. However, none of the samples from different diagnostic sources have revealed any apoptotic nucleus within the smooth muscle component. Conclusions: While the vascular and mesothelial structures within the sacs reveal evidence of apoptosis, the smooth muscle component lacks apoptotic process. The failed apoptosis of smooth muscle may have a role in the persistence of PV.

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“…While the failed descent has been proposed to reflect a failure of propulsion [2], the persistence of smooth muscle after descent has been suggested to hinder the obliteration and give rise to either inguinal hernia or hydrocele, depending upon the amount of smooth muscle [3][4][5].…”

Section: Introductionmentioning

confidence: 99%

Less Calcium in Cremaster Muscles of Boys with Undescended Testis Supports a Deficiency in Sympathetic Innervation

Tanyel¹,

Ulusu

Tezcan

et al. 2002

Urol Int

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In addition to an increase in contractility, contracted fibers and small and electron-dense mitochondria have suggested an increase of cytosolic Ca²⁺ within the cremaster muscles (CM) associated with undescended testis. Therefore, the Ca²⁺ content of CM associated with an undescended testis was determined and compared with the Ca²⁺ content associated with inguinal hernia and hydrocele and in internal oblique muscles. CM samples from boys with undescended testis (n = 9), inguinal hernia (n = 15), and hydrocele (n = 7) and from girls with inguinal hernia (n = 8) were obtained. The calcium contents of these samples and of samples from internal oblique muscle (n = 6) were determined by atomic absorption spectrophotometry. While the Ca²⁺contents of CM from boys with undescended testis and from girls with inguinal hernia were similar (p > 0.05), the internal oblique muscle and the CM from boys with inguinal hernia and hydrocele contained more Ca²⁺than CM from boys with undescended testis (p < 0.05). Despite evidence of an increase in cytosolic calcium, the decrease in total calcium content suggests a decrease in the adenylyl cyclase activity, thus inhibition of influx of Ca²⁺, but an increase in phospholipase C activity, and generation of more inositol 1,4,5-trisphosphate and mobilization of calcium from internal stores. Since the sympathetic system acts through adenylyl cyclase in striated muscles and is sexually dimorphic, similar Ca²⁺ contents as encountered in girls suggest an alteration in the balance of autonomic innervation against the sympathetic system in boys with undescended testis.

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Myofibroblasts defined by electron microscopy suggest the dedifferentiation of smooth muscle within the sac walls associated with congenital inguinal hernia

Cited by 34 publications

References 11 publications

Orchidopexy Without Ligation of Hernia Sac: Our Experience

Orchidopexy Without Ligation of Hernia Sac: Our Experience

Smooth Muscle within Incomplete Obliterations of Processus vaginalis Lacks Apoptotic Nuclei

Less Calcium in Cremaster Muscles of Boys with Undescended Testis Supports a Deficiency in Sympathetic Innervation

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