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Preoperative progressive pneumoperitoneum and botulinum toxin type A are useful tools in the preparation of patients with loss of domain hernias. Both procedures are complementary in the surgical repair, especially with the use of prosthetic techniques without tension, that allow a integral management of these patients. The aim of this paper is to update concepts related to both procedures, emphasizing the advantages that take place in the preoperative management of loss of domain hernias., (Copyright © 2017 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.)

Introduction: Current studies have shown the validity of the atraumatic fixation with fibrin glue (Tissucol) compared to conventional sutures in polypropylene mesh fixation. We propose to study the behaviour of absorbable mesh., Material and Methods: We used 20 Wistar white rats. Two hernia defects were made in the abdominal wall, which were repaired using absorbable PGA-TMC preperitoneal mesh. The right side of the mesh was fixed with Tissucol and left side with conventional suture attached to the muscle fascia. One group of 10 rats were sacrificed at day 14 (Series A) and the other 10 rats at 28 days (Series B). We used two tests to assess the contingency of the abdominal wall; Pressure Test: pneumoperitoneum more than 40mmHg maintained for 1min, Traction Test: dynamometry of the affected area more than 300mg per cm(2) of traction. Abdominal wall was analysed to determine the integration of the new generation mesh., Results: The fixation of the mesh after the pressure and traction tests showed no statistically significant changes in either group. The integration of the mesh and vessel neoformation was higher in the cases of fixation with fibrin glue., Conclusions: Biological fixation with fibrin glue is similar to the conventional. Absorbable mesh was suitably integrated and vascular neoformation and integration of the mesh was also found to be better than conventional sutures when fibrin sealant was applied.

Bladder hernia is not a rare pathological condition, with a frequency between 0,3 and 3%. Massive bladder hernia is less frequent an very rarely ureterohydronephrosis with this pathology. We will present a case a renal failure secondary to inguinoscrotal bladder hernia with bilateral obstructive uropathy and an analyzed the clinical presentation, the diagnosis and the treatment for those hernias.