Collagen content of nonsupport tissue in pelvic organ prolapse and stress urinary incontinence

Wong, Margaret Wan Nar; Harmanli, Oz; Agar, Mehmet; Dandolu, Vani; Grody, Marvin H. Terry

doi:10.1016/j.ajog.2003.09.043

Cited by 85 publications

(44 citation statements)

References 9 publications

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“…Pudendal nerve damage mostly occurs after forceps delivery, increased duration of second stage of labor, third-degree perineal tear and high birth weight [8] . Reduced collagen content of the pelvic floor tissue causing pelvic floor dysfunction in patients with pelvic organ prolapse and/or SUI has been demonstrated before [9] . Similarly, defects in the support of the anterior pelvic compartment result in a number of anatomic and physiologic problems such as SUI in women [10] .…”

Section: Pelvic Floor Problems/dysfunction and Suimentioning

confidence: 99%

Pharmacologic Targets on the Female Urethra

Canda

Çınar²,

Turna

et al. 2008

Urol Int

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Introduction: This article reviews the mechanisms affecting contraction and relaxation of the urethra in order to establish a basis for current and future treatments for urinary incontinence in women. Material and Methods: A review of the English literature using MEDLINE was performed between 1970 and 2008 on female urethra pharmacology, urinary incontinence, and mechanisms involved in contraction and relaxation of the female human urethra. Results: α-Adrenoceptors (ARs) cause contraction and β-ARs cause relaxation. Use of selective α-agonist and β-AR blocker agents might have potential for the treatment of stress urinary incontinence. Tolerable doses of cholinergic agonists did not have significant effects on intraurethral pressure. Nitric oxide seems to be the major nonadrenergic-noncholinergic inhibitory transmitter causing relaxation. c-kit-positive interstitial cells seem to regulate urethral tone. The roles of adenosine triphosphate and carbon monoxide have not been fully investigated in humans. Neuropeptides function similarly to the urinary bladder. Prostanoids cause urethral contraction and relaxation depending on their subtypes. Serotonin enhances the strength of urethral sphincteric contractions. The Rho-kinase pathway also appears to be modulating smooth muscle contraction in the urethra. Conclusions: Understanding of the urethral function and pharmacology may lead to the development of promising new agents which might be useful in the management of urinary incontinence in women.

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Section: Pelvic Floor Problems/dysfunction and Suimentioning

confidence: 99%

Pharmacologic Targets on the Female Urethra

Canda

Çınar²,

Turna

et al. 2008

Urol Int

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“…Wong et al, 52 used hydroxyproline assays and found that in women with prolapse, there was significantly reduced collagen content (P = 0.01) in the cervix compared to women without prolapse. However, the cervix is a nonsupporting tissue and is not susceptible to the ECM changes induced by prolapse.…”

Section: Regulators Of Collagenmentioning

confidence: 99%

Recent studies of genetic dysfunction in pelvic organ prolapse: The role of collagen defects

Lim

Khoo

Wong

et al. 2014

Aust NZ J Obst Gynaeco

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Gynaecologists are becoming increasingly aware that women with a family history of prolapse are at an increased risk of prolapse refractory to treatment. In the past five years, several genetic mutations have been shown to correlate with increased prolapse susceptibility. These mutations can result in disordered collagen metabolism, which weaken the fascial support of the pelvic organs. This review examines the contemporary evidence regarding the role of collagen in prolapse.

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“…Recent studies indicate that there are altered histomorphological features in patients with pelvic floor disorders such as prolapsed vaginas and incontinence and that these features are accompanied by changes in the ratio of collagen subtypes and in elastic fiber homeostasis (3)(4)(5)(6)(7)(8). Fewer studies have examined the changes in biomechanical properties associated with the physiologic events of pregnancy and parturition or the pathologic events of prolapse.…”

Section: Introductionmentioning

confidence: 99%

Biomechanical properties of the vaginal wall: effect of pregnancy, elastic fiber deficiency, and pelvic organ prolapse

Rahn

Ruff

Brown

et al. 2008

American Journal of Obstetrics and Gynecology

122

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Objectives-To identify pregnancy-induced changes in biomechanical properties of the vaginal wall and compare these with Fibulin-5 knockout mice (Fbln5 -/-) with and without prolapse.Study Design-Mid-vaginal segments of nonpregnant and late-pregnant wild type (WT), Fbln5 -/-with prolapse, and Fbln5 -/-mice without prolapse were studied. Tissue length at failure, maximal strain, maximal stress, and tissue stiffness were determined.Results-Compared with nonpregnant mice, vaginas of pregnant and Fbln5 -/-(with prolapse) mice exhibited decreased maximal stress, increased distensibility and strain, and decreased stiffness. Tissues from Fbln5 -/-mice without prolapse were similar to nonpregnant WT animals.Conclusions-Pregnancy confers remarkable changes in the vaginal wall including increased distensibility and decreased stiffness and maximal stress. Elastinopathy alone is insufficient to cause significant changes in these properties, but prolapse confers additional alterations in distensibility and stiffness similar to those observed in pregnancy. These changes may contribute to the poor durability of many restorative surgical procedures for prolapse.

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Collagen content of nonsupport tissue in pelvic organ prolapse and stress urinary incontinence

Cited by 85 publications

References 9 publications

Pharmacologic Targets on the Female Urethra

Pharmacologic Targets on the Female Urethra

Recent studies of genetic dysfunction in pelvic organ prolapse: The role of collagen defects

Biomechanical properties of the vaginal wall: effect of pregnancy, elastic fiber deficiency, and pelvic organ prolapse

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