Analysis of Collagen in Parametrium and Vaginal Apex of Women with and without Uterine Prolapse

Takano, Cláudia Cristina; Sartori, Marair Grácio Ferreira; Castro, Rodrigo Aquino; Arruda, R. P.; Es, Mahgoub; Baracat, Edmund Chada; Lima, Geraldo Rodrigues de

doi:10.1007/s001920200076

Cited by 61 publications

(29 citation statements)

References 15 publications

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“…One study reported that collagen content was similar between prolapse patients and controls at the vaginal apex but was lower in the parametrial tissue [19]. The resiliency of the apical support structures such as the uterosacral ligaments has also been found to be significantly reduced among women with symptomatic uterovaginal prolapse [20].…”

Section: Discussionmentioning

confidence: 99%

Anterior vaginal wall length and degree of anterior compartment prolapse seen on dynamic MRI

et al. 2007

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The objective of the study was to determine the relationship between midsagittal vaginal wall geometric parameters and the degree of anterior vaginal prolapse. We have previously presented data indicating that about half of anterior wall descent can be explained by the degree of apical descent present (Summers et al., Am J Obstet Gynecol, 194:1438−1443, 2006. This led us to examine whether other midsagittal vaginal geometric parameters are associated with anterior wall descent. Magnetic resonance (MR) scans of 145 women from the prior study were suitable for analysis after eight were excluded because of inadequate visibility of the anterior vaginal wall. Subjects had been selected from a study of pelvic organ prolapse that included women with and without prolapse. All patients underwent supine dynamic MR scans in the midsagittal plane. Anterior vaginal wall length, location of distal vaginal wall point, and the area under the midsagittal profile of the anterior vaginal wall were measured during maximal Valsalva. A linear regression model was used to examine how much of the variance in cystocele size could be explained by these vaginal parameters. When both apical descent and vaginal length were considered in the linear regression model, 77% (R 2 =0.77, p<0.001) of the variation in anterior wall descent was explained. Distal vaginal point and a measure anterior wall shape, the area under the profile of the anterior vaginal wall, added little to the model. Increasing vaginal length was positively correlated with greater degrees of anterior vaginal prolapse during maximal Valsalva (R 2 =0.30, p<0.01) determining 30% of the variation in anterior wall decent. Greater degrees of anterior vaginal prolapse are associated with a longer vaginal wall. Linear regression modeling suggests that 77% of anterior wall descent can be explained by apical descent and midsagittal anterior vaginal wall length.

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Section: Discussionmentioning

confidence: 99%

Anterior vaginal wall length and degree of anterior compartment prolapse seen on dynamic MRI

et al. 2007

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“…Contrasting with the above studies, Takano et al did not find any significant difference between the POP and control groups [14]. By using a Picrosirius polarization method, Borges et al observed a molecular disorganization and fragmentation of the collagen fibers in the lamina propria of women with POP [15].…”

Section: Collagenmentioning

confidence: 87%

“…Several studies have analyzed changes in the vaginal connective tissue of patients with and without POP by histology [12][13][14][15][16][17][18][19] using various methods and stainings to assess changes in collagen content in the vaginal wall. The results of these studies are described in Table 1.…”

Section: Collagenmentioning

confidence: 99%

Histology of the vaginal wall in women with pelvic organ prolapse: a literature review

et al. 2013

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Introduction and hypothesis The pathophysiology of pelvic organ prolapse (POP) is incompletely understood. The purpose of this study is to describe the current knowledge about histology of the vaginal wall and its possible involvement in the pathogenesis of pelvic organ prolapse. Methods Eligible studies were selected through a MEDLINE search covering January 1986 to December 2012. The research was limited to English-language publications. Results Investigations of changes in the vaginal tissue that occur in women with genital prolapse are currently still limited and produced contrary results. The heterogeneity of the patients and the control groups in terms of age, parity and hormonal status, of the localization of biopsies and the histological methods as well as the lack of validation of the quantification procedures do not allow clear and definitive conclusions to be drawn. Conclusions This review shows that current knowledge of the histological changes observed in women with POP are inconclusive and relatively limited. More studies are needed in this specific field to better understand the mechanisms that lead to POP.

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“…Ocorre a formação de fibras menos elásticas que suportam menos tensão e estiramento [14][15][16][17][18] . Contudo, a real importância dos demais constituintes da matriz extracelular ainda está por ser esclarecida.…”

Section: Discussionunclassified

Avaliação dos glicosaminoglicanos do tecido periuretral de pacientes com e sem prolapso genital

Feldner

Kobayashi²,

Sartori³

et al. 2008

Rev. Assoc. Med. Bras.

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CorrespondênciaRua dos Otonis, 601 -Vila Clementino -São Paulo -SP Cep 04025-001 Tel/Fax: (11)5084-2514 pfeldner@alfa.epm.br RESUMO OBJETIVOS. Caracterizar e quantificar os subtipos de glicosaminoglicanos sulfatados (GAGs) existentes no tecido peri-uretral de pacientes com e sem prolapso genital. METODOS. Foram incluídas 35 pacientes que se submeteram a cirurgia vaginal para correção de distopias genitais e/ou incontinência urinária de esforço ou por outra condição benigna. As pacientes foram avaliadas por anamnese padronizada, exame físico e urodinâmico e agrupadas segundo a existência do prolapso genital. Durante o procedimento cirúrgico, amostras de aproximadamente 1,0 x 1,0 cm do tecido periuretral foram retiradas para avaliação. Os GAGs foram extraídos do tecido por proteólise e precipitação por ácido tricloroacético e caracterizados por eletroforese em gel de agarose. A quantificação foi feita por meio de densitometria a 525 nm do gel corado com azul de toluidina. Compararam-se os dados pela análise de variância (ANOVA). RESULTADOS. Nos grupos estudados, houve maior predomínio de dermatam sulfato (DS), em torno de 85% do total de GAGs, seguido do condroitim sulfato (CS) e do heparam sulfato (HS). Observou-se aumento significativo dos GAGs totais, do DS e do HS em mulheres com prolapso genital. Não se observou diferença significante com relação ao CS. CONCLUSÃO. Este estudo demonstrou diferenças na matriz extracelular do tecido periuretral com aumento de GAGs totais, DS e HS nas mulheres com prolapso genital.UNITERMOS: Prolapso uterino. Glicosaminoglicanas. Bioquímica. Matriz celular. . Resulta do deslocamento das vísceras pélvicas no sentido caudal, em direção ao hiato genital decorrente do desequilíbrio entre as forças encarregadas de manter os órgãos pélvicos em sua posição normal, e aquelas que tendem a expeli-los para fora da pelve. Dentre as diversas teorias, sabe-se que a fisiopatologia do prolapso genital envolve fundamentalmente defeitos nos tecidos de suporte. Esta frouxidão poderia ser causada por defeito intrínseco dos tecidos constituintes das estruturas de suporte, como ligamentos, fáscias e músculos 3,4 . A integridade das estruturas de sustentação depende da composição e arranjo do tecido conjuntivo. Desta forma, o espaço extracelular, freqüentemente preenchido por componentes fibroconjuntivos denominados de matriz extracelular, é de importância fundamental para a função dos tecidos. A matriz extracelular é constituída, em proporções variáveis, por colágeno, fibras elásticas, proteoglicanos, glicosaminoglicanos e elementos celulares, que se organizam formando uma rede, em parte responsável pela grande diversidade morfológica e funcional 5,6 . Os múltiplos componentes da matriz dividem-se em dois tipos: 1) moléculas protéicas alongadas que se unem formando estruturas fibrilares, como o colágeno e a elastina; 2) estruturas não fibrilares que podem ter dois subtipos, a saber: a) glicoproteínas alongadas como a fibronectina e a laminina; b) glicosaminoglicanos e proteoglicanos. O colágeno e a el...

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Analysis of Collagen in Parametrium and Vaginal Apex of Women with and without Uterine Prolapse

Cited by 61 publications

References 15 publications

Anterior vaginal wall length and degree of anterior compartment prolapse seen on dynamic MRI

Anterior vaginal wall length and degree of anterior compartment prolapse seen on dynamic MRI

Histology of the vaginal wall in women with pelvic organ prolapse: a literature review

Avaliação dos glicosaminoglicanos do tecido periuretral de pacientes com e sem prolapso genital

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