Advertisement

Reproductive Sciences

, Volume 18, Issue 3, pp 296–303 | Cite as

Contractile Response of Human Anterior Vaginal Muscularis in Women With and Without Pelvic Organ Prolapse

  • Gina M. NorthingtonEmail author
  • Maureen Basha
  • Lily A. Arya
  • Alan J. Wein
  • Samuel Chacko
Original Articles

Abstract

The aim of this study was to compare the contractility of the anterior vaginal muscularis (AVM) from women with and without pelvic organ prolapse (POP). In vitro experiments were performed to measure the peak force generated in response to potassium chloride (KCl; 125 mmol/L) and phenylephrine by AVM tissue from women with and without POP. Cross-sectional areas and co-localization of α1A adrenergic receptor protein with smooth muscle α-actin in AVM strips were determined by histology and immunofluorescence, respectively. There were no differences in the mean amplitude of force generated in response to KCl normalized to either wet weight or muscle cross-sectional area (mN/mm2) between women with and without POP (P >.30). However, AVM from women with prolapse produced a significantly higher mean force to KCl normalized to total cross-sectional area compared to controls (P =.007). While the control samples demonstrated a consistent response to phenylephrine, there was no response to this stimulant generated by AVM tissue from women with POP. The proportion of co-localized α1A adrenergic receptors with smooth muscle α actin in AVM tissue was significantly less in women with POP compared to normal controls (P <.0001). Although there was significantly greater tissue stress generated by AVM from women with prolapse compared to controls, there were no differences in muscle stress. Absent response to phenylephrine by AVM from women with prolapse may be related to a lower expression of α1A adrenergic receptors in vaginal smooth muscle.

Keywords

vagina smooth muscle pelvic organ prolapse contractility adrenergic receptors 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Olsen AL, Smith VJ, Bergstrom JO, Colling JC, Clark Al. Epidemiology of surgically managed pelvic organ prolapse and urinary incontinence. Obstet Gynecol. 1997;89(4):501–506.CrossRefGoogle Scholar
  2. 2.
    Mant J, Painter R, Vessey M. Epidemiology of genital prolapse: observations from the Oxford Family Planning Association Study. Br J Obstet Gynaecol. 1997;104(5):579–585.CrossRefGoogle Scholar
  3. 3.
    Smith AR, Hosker GL, Warrell DW. The role of partial denervation of the pelvic floor in the aetiology of genitourinary prolapse and stress incontinence of urine. A neurophysiological study. Br J Obstet Gynaecol. 1989;96(1):24–28.CrossRefGoogle Scholar
  4. 4.
    Jackson SR, Avery NC, Tarlton JF, Eckford SD, Abrams P, Bailey AJ. Changes in metabolism of collagen in genitourinary prolapse. Lancet. 1996;347(9016):1658–1661.CrossRefGoogle Scholar
  5. 5.
    Ewies AA, Al-Azzawi F, Thompson J. Changes in extracellular matrix proteins in the cardinal ligaments of post-menopausal women with or without prolapse: a computerized immunohistomorphometric analysis. Hum Reprod. 2003;18(10):2189–2195.CrossRefGoogle Scholar
  6. 6.
    Lin SY, Tee YT, Ng SC, Chang H, Lin P, Chen GD. Changes in the extracellular matrix in the anterior vagina of women with or without prolapse. Int Urogynecol J Pelvic Floor Dysfunct. 2007;18(1):43–48.CrossRefGoogle Scholar
  7. 7.
    Moalli PA, Shand SH, Zyczynski HM, Gordy SC, Meyn LA. Remodeling of vaginal connective tissue in patients with prolapse. Obstet Gynecol. 2005;106(5 pt 1):953–963.CrossRefGoogle Scholar
  8. 8.
    Visco AG, Yuan L. Differential gene expression in pubococcygeus muscle from patients with pelvic organ prolapse. Am J Obstet Gynecol. 2003;189(1):102–112.CrossRefGoogle Scholar
  9. 9.
    Chen BH, Wen Y, Li H, Polan ML. Collagen metabolism and turnover in women with stress urinary incontinence and pelvic prolapse. Int Urogynecol J Pelvic Floor Dysfunct. 2002;13(2):80–87.CrossRefGoogle Scholar
  10. 10.
    Delancey JO, Starr RA. Histology of the connection between the vagina and levator ani muscles. Implications for urinary tract function. J Reprod Med. 1990;35(8):765–771.PubMedGoogle Scholar
  11. 11.
    Gunst SJ, Fredberg JJ. The first three minutes: smooth muscle contraction, cytoskeletal events, and soft glasses. J Appl Physiol. 2003;95(1):413–425.CrossRefGoogle Scholar
  12. 12.
    Boreham MK, Wai CY, Miller RT, Schaffer JI, Word RA. Morphometric properties of the posterior vaginal wall in women with pelvic organ prolapse. Am J Obstet Gynecol. 2002;187(6):1501–1508.CrossRefGoogle Scholar
  13. 13.
    Boreham MK, Wai CY, Miller RT, Schaffer JI, Word RA. Morphometric analysis of smooth muscle in the anterior vaginal wall of women with pelvic organ prolapse. Am J Obstet Gynecol. 2002;187(1):56–63.CrossRefGoogle Scholar
  14. 14.
    Takacs P, Gualtieri M, Nassiri M, Candiotti K, Medina CA. Vaginal smooth muscle cell apoptosis is increased in women with pelvic organ prolapse. Int Urogynecol J Pelvic Floor Dysfunct. 2008;19(11):1559–1564.CrossRefGoogle Scholar
  15. 15.
    Boreham MK, Miller RT, Schaffer JI, Word RA. Smooth muscle myosin heavy chain and caldesmon expression in the anterior vaginal wall of women with and without pelvic organ prolapse. Am J Obstet Gynecol. 2001;185(4):944–952.CrossRefGoogle Scholar
  16. 16.
    Takacs P, Gualtieri M, Nassiri M, Candiotti K, Fornoni A, Medina CA. Caldesmon expression is decreased in women with anterior vaginal wall prolapse: a pilot study. Int Urogynecol J Pelvic Floor Dysfunct. 2009;20(8):985–990.CrossRefGoogle Scholar
  17. 17.
    Bump RC, Mattiasson A, Bo K, et al. The standardization of terminology of female pelvic organ prolapse and pelvic floor dysfunction. Am J Obstet Gynecol. 1996;175(1):10–17.CrossRefGoogle Scholar
  18. 18.
    Soules MR, Sherman S, Parrott E, et al. Executive summary: Stages of Reproductive Aging Workshop (STRAW). Climacteric. 2001;4(4):267–272.CrossRefGoogle Scholar
  19. 19.
    Thompson JD, Warshaw JS Hysterectomy Rock JA, Thompson JD (Eds.), Te Linde’s Operative Gynecology. 8 ed. Philadelphia, PA: Lippincott-Raven; 1997:771–854.Google Scholar
  20. 20.
    Basha M, Chang S, Smolock EM, Moreland RS, Wein AJ, Chacko S. Regional differences in myosin heavy chain isoform expression and maximal shortening velocity of the rat vaginal wall smooth muscle. Am J Physiol Regul Integr Comp Physiol. 2006;291(4):R1076–R1084.CrossRefGoogle Scholar
  21. 21.
    Basha M, Labelle EF, Northington G, Wang T, Wein AJ, Chacko S. Functional significance of muscarinic receptor expression within the proximal and distal rat vagina. Am J Physiol Regul Integr Comp Physiol. 2009;297(5):R1486–93.CrossRefGoogle Scholar
  22. 22.
    Uckert S, Ehlers V, Nuser V. F, et al. In vitro functional responses of isolated human vaginal tissue to selective phosphodiesterase inhibitors. World J Urol. 2005;23(6):398–404.CrossRefGoogle Scholar
  23. 23.
    Horiuchi KY, Chacko S. Effect of unphosphorylated smooth muscle myosin on caldesmon-mediated regulation of actin filament velocity. J Muscle Res Cell Motil. 1995;16(1):11–19.CrossRefGoogle Scholar
  24. 24.
    Soderberg MW, Falconer C, Bystrom B, Malmstrom A, Ekman G. Young women with genital prolapse have a low collagen concentration. Acta Obstet Gynecol Scand. 2004;83(12):1193–1198.CrossRefGoogle Scholar
  25. 25.
    Liapis A, Bakas P, Pafiti A, Frangos-Plemenos M, Arnoyannaki N, Creatsas G. Changes of collagen type III in female patients with genuine stress incontinence and pelvic floor prolapse. Eur J Obstet Gynecol Reprod Biol. 2001;97(1):76–79.CrossRefGoogle Scholar

Copyright information

© Society for Reproductive Investigation 2011

Authors and Affiliations

  • Gina M. Northington
    • 1
    Email author
  • Maureen Basha
    • 2
  • Lily A. Arya
    • 1
  • Alan J. Wein
    • 3
  • Samuel Chacko
    • 4
  1. 1.Division of Urogynecology and Reconstructive Pelvic Surgery, Department of Obstetrics and GynecologyUniversity of PennsylvaniaPhiladelphiaUSA
  2. 2.Department of Human ScienceGeorgetown UniversityWashington, DCUSA
  3. 3.Division of Urology, Department of SurgeryUniversity of PennsylvaniaPhiladelphiaUSA
  4. 4.Basic Urologic Research, Department of SurgeryUniversity of PennsylvaniaPhiladelphiaUSA

Personalised recommendations