Biomechanical Properties of Vaginal Tissue in Women with Pelvic Organ Prolapse

Abstract

Background/Aims: To compare biomechanical properties of vaginal tissues between women with and without pelvic organ prolapse (POP) and investigate factors that may influence these properties. Methods: Forty patients submitted to POP surgery and 15 non-POP cadavers were evaluated. The tissue was excised from anterior and posterior middle third vagina. The biomechanical properties considered were stiffness (E) and maximum stress (S_max), and they were evaluated by means of uniaxial tension tests. Results: POP patients were associated with higher values of E (13.1 ± 0.8 vs. 9.5 ± 0.7 MPa; p < 0.001) and S_max (5.3 ± 0.5 vs. 3.2 ± 0.9 MPa; p < 0.001) in the anterior vaginal wall compared to the posterior wall. In contrast, non-POP women presented lower values of E (6.9 ± 1.1 vs. 10.5 ± 1.0 MPa; p = 0.01) and S_max (2.6 ± 0.4 vs. 3.5 ± 0.4 MPa; p = 0.043) in the anterior wall. The occurrence of POP was the only independent predictor of higher values of E and S_max in anterior vaginal samples (p = 0.003 and p = 0.008, respectively). Women with severe anterior vaginal prolapse presented higher levels of E and S_max in the anterior sample compared to those with lower POP stages (p = 0.001 and p = 0.01; respectively). Conclusion: Women with POP present significant changes of biomechanical properties in the vagina.

Primary Vulvo-Vaginal Cancers: Trends in Incidence and Mortality in Poland (1999-2012)

“…However, proven risk factors of vaginal cancer are as follows: low socioeconomic status, abnormal cervical smear, chronic vaginitis, HPV infection and exposure to radiation (especially if it occurs before 45 years of age). Pelvic organ prolapse as a result of changes in vaginal biomedical properties can also increase the risk of vaginal cancer [9,10]. Pessaries, the second most common treatment chosen by women with pelvic organ prolapse, can be responsible for chronic vaginitis, a proven risk factor of vaginal cancer [11].…”

Does Uterine Prolapse Alter Endometrial Cyclooxygenase 2 Expression and Promote the Development of Premalignant Lesions?

“…A postmenopausal estrogen decline is a strong etiological factor for the development of a pelvic organ prolapse [1,2,3]. Certain conditions such as endometrial hyperplasia are known to be associated with estrogen levels and endometrial cancer risk.…”

“…Advanced age, vaginal birth of a large baby, postmenopausal estrogen decline, previous hysterectomy, biomechanical properties and tissue composition of the vaginal wall, or pelvic prolapse surgery are all strong etiological factors for the development of severe pelvic organ prolapse [1,2,3,4]. …”

Value of Clinical and Laboratory Inflammation Factors in the Postoperative Period after Laparoscopic Urogynecological Surgery

“…This retrospective study included 287 patients who had undergone laparoscopic surgery for vaginal vault prolapse [12] in the gynecological clinic of a Dormagen hospital within a 4-year period. In cases where there was a remaining uterus and when family planning had been completed, a laparoscopic supracervical hysterectomy (LASH) was carried out in addition to prolapse correction (n = 171).…”