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Analysis of type I collagen in the parametrium of women with and without uterine prolapse, according to hormonal status

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Abstract

The content and quality of type I collagen in the parametrium of women with and without uterine prolapse was evaluated. Forty-four consecutive patients were selected and divided into two groups: A, 21 women without uterine prolapse, and B, 23 with uterine prolapse. Patients in group A had uterine leiomyoma and were submitted to abdominal hysterectomy; in those from group B, vaginal hysterectomy was performed for correction of the uterine prolapse. During surgery, fragments of the parametrium were removed and processed for immunohistochemical analysis using polyclonal antibodies for type I collagen . A system of computerized digital imaging analysis was used for the quantification of collagen fibers. There was no difference between collagen content in patients either with or without prolapse, nor between pre- and postmenopausal women with prolapse. A modification of the quality of the collagen fiber was observed, it being longer and more compact in the group without uterine prolapse. In contrast, in the group with prolapse, the fibers were shorter and thinner and areas with large spaces between fibers were found at several points of the parametrium. The conclusion was that patients with uterine prolapse have the same type I collagen content as those without, but the quality of the fiber is modified. The hormonal status also did not affect collagen content.

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Authors and Affiliations

  1. Sector of Urogynecology and Vaginal Surgery, Department of Gynecology, Escola Paulista de Medicina (UNIFESP/EPM), Universidade Federal de São Paulo, Avenida Onze de Junho, 1006 apto. 51, 04041–003, São Paulo, SPBrazil

    Eliana Cristina Barbiero, Marair Gracio Ferreira Sartori, Manoel João Batista Castello Girão, Edmund Chada Baracat & Geraldo Rodrigues de Lima

Authors
  1. Eliana Cristina Barbiero
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  2. Marair Gracio Ferreira Sartori
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  3. Manoel João Batista Castello Girão
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  4. Edmund Chada Baracat
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  5. Geraldo Rodrigues de Lima
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Corresponding author

Correspondence to Marair Gracio Ferreira Sartori.

Additional information

Editorial Comment: It is widely accepted that the etiology of pelvic organ prolapse is multifactorial, and that multiparity and menopausal status are two of the most important factors that influence the development of pelvic support defects. As the authors note, however, it is currently impossible to accurately predict which patients will ultimately suffer from prolapse. The authors of this paper report on the collagen content and quality of parametrial tissue from women with and without uterine prolapse. Although they found no difference in quantity of collagen between groups (prolapse vs. no prolapse, menopausal vs. premenopausal), they did demonstrate significant changes in the quality of the collagen structure, with shorter and thinner fibers evident in those women with uterine prolapse. Although it would be premature to assume a causal relationship between the collagen changes and the development of prolapse, this finding is intriguing in that analysis of collagen may one day assist physicians in counseling patients regarding such events as delivery mode and prognosis for recurrent prolapse after reconstructive pelvic surgery.

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Barbiero, E.C., Sartori, M.G.F., Girão, M.J.B.C. et al. Analysis of type I collagen in the parametrium of women with and without uterine prolapse, according to hormonal status. Int Urogynecol J 14, 331–334 (2003). https://doi.org/10.1007/s00192-003-1076-x

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  • DOI: https://doi.org/10.1007/s00192-003-1076-x

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