Skip to main content

Advertisement

SpringerLink
Log in

Genetics of pelvic organ prolapse: crossing the bridge between bench and bedside in urogynecologic research

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

Abstract

An increasing number of scientists have studied the molecular and biochemical basis of pelvic organ prolapse (POP). The extracellular matrix content of the pelvic floor is the major focus of those investigations and pointed for potential molecular markers of the dysfunction. The identification of women predisposed to develop POP would help in the patients’ management and care. This article includes a critical analysis of the literature up to now; discusses implications for future research and the role of the genetics in POP.

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

Access this article

Log in via an institution

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

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. 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 

  2. Olsen AL, Smith VJ, Bergstrom JO, Colling JC, Clark AL (1997) Epidemiology of surgically managed pelvic organ prolapse and urinary incontinence. Obstet Gynecol 89:501–506

    Article  PubMed  CAS  Google Scholar 

  3. Subak LL, Waetjen LE, Van den Eaden S et al (2001) Cost of pelvic organ prolapse surgery in the United States. Obstet Gynecol 98:646–651

    Article  PubMed  CAS  Google Scholar 

  4. Drutz HP, Alarab M (2006) Pelvic organ prolapse: demographics and future growth prospects. Int Urogynecol J Pelvic Floor Dysfunct 17(Suppl 1):S6–S9

    PubMed  Google Scholar 

  5. Fornell EU, Wingren G, Kjolhede P (2004) Factors associated with pelvic floor dysfunction with emphasis on urinary and fecal incontinence and genital prolapse: an epidemiological study. Acta Obstet Gynecol Scand 83:383–389

    Article  Google Scholar 

  6. Mant J, Painter R, Vessey M (1997) Epidemiology of genital prolapse: observations from the Oxford Family Planning Association Study. Br J Obstet Gynecol 104(5):579–585

    Article  CAS  Google Scholar 

  7. Harris RL, Cundiff GW, Coates KW, Bump RC (1998) Urinary incontinence and pelvic organ prolapse in nulliparous women. Obstet Gynecol 92:951–954

    Article  PubMed  CAS  Google Scholar 

  8. DeLancey JOL (1993) Anatomy and biomechanics of genital prolapse. Clin Obstet Gynecol 36:897–909

    Article  PubMed  CAS  Google Scholar 

  9. Patel DA, Xu X, Thomason AD, Ransom SB, Ivy JS, DeLancey JO (2006) Childbirth and pelvic floor dysfunction: an epidemiologic approach to the assessment of prevention opportunities at delivery. Am J Obstet Gynecol 195(1):23–28

    Article  PubMed  Google Scholar 

  10. Bortolini MA, Drutz HP, Lovatsis D, Alarab M (2010) Vaginal delivery and pelvic floor dysfunction: current evidence and implications for future research. Int Urogynecol J Pelvic Floor Dysfunct 21(8):1025–1030

    Article  CAS  Google Scholar 

  11. Rizk DEE (2009) Minimizing the risk of childbirth-induced pelvic floor dysfunctions in the developing world: “preventive” urogynecology. Int Urogynecol J Pelvic Floor Dysfunct 20:615–617

    Article  PubMed  Google Scholar 

  12. Kerkhof MH, Hendriks L, Brölmann HA (2009) Changes in connective tissue in patients with pelvic organ prolapse—a review of the current literature. Int Urogynecol J Pelvic Floor Dysfunct 20(4):461–474

    Article  PubMed  CAS  Google Scholar 

  13. Jackson SR, Avery NC, Tarlton JF, Eckford SD, Abrams P, Bailey AJ (1996) Changes in metabolism of collagen in genitourinary prolapse. Lancet 347(9016):1658–1661

    Article  PubMed  CAS  Google Scholar 

  14. Moalli PA, Shand SH, Zyczynski HM, Gordy SC, Meyn LA (2005) Remodeling of vaginal connective tissue in patients with prolapse. Obstet Gynecol 106:620–627

    Article  Google Scholar 

  15. Takano CC, Girão MJ, Sartori MG et al (2002) Analysis of collagen in parametrium and vaginal apex of women with and without uterine prolapse. Int Urogynecol J Pelvic Floor Dysfunct 13(6):342–345

    Article  PubMed  CAS  Google Scholar 

  16. Klutke J, Ji Q, Campeau J et al (2008) Decreased endopelvic fascia elastin content in uterine prolapse. Acta Obstet Gynecol Scand 87:111–115

    Article  PubMed  CAS  Google Scholar 

  17. Yamamoto K, Yamamoto M, Akazawa K, Tajima S, Wakimoto H, Aoyagi M (1997) Decrease in elastin gene expression and protein synthesis in fibroblasts derived from cardinal ligaments of patients with prolapsus uteri. Cell Biol Int 21:605–611

    Article  PubMed  CAS  Google Scholar 

  18. Chen B, Wen Y, Yu X, Polan ML (2007) The role of neutrophil elastase in elastin metabolism of pelvic tissues from women with stress urinary incontinence. Neurourol Urodynam 26:274–279

    Article  CAS  Google Scholar 

  19. Trackman PC (2005) Diverse biological functions of extracellular collagen processing enzymes. J Cell Biochem 96(5):927–937

    Article  PubMed  CAS  Google Scholar 

  20. Kagan HM, Li W (2003) Lysyl oxidase: properties, specificity, and biological roles inside and outside the cell. J Cell Biochem 88:660–672

    Article  PubMed  CAS  Google Scholar 

  21. Liu X, Zhao Y, Pawlyk B, Damaser M, Li T (2006) Failure of elastic fiber homeostasis leads to pelvic floor disorders. Am J Pathol 168(2):519–528

    Article  PubMed  CAS  Google Scholar 

  22. Liu G, Daneshgari F, Li M et al (2007) Bladder and urethral function in pelvic organ prolapsed lysyl oxidase like-1 knockout mice. BJU Int 100(2):414–418

    Article  PubMed  Google Scholar 

  23. Alperin M, Debes K, Abramowitch S, Meyn L, Moalli PA (2008) LOXL1 deficiency negatively impacts the biomechanical properties of the mouse vagina and supportive tissues. Int Urogynecol J Pelvic Floor Dysfunct 19(7):977–986

    Article  PubMed  Google Scholar 

  24. Nakamura T, Lozano PR, Ikeda Y (2002) Fibulin-5/DANCE is essential for elastogenesis in vivo. Nature 415(6868):171–175

    Article  PubMed  CAS  Google Scholar 

  25. Drewes PG, Yanagisawa H, Starcher B et al (2007) Pelvic organ prolapse in fibulin-5 knockout mice: pregnancy-induced changes in elastic fiber homeostasis in mouse vagina. Am J Pathol 170(2):578–589

    Article  PubMed  CAS  Google Scholar 

  26. Rahn DD, Ruff MD, Brown SA, Tibbals HF, Word RA (2008) Biomechanical properties of the vaginal wall: effect of pregnancy, elastic fiber deficiency, and pelvic organ prolapse. Am J Obstet Gynecol 198(5):590, e1-6

    Article  PubMed  Google Scholar 

  27. Rahn DD, Acevedo JF, Roshanravan S et al (2009) Failure of pelvic organ support in mice deficient in fibulin-3. Am J Pathol 174(1):206–215

    Article  PubMed  CAS  Google Scholar 

  28. Alarab M, Bortolini MA, Drutz H, Lye S, Shynlova O (2010) LOX family enzymes expression in vaginal tissue of premenopausal women with severe pelvic organ prolapse. Int Urogynecol J Pelvic Floor Dysfunct 21(11):1397–1404

    Article  Google Scholar 

  29. Söderberg MW, Byström B, Kalamajski S, Malmström A, Ekman-Ordeberg G (2009) Gene expressions of small leucine-rich repeat proteoglycans and fibulin-5 are decreased in pelvic organ prolapse. Mol Hum Reprod 15(4):251–257

    Article  PubMed  Google Scholar 

  30. Takacs P, Nassiri M, Viciana A, Candiotti K, Fornoni A, Medina CA (2009) Fibulin-5 expression is decreased in women with anterior vaginal wall prolapse. Int Urogynecol J Pelvic Floor Dysfunct 20(2):207–211

    Article  PubMed  Google Scholar 

  31. Jung HJ, Jeon MJ, Yim GW, Kim SK, Choi JR, Bai SW (2009) Changes in expression of fibulin-5 and lysyl oxidase-like 1 associated with pelvic organ prolapse. Eur J Obstet Gynecol Reprod Biol 145(1):117–122

    Article  PubMed  CAS  Google Scholar 

  32. Ge G, Greenspan DS (2006) Developmental roles of the BMP1/TLD metalloproteinases. Birth Defects Research (Part C) 78:47–68

    Article  CAS  Google Scholar 

  33. Bortolini MAT, Shynlova O, Drutz HP et al (2011) Expression of bone morphogenetic protein-1 in vaginal tissue of women with severe pelvic organ prolapse. Am J Obstet Gynecol 204(6):544, e1-8

    Article  PubMed  CAS  Google Scholar 

  34. Shapiro SD (1998) Matrix metalloproteinase degradation of extracellular matrix: biological consequences. Curr Opin Cell Biol 10:602–608

    Article  PubMed  CAS  Google Scholar 

  35. Gomez DE, Alonso DF, Yoshiji H, Thorgeirsson UP (1997) Tissue inhibitors of metalloproteinases: structure, regulation and biological functions. Eur J Cell Biol 74:111–122

    PubMed  CAS  Google Scholar 

  36. Chen B, Wen Y, Wang H, Polan ML (2003) Differences in estrogen modulation of tissue inhibitor of matrix metalloproteinase-1 and matrix metalloproteinase-1 expression in cultured fibroblasts from continent and incontinent women. Am J Obstet Gynecol 189:59–65

    Article  PubMed  CAS  Google Scholar 

  37. Strinic T, Vulic M, Tomic S, Capkun V, Stipic I, Alujevic I (2009) Matrix metalloproteinases -1, -2 expression in uterosacral ligaments from women with pelvic organ prolapse. Maturitas 64:132–135

    Article  PubMed  CAS  Google Scholar 

  38. Gabriel B, Watermann D, Hancke K et al (2006) Increased expression of matrix metalloproteinase 2 in uterosacral ligaments is associated with pelvic organ prolapse. Int Urogynecol J Pelvic Floor Dysfunct 17(5):478–482

    Article  PubMed  Google Scholar 

  39. Alarab M, Shynlova O, Drutz H, Lye S (2008) Extracellular matrix remodeling is increased in vaginal tissue of premenopausal patients with pelvic organ prolapse. Reprod Sci 15(1S):311A

    Google Scholar 

  40. Paul L (1989) Alpha1-antitrypsin deficiency. Pulm Crit Care Update 5:2–8

    Google Scholar 

  41. Kawabata K, Hagio T, Matsuoka S (2002) The role of neutrophil elastase in acute lung injury. Eur J Pharmacol 451:1–10

    Article  PubMed  CAS  Google Scholar 

  42. Chen BH, Wen Y, Li H, Polan ML (2002) Collagen metabolism and turnover in women with stress urinary incontinence and pelvic prolapse. Int Urogynecol J Pelvic Floor Dysfunct 13(2):80–87

    Article  PubMed  CAS  Google Scholar 

  43. Chen B, Wen Y, Polan ML (2004) Elastolytic activity in women with stress urinary incontinence and pelvic organ prolapse. Neurourol Urodyn 23(2):119–126

    Article  PubMed  Google Scholar 

  44. Goepel C, Johanna Kantelhardt E, Karbe I, Stoerer S, Dittmer J (2011) Changes of glycoprotein and collagen immunolocalization in the uterine artery wall of postmenopausal women with and without pelvic organ prolapse. Acta Histochem 113(3):375–381

    Article  PubMed  CAS  Google Scholar 

  45. Jaenisch R, Bird A (2003) Epigenetic regulation of gene expression: how the genome integrates intrinsic and environmental signals. Nat Genet 33 Suppl:245–254

    Article  PubMed  Google Scholar 

  46. Leung AK, Sharp PA (2010) MicroRNA functions in stress responses. Mol Cell 22(40(2)):205–215

    Article  Google Scholar 

  47. Rahn DD, Acevedo JF, Word RA (2008) Effect of vaginal distention on elastic fiber synthesis and matrix degradation in the vaginal wall: potential role in the pathogenesis of pelvic organ prolapse. Am J Physiol Regul Integr Comp Physiol 295:R1351–R1358

    Article  PubMed  CAS  Google Scholar 

  48. Chen B, Wen Y, Zhang Z, Wang H, Warrington JA, Polan ML (2003) Menstrual phase-dependent gene expression differences in periurethral vaginal tissue from women with stress incontinence. Am J Obstet Gynecol 189(1):89–97

    Article  PubMed  Google Scholar 

  49. Jackson S, James M, Abrams P (2002) The effect of oestradiol on vaginal collagen metabolism in postmenopausal women with genuine stress incontinence. BJOG 109(3):339–344

    Article  PubMed  CAS  Google Scholar 

  50. Bortolini MAT, Shynlova O, Oleksiv N, Drutz HP, Lye S, Alarab M (2010) Expression of enzymes regulating extracellular matrix biogenesis in vaginal tissue of women with and without pelvic organ prolapse. Reprod Sci 17(Suppl 3):158A

    Google Scholar 

  51. Rizk DEE, Fahim MA (2008) Ageing of the female pelvic floor: towards treatment a la carte of the “geripause”. Urogynecol J Pelvic Floor Dysfunct 19:455–458

    Article  Google Scholar 

  52. Holliday R (2006) Epigenetics: a historical overview. Epigenetics 1(2):76–80

    Article  PubMed  Google Scholar 

  53. Klutke J, Stanczyk FZ, Ji Q, Campeau JD, Klutke CG (2010) Suppression of lysyl oxidase gene expression by methylation in pelvic organ prolapse. Int Urogynecol J Pelvic Floor Dysfunct 21(7):869–872

    Article  Google Scholar 

  54. Hundley AF, Yuan L, Visco AG (2008) Gene expression in the rectus abdominus muscle of patients with and without pelvic organ prolapse. Am J Obstet Gynecol 198(2):220, e1-7

    Article  PubMed  Google Scholar 

  55. Edwall L, Carlström K, Fianu Jonasson A (2008) Markers of collagen synthesis and degradation in urogenital tissue and serum from women with and without uterovaginal prolapse. Mol Hum Reprod 14(3):193–197

    Article  PubMed  CAS  Google Scholar 

  56. Knuuti E, Kauppila S, Kotila V, Risteli J, Nissi R (2011) Genitourinary prolapse and joint hypermobility are associated with altered type I and III collagen metabolism. Arch Gynecol Obstet 283(5):1081–1085

    Article  PubMed  CAS  Google Scholar 

  57. Hendrix SL, Clark A, Nygaard I, Aragaki A, Barnabei V, McTiernan A (2002) Pelvic organ prolapse in the Women’s Health Initiative: gravity and gravidity. Am J Obstet Gynecol 186:1160–1166

    Article  PubMed  Google Scholar 

  58. Rizk DE, Czechowski J, Ekelund L (2004) Dynamic assessment of pelvic floor and bony pelvis morphologic condition with the use of magnetic resonance imaging in a multi-ethnic, nulliparous, and healthy female population. Am J Obstet Gynecol 191:83–89

    Article  PubMed  Google Scholar 

  59. Jack GS, Nikolova G, Vilain E, Raz S, Rodríguez LV (2006) Familial transmission of genitovaginal prolapse. Int Urogynecol J Pelvic Floor Dysfunct 17(5):498–501

    Article  PubMed  Google Scholar 

  60. Miedel A, Tegerstedt G, Maehle-Schmidt M, Nyrén O, Hammarström M (2009) Nonobstetric risk factors for symptomatic pelvic organ prolapse. Obstet Gynecol 113(5):1089–1097

    PubMed  Google Scholar 

  61. Norton P, Milsom I (2010) Genetics and the lower urinary tract. Neurourol Urodyn 29:609–611

    Article  PubMed  Google Scholar 

  62. Altman D, Forsman M, Falconer C, Lichtenstein P (2008) Genetic influence on stress urinary incontinence and pelvic organ prolapse. Eur Urol 54(4):918–922

    Article  PubMed  Google Scholar 

  63. Norton PA, Baker JE, Sharp HC, Warenski JC (1995) Genitourinary prolapse and joint hypermobility in women. Obstet Gynecol 85(2):225–228

    Article  PubMed  CAS  Google Scholar 

  64. Sayer TR, Dixon JS, Hosker GL, Warrel DW (1990) A study of paraurethral connective tissue in women with stress incontinence of urine. Neurourol Urodyn 9:319–320

    Article  Google Scholar 

  65. Carley ME, Schaffer J (2000) Urinary incontinence and pelvic organ prolapse in women with Marfan or Ehlers Danlos syndrome. Am J Obstet Gynecol 182(5):1021–1023

    Article  PubMed  CAS  Google Scholar 

  66. Dietz HP, Eldridge A, Grace M, Clarke B (2004) Pelvic organ descent in young nulligravid women. Am J Obstet Gynecol 191(1):95–99

    Article  PubMed  CAS  Google Scholar 

  67. Dietz HP, Hansell NK, Grace ME, Eldridge AM, Clarke B, Martin NG (2005) Bladder neck mobility is a heritable trait. BJOG 112(3):334–339

    Article  PubMed  CAS  Google Scholar 

  68. Hansell NK, Dietz HP, Treloar SA, Clarke B, Martin NG (2004) Genetic covariation of pelvic organ and elbow mobility in twins and their sisters. Twin Res 7(3):254–260

    Article  PubMed  Google Scholar 

  69. Cooper DN, Smith BA, Cooke HJ, Niemann S, Schmidtke J (1985) An estimate of unique DNA sequence heterozygosity in the human genome. Hum Genet 69:201–205

    Article  PubMed  CAS  Google Scholar 

  70. Shastry BS (2002) SNP alleles in human disease and evolution. J Hum Genet 47:561–566

    Article  PubMed  CAS  Google Scholar 

  71. Brookes AJ (1999) The essence of SNPs. Gene 234:177–186

    Article  PubMed  CAS  Google Scholar 

  72. Collins FS, Guyer MS, Charkravarti A (1997) Variations on a theme: cataloging human DNA sequence variation. Science 278:1580–1581

    Article  PubMed  CAS  Google Scholar 

  73. Lohrer HD, Tangen U (2000) Investigations into the molecular effects of single nucleotide polymorphism. Pathobiology 68:283–290

    Article  PubMed  CAS  Google Scholar 

  74. Kwok PY, Chen X (2003) Detection of single nucleotide polymorphisms. Curr Issues Mol Biol 5:43–60

    PubMed  CAS  Google Scholar 

  75. Skorupski P, Miotła P, Jankiewicz K, Rechberger T (2007) Polymorphism of the gene encoding alpha-1 chain of collagen type I and a risk of pelvic organ prolapse—a preliminary study. Ginekol Pol 78(11):852–855

    PubMed  Google Scholar 

  76. Rodrigues AM, Girão MJ, da Silva ID, Sartori MG, Martins KdeF, Castro RdeA (2008) COL1A1 Sp1-binding site polymorphism as a risk factor for genital prolapse. Int Urogynecol J Pelvic Floor Dysfunct 19(11):1471–5

    Article  PubMed  Google Scholar 

  77. Martins K, Fonseca A, Castro R et al (2010) Collagen type III alpha 1 polymorphism as a risk factor for genital prolapse. Int Urogynecol J Pelvic Floor Dysfunct 21(Suppl 1):S380

    Google Scholar 

  78. Jeon MJ, Chung SM, Choi JR, Jung HJ, Kim SK, Bai SW (2009) The relationship between COL3A1 exon 31 polymorphism and pelvic organ prolapse. J Urol 181(3):1213–1216

    Article  PubMed  Google Scholar 

  79. Chou HT, Hung JS, Chen YT, Wu JY, Tsai FJ (2004) Association between COL3A1 collagen gene exon 31 polymorphism and risk of floppy mitral valve/mitral valve prolapse. Int J Cardiol 95:299

    Article  PubMed  Google Scholar 

  80. Kluivers KB, Dijkstra JR, Hendriks JC, Lince SL, Vierhout ME, van Kempen LC (2009) COL3A1 2209G>A is a predictor of pelvic organ prolapse. Int Urogynecol J Pelvic Floor Dysfunct 20(9):1113–1118

    Article  PubMed  Google Scholar 

  81. Chen HY, Chung YW, Lin WY, Wang JC, Tsai FJ, Tsai CH (2008) Collagen type 3 alpha 1 polymorphism and risk of pelvic organ prolapse. Int J Gynaecol Obstet 103(1):55–58

    Article  PubMed  CAS  Google Scholar 

  82. Ferrell G, Lu M, Stoddard P et al (2009) A single nucleotide polymorphism in the promoter of the LOXL1 gene and its relationship to pelvic organ prolapse and preterm premature rupture of membranes. Reprod Sci 16(5):438–446

    Article  PubMed  CAS  Google Scholar 

  83. Nikolova G, Lee H, Berkovitz S et al (2007) Sequence variation in laminin gamma 1 (LAMC1) gene associated with familial pelvic organ prolapse. Human Genet 120:847–856

    Article  CAS  Google Scholar 

  84. Chen C, Hill LD, Schubert CM, Strauss JF 3rd, Matthews CA (2010) Is laminin gamma-1 a candidate gene for advanced pelvic organ prolapse? Am J Obstet Gynecol 202(5):505, e1-5

    Article  PubMed  Google Scholar 

  85. Skorupski P, Miotła P, Jankiewicz K, Rechberger T (2010) MMP-1 and MMP-3 gene encoding polymorphism and the risk of the development of pelvic organ prolapse and stress urinary incontinence. Ginekol Pol 81(8):594–599

    PubMed  Google Scholar 

  86. Chen HY, Lin WY, Chen YH, Chen WC, Tsai FJ, Tsai CH (2010) Matrix metalloproteinase-9 polymorphism and risk of pelvic organ prolapse in Taiwanese women. Eur J Obstet Gynecol Reprod Biol 149(2):222–224

    Article  PubMed  CAS  Google Scholar 

  87. Gibbs JR, Singleton A (2006) Application of genome-wide single nucleotide polymorphism typing: simple association and beyond. PLoS Genet 2(10):e150

    Article  PubMed  Google Scholar 

  88. Hirschhorn JN (2005) Genetic approaches to studying common diseases and complex traits. Pediatr Res 57(5 Pt 2):74R–77R

    Article  PubMed  Google Scholar 

  89. Allen-Brady K, Norton P, Farnsworth A et al (2009) Significance linkage evidence for a predisposition gene for pelvic floor disorders on chromosome 9q2. Am J Hum Genet 84:678–682

    Article  PubMed  CAS  Google Scholar 

  90. Roberts R, Wells GA, Stewart AFR, Dandona S, Chen L (2010) The genome-wide association study—a new era for common polygenic disorders. J Cardiovasc Trans Res 3:173–182

    Article  Google Scholar 

  91. Freedman ML, Reich D, Penney KL, McDonald GJ, Mignault AA et al (2004) Assessing the impact of population stratification on genetic association studies. Nat Genet 36:388–393

    Article  PubMed  CAS  Google Scholar 

  92. Bortolini MAT, Shynlova O, Oleksiv N et al (2010) Expression of genes regulating the smooth muscle contraction in the vaginal tissue of women with and without pelvic organ prolapse. Int Urogynecol J Pelvic Floor Dysfunct 21(Suppl 1):S128

    Google Scholar 

  93. 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(4):944–952

    Article  PubMed  CAS  Google Scholar 

  94. Hundley AF, Yuan L, Visco AG (2006) Skeletal muscle heavy-chain polypeptide 3 and myosin binding protein H in the pubococcygeus muscle in patients with and without pelvic organ prolapse. Am J Obstet Gynecol 194(5):1404–1410

    Article  PubMed  CAS  Google Scholar 

  95. Tseng LH, Chen I, Lin YH, Chen MY, Lo TS, Lee CL (2010) Genome-based expression profiles study for the pathogenesis of pelvic organ prolapse: an array of 33 genes model. Int Urogynecol J Pelvic Floor Dysfunct 21(1):79–84

    Article  Google Scholar 

  96. Chen HY, Chung YW, Lin WY, Chen WC, Tsai FJ, Tsai CH (2008) Estrogen receptor alpha polymorphism is associated with pelvic organ prolapse risk. Int Urogynecol J Pelvic Floor Dysfunct 19(8):1159–1163

    Article  PubMed  Google Scholar 

  97. Chen HY, Chung YW, Lin WY, Chen WC, Tsai FJ, Tsai CH (2009) Progesterone receptor polymorphism is associated with pelvic organ prolapse risk. Acta Obstet Gynecol Scand 88(7):835–838

    Article  PubMed  CAS  Google Scholar 

Download references

Conflicts of interest

None.

Author information

Authors and Affiliations

  1. Division of Urogynecology and Reconstructive Pelvic Surgery, Department of Gynecology, Federal University of São Paulo, Borges Lagoa, 783 Cj. 31, 04038-031, São Paulo, SP, Brazil

    Maria Augusta Tezelli Bortolini

  2. Department of Obstetrics and Gynecology, Faculty of Medicine, Ain Shams University, Cairo, Egypt

    Diaa E. E. Rizk

Authors
  1. Maria Augusta Tezelli Bortolini
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Diaa E. E. Rizk
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Maria Augusta Tezelli Bortolini.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Bortolini, M.A.T., Rizk, D.E.E. Genetics of pelvic organ prolapse: crossing the bridge between bench and bedside in urogynecologic research. Int Urogynecol J 22, 1211–1219 (2011). https://doi.org/10.1007/s00192-011-1502-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00192-011-1502-4

Keywords

Search

Navigation