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

Bakas, Panagiotis; Liapis, Angelos; Salamalekis, E.; Pafiti, Agathi; Creatsas, G.

doi:10.1159/000076014

Cited by 7 publications

(3 citation statements)

References 14 publications

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“…It has been reported that the total collagen content of vaginal fascia in patients with SUI is severely compromised due to a decrease in the amount of collagen fibers I and III. 29 Our results of Sirius red staining showed that collagen fiber I was significantly decreased and collagen fiber III decreased slightly in vaginal tissue of VD+OVX group and OVX group. At the same time, the ratio of collagen fiber I/III decreased significantly, which led to the thinning of collagen fiber and the decrease of tension ability, which was consistent with the previous study.…”

Section: Discussionmentioning

confidence: 68%

Establishment of Rat Model of Female Genital Sexual Arousal Disorder

et al. 2022

Sexual Medicine

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Introduction Female Genital Sexual Arousal Disorder (FGSAD) seriously affects women's quality of life and Sexual life, but it still lacks ideal FGSAD animal models for further study. Aim To establish a specific model of female genital sexual arousal disorder and explore the mechanisms resulting in FGSAD. Methods After delivery, female rats were guided by expansions of the vagina and ovariectomy (VD+OVX, n = 10); in VD group female rats were just extended by the vagina (VD, n = 10), in OVX group female rats were treated with ovariectomy (OVX, n = 10);the remaining had 1 longitudinal incision as sham group(n = 10). Outcomes Vaginal dilatation combined with ovariectomy in rats may reflect female genital sexual arousal disorder with high reproducibility and stability. Results Vaginal tissue of female rats in OVX group and VD+OVX group showed an increase in blood flow, decrease in muscle content compared to the sham group. The proportion of collagen fiber I/III decreased and the elastic fiber showed significant rupture and fragmentation; Structural reticular integrity was also significantly separated and broken from the muscle fibers. However, there was no significant difference in vaginal blood flow, fibers and vascular between VD group and Sham group. The damage of vaginal tissue in VD+OVX group was more significant than that in OVX and VD groups. Clinical Translation We have constructed a specific animal model that can provide clinical insights into the mechanism of FGSAD and serves as a good avenue for further research of its treatment. Strengths and Limitations Vaginal dilatation combined with ovariectomy in rats is a specific animal model with high reproducibility and stability, but we do acknowledge the shortcomings and limitation present in our study. Since genital arousal disorder has many different etiologies that impact the vagina, the clitoris and surrounding tissues, there is no “gold standard” model that different models attempt to investigate different etiologies. Conclusion The female genital sexual arousal disorder model established by vaginal dilatation combined with ovariectomy is a novel rat model with simple induction conditions, which pathogenic mechanism of female genital sexual arousal disorders maybe connected with the change of VEGF and MMP-9 in vaginal fibromuscular system and microvascular.

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Section: Discussionmentioning

confidence: 68%

Establishment of Rat Model of Female Genital Sexual Arousal Disorder

et al. 2022

Sexual Medicine

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“…A weak endopelvic fascia, that stretched over time, causing urodynamic stress incontinence due to urethral hypermobility, might stretch and become lax again after shortening, regardless of the method of shortening. Whilst a small study showed lack of re-stretching at 6 weeks [24], no longterm evaluation is available.…”

Section: Discussionmentioning

confidence: 99%

Radiofrequency remodelling of the endopelvic fascia is not an effective procedure for urodynamic stress incontinence in women

Ismail

2008

Int Urogynecol J

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The aim of this study was to assess the efficacy and safety of transvaginal radiofrequency remodelling of the endopelvic fascia as a primary procedure for urodynamic stress incontinence due to urethral hypermobility in women. It included 24 patients who had the procedure at two district general hospitals. Outcome measures included the pad test, urodynamic assessment, continence diary, pain scores and operative as well as post-operative complications and assessment was made on recruitment during hospital admission and at 3, 6 and 12 months follow-up. A rising failure rate was noted as early as 3 months, leading to a cumulative cure rate of 45.8% at 12 months follow-up. This low effectiveness could be attributed to inherent weakness of the endopelvic fascia. No major complications were encountered and pain scores were mild.

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“…Aucune étude pour l'heure n'a trouvé de liens significatifs entre l'efficacité de la chirurgie et la qualité du tissu conjonctif de soutien, même si le rôle capital du fascia dans la genèse de l'IUE est parfaitement admis [34,35]. …”

Section: Influence De La Qualité Du Fascia Pubocervicalunclassified