Role of fascial collagen in stress urinary incontinence

Rechberger, Tomasz; Postawski, Krzysztof; Jakowicki, J; Gunja‐Smith, Zeenat; Woessner, Jeff

doi:10.1016/s0002-9378(98)70017-1

Cited by 87 publications

(61 citation statements)

References 18 publications

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“…13,14 This has been shown to be associated with race, age, sex, air temperature, and even deformation of the tissue when applying the probe. 13,[15][16][17][18][19][20][21] The results of this patient and sampling variability include fluctuations in absolute emission intensity, emission peak shifts, and changes in the scattering and absorption properties of the tissue, among other effects.…”

Section: Introductionmentioning

confidence: 99%

Comparative evaluation of differential laser-induced perturbation spectroscopy as a technique to discriminate emerging skin pathology

et al. 2012

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Abstract. Fluorescence spectroscopy has been widely investigated as a technique for identifying pathological tissue; however, unrelated subject-to-subject variations in spectra complicate data analysis and interpretation. We describe and evaluate a new biosensing technique, differential laser-induced perturbation spectroscopy (DLIPS), based on deep ultraviolet (UV) photochemical perturbation in combination with difference spectroscopy. This technique combines sequential fluorescence probing (pre-and post-perturbation) with sub-ablative UV perturbation and difference spectroscopy to provide a new spectral dimension, facilitating two improvements over fluorescence spectroscopy. First, the differential technique eliminates significant variations in absolute fluorescence response within subject populations. Second, UV perturbations alter the extracellular matrix (ECM), directly coupling the DLIPS response to the biological structure. Improved biosensing with DLIPS is demonstrated in vivo in a murine model of chemically induced skin lesion development. Component loading analysis of the data indicates that the DLIPS technique couples to structural proteins in the ECM. Analysis of variance shows that DLIPS has a significant response to emerging pathology as opposed to other population differences. An optimal likelihood ratio classifier for the DLIPS dataset shows that this technique holds promise for improved diagnosis of epithelial pathology.Results further indicate that DLIPS may improve diagnosis of tissue by augmenting fluorescence spectra (i.e. orthogonal sensing).

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Section: Introductionmentioning

confidence: 99%

Comparative evaluation of differential laser-induced perturbation spectroscopy as a technique to discriminate emerging skin pathology

et al. 2012

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“…GSI covers about 60% of these cases [10] and is believed to be caused by inadequate support of the bladder base and bladder neck or insufficiency of the urethral sphincter [4,5]. In addition, adequate function of the pubourethral ligaments, the pubococcygeal muscle and the connective tissue of the suburethral wall (pubocervical fascia) is important for urinary continence in women [5,6].…”

Section: Discussionmentioning

confidence: 99%

“…GSI is believed to be caused by inadequate support of the bladder base and bladder neck or insufficiency of the urethral sphincter [4,5]. In addition, adequate function of the pubourethral ligaments, the pubococcygeal muscle and the connective tissue of the suburethral wall (pubocervical fascia) is important for urinary continence in women [5,6].The main constituent of the connective tissue of the pubocervical fascia is collagen [7]. The quantity and organization of collagen fibers significantly affects the tensile strength of the pubocervical fascia and consequently the support that is provided to the bladder neck and bladder base.…”

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confidence: 99%

Tension-Free Vaginal Tape Efficacy in Relation to Collagen Quantity of Pubocervical Fascia

Bakas

Liapis²,

Salamalekis³

et al. 2004

Gynecol Obstet Invest

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Objective(s): To investigate whether the quantity of collagen types I and III in the pubocervical fascia of women with genuine stress incontinence (GSI) affects the efficacy of the tension-free vaginal tape (TVT) procedure. Methods: Sixty-three patients participated in the study and were divided in 2 groups as follows: 37 patients with GSI and pelvic organ prolapse stage I (group 1), and 26 patients with pelvic organ prolapse stage I but not GSI (control group). Urodynamic studies confirmed the diagnosis of GSI. Biopsies were obtained during surgery from the pubocervical fascia. Results: The quantity of collagen types I and III was statistically significantly reduced in patients with GSI compared to the control group. The efficacy of the TVT procedure in patients with a significant reduction in collagen type I was an 82.1% cure. In patients with a significant reduction in collagen type III, the TVT efficacy was an 85.1% cure. The efficacy of the TVT procedure was not statistically significantly different between patients with GSI and a significant reduction in collagen types I and III, and patients with no reduction in collagen types I and III. Conclusions: The significantly reduced quantity of collagen types I and III in the pubocervical fascia of women with GSI does not affect the efficacy of the TVT procedure at an average of 25 months of follow-up.

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“…However, because there is no cutoff point of MUCP below which GSI develops, it is difficult to determine to what degree damage to the perineal branch of the pudendal nerve could lead to the development of GSI. In addition, changes in the collagen content of the pubocervical fascia that supports the bladder neck appear to have significant importance in the development of GSI [17]. Therefore, GSI seems to be the result of different factors, which may each contribute to a different degree to the development of GSI in each individual.…”

Section: Discussionmentioning

confidence: 99%

Pudendal Nerve Terminal Motor Latency in Women with Genuine Stress Incontinence and Prolapse

Bakas

Liapis

Karandreas

et al. 2001

Gynecol Obstet Invest

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The aim of this study was to investigate changes in pudendal nerve terminal motor latency (PNTML) time in women with genuine stress incontinence (GSI) and with or without prolapse, in conjunction with measurement of maximal urethral closure pressure (MUCP). Eighty-five patients participated in the study and they were allocated to one of four groups, including the control group. A statistically significant difference was found in the PNTML time between patients with GSI and patients of the control group. The conduction time in patients with prolapse but no GSI did not show a statistically significant difference compared to the patients of the control group. The MUCP was reduced in patients with GSI, but no cutoff value of MUCP, which is pathognomonic of GSI, could be identified. We conclude that GSI is associated with a prolongation of PNTML time and a reduction in MUCP.

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Role of fascial collagen in stress urinary incontinence

Cited by 87 publications

References 18 publications

Comparative evaluation of differential laser-induced perturbation spectroscopy as a technique to discriminate emerging skin pathology

Comparative evaluation of differential laser-induced perturbation spectroscopy as a technique to discriminate emerging skin pathology

Tension-Free Vaginal Tape Efficacy in Relation to Collagen Quantity of Pubocervical Fascia

Pudendal Nerve Terminal Motor Latency in Women with Genuine Stress Incontinence and Prolapse

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