Skip to main content

Advertisement

Log in

Changes in the extracellular matrix in the anterior vagina of women with or without prolapse

  • Original Article
  • Published:
International Urogynecology Journal Aims and scope Submit manuscript

Abstract

To investigate the changes in the connective tissues located in the upper portion of the anterior vaginal wall, which are associated with anterior vaginal wall prolapse, 23 women with anterior vaginal wall prolapse were included in the study group and 15 women with normal genital support served as control group. The anterior vaginal wall tissue samples were obtained for immunohistochemical staining of collagen (type I, III, IV, V, VI), elastin, and glycoproteins from the extracellular matrix (fibronectin, vitronectin, laminin). The number of capillaries per arteriole and mitochondria numbers per smooth muscle cell were evaluated for demonstrating whether the anatomical prolapse affect on blood supply to these tissues. Collagen III was significantly less in the anterior vaginal wall of patients with anterior vaginal wall prolapse. Quantitative immunoreactivity of collagen I and III had significant positive correlations with ageing.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others

References

  1. Dietz HP, Haylen BT, Vancaillie TG (2002) Female pelvic organ prolapse and voiding function. Int Urogynecol J Pelvic Floor Dysfunct 13:284–288

    Article  PubMed  CAS  Google Scholar 

  2. Bump RC, Norton PA (1998) Epidemiology and natural history of pelvic floor dysfunction. Obstet Gynecol Clin North Am 25:723–746

    Article  PubMed  CAS  Google Scholar 

  3. Goepel C, Hefler L, Methfessel HD, Koelbl H (2003) Periurethral connective tissue status of postmenopausal women with genital prolapse with and without stress incontinence. Acta Obstet Gynecol Scand 82:659–664

    Article  PubMed  Google Scholar 

  4. Rechberger T, Postawski K, Jakowicki JA, Gunja-Smith Z, Woessner JF Jr (1998) Role of fascial collagen in stress urinary incontinence. Am J Obstet Gynecol 179:1511–1514

    Article  PubMed  CAS  Google Scholar 

  5. Liapis A, Bakas P, Pafiti A, Frangos-Plemenos M, Arnoyannaki N, Creatsas G (2001) Changes of collagen type III in female patients with genuine stress incontinence and pelvic floor prolapse. Eur J Obstet Gynecol Reprod Biol 97:76–79

    Article  PubMed  CAS  Google Scholar 

  6. Keane DP, Sims TJ, Abrams P, Bailey AJ (1997) Analysis of collagen status in premenopausal nulliparous women with genuine stress incontinence. Br J Obstet Gynaecol 104(9):994–998

    PubMed  CAS  Google Scholar 

  7. Falconer C, Ekman G, Malmstrom A, Ulmsten U (1994) Decreased collagen synthesis in stress-incontinent women. Obstet Gynecol 84:583–586

    PubMed  CAS  Google Scholar 

  8. Falconer C, Blomgren B, Johansson O, Ulmsten U, Malmatrom A, Westergren-Thorsson G, Ekman-Ordeberg G (1998) Different organization of collagen fibrils in stress incontinent women of fertile age. Acta Obstet Gynecol Scand 77:87–94

    Article  PubMed  CAS  Google Scholar 

  9. Falconer C, Ekman-Ordeberg G, Blomgren B, Johansson O, Ulmsten U, Malmatrom A, Westergren-Thorsson G, Malmstrom A (1998) Paraurethral connective tissue in stress incontinent women after menopause. Acta Obstet Gynecol Scand 77:94–100

    Google Scholar 

  10. Wong MY, Harmanli OH, Agar M, Dandolu V, Grody MHT (2003) Collagen content of nonsupport tissue in pelvic organ prolapse and stress urinary incontinence. Am J Obstet Gynecol 189:1597–1600

    Article  PubMed  CAS  Google Scholar 

  11. Bai SW, Choe BH, Kim JY, Park KH (2002) Pelvic organ prolapse and connective tissue abnormalities in Korean women. J Reprod Med 47:231–234

    PubMed  Google Scholar 

  12. Scott JE (1988) Proteoglycan-fibrillar collagen interactions. Biochem J 252:313–323

    PubMed  CAS  Google Scholar 

  13. Bailey AJ (2001) Molecular mechanisms of ageing in connective tissue. Mech Ageing Dev 122:735–755

    Article  PubMed  CAS  Google Scholar 

  14. Van der Rest M, Garrone R (1991) Collagen family of proteins. FASEB J 5:2814–2823

    PubMed  Google Scholar 

  15. Maolli PA, Talarico LC, Sung VW, Klingensmith WL, Shand SH, Meyn LA, Watkins SC (2004) Impact of menopause on collagen subtypes in the arcus tendineous fasciae pelvis. Am J Obstet Gynecol 190:620–627

    Article  Google Scholar 

  16. Hardingham TE, Fosang AJ (1992) Proteoglycans: many forms and many functions FASEB J 6:861–870

    PubMed  CAS  Google Scholar 

  17. Norton PA (1993) Pelvic floor disorders: the role of fascia and ligament. Clin Obstet Gynecol 36:926–938

    Article  PubMed  CAS  Google Scholar 

  18. Norton P, Baker J, Sharp H, Warenski J (1995) Genitourinary prolapse and joint hypermobility in women. Obstet Gynecol 85:225–228

    Article  PubMed  CAS  Google Scholar 

  19. DeLancey JOL (1992) Anatomic aspects of vaginal eversion after hysterectomy. Am J Obstet Gynecol 166:1717–1728

    PubMed  CAS  Google Scholar 

  20. Bump RC, Mattiasson A, Bo K, Brubaker LP, DeLancey JO, Klarskov P, Shull BL, Smith ARB (1996) The standardization of terminology of female pelvic organ prolapse and pelvic floor dysfunction. Am J Obstet Gynecol 175:10–17

    Article  PubMed  CAS  Google Scholar 

  21. Lu SH, Wei YH, Chang LS, Lin ATL, Chen KK, Yang CH (2000) Morphological and morphometric analysis of human detrusor mitochondria with urodynamic correlation after partial bladder outlet obstruction. J Urol 163:225–229

    Article  PubMed  CAS  Google Scholar 

  22. Goh JTW (2003) Biomechanical and biochemical assessments for pelvic organ prolase. Curr Opin Obstet Gynecol 15:391–394

    Article  PubMed  Google Scholar 

  23. Boreham MK, Wai CY, Miller RT, Schaffer JI, Word RA (2002) Morphometric analysis of smooth muscle in the anterior wall of women with pelvic organ prolapse. Am J Obstet Gynecol 187:56–63

    Article  PubMed  Google Scholar 

  24. Boreham MK, Miller RT, Schaffer JI, Word RA (2001) 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 185:944–952

    Article  PubMed  CAS  Google Scholar 

  25. DeLancey JOL, Starr RA (1990) Histology of the connection between the vagina and levator ani muscles. J Reprod Med 35:765–771

    PubMed  CAS  Google Scholar 

  26. Makinen J, Kahari VM, Soderstrom KO, Vuorio E, Hironen T (1987) Collagen synthesis in the vaginal connective tissue of patients with and without uterine prolapse. Eur J Obstet Gynecol Reprod Biol 24:319–325

    Article  PubMed  CAS  Google Scholar 

  27. Ewies AA, Al-Azzawi F, Thompson J (2003) Changes in extracellular matrix proteins in the cardinal ligaments of post-menopausal women with or without prolapse: a computerized immunohistomorphometric analysis. Hum Reprod 18:2189–2195

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgement

We thank the National Science Council in Taiwan for supporting this study (Grants NSC-90-2314-B-040-019 and NSC-90-2314-B-040-021).

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Gin-Den Chen.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Lin, SY., Tee, YT., Ng, SC. et al. Changes in the extracellular matrix in the anterior vagina of women with or without prolapse. Int Urogynecol J 18, 43–48 (2007). https://doi.org/10.1007/s00192-006-0090-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00192-006-0090-1

Keywords

Navigation