Features of connective tissue structure of ligaments of the uterus in female genital prolapse

Cover Page


Cite item

Full Text

Abstract

Aim. To study the features of collagen I and III deposition and elastin in uterosacral ligaments and round ligaments of uterus in females with genital prolapse.

Methods. The study was performed on surgical specimens and biopsies of uterosacral ligaments and round ligaments of uterus of 15 females with genital prolapse and 15 females without prolapse who also underwent metrectomy using abdominal access. Four tissue specimens were obtained from every patient, biopsy material was fixed in 10% neutral formalin and were embedded in paraffin, and cut for the paraffin slices of 4 μm. Specimens were stained by haematoxylin and eosine, Van Gieson’s picro-fuchsin stain and Weigert’s Resorcin-Fuchsin stain, immunohistochemistry (immunoperoxidase reactions) with primary antibodies to collagen I and III and elastin were also performed.

Results. Morphologic study of the ligaments of the uterus in females with genital prolapse revealed fibrosis and fragmentation of elastin, diffuse atrophy, hyaline or mucinous degeneration of smooth muscle and extracellular matrix edema. Connective tissue disarrangement at genital prolapse was seen as decreased expression of collagen type I and elastin. Decreased elasticity determined over-stretching of uterosacral ligaments and round ligaments of uterus, which decreased microcirculation and promoted the ischemia of ligaments of uterus connective tissue. Disproportion of connective tissue proteins expression was enhanced by imbalance of collagen I and III, with the last, which is the least strong, prevailing. Stereotypic changes in the ligaments of uterus structures, seen as misallocation and placing of collagen and elastin fibers and, consequently, loosening of the elastic and collagen fibers, were revealed in patients with genital prolapse.

Conclusion. Revealed features of collagen I and III and elastin deposition in uterosacral ligaments and round ligaments of uterus in females of reproductive age with genital prolapse allow predicting the risk for development and relapses of genital prolapse.

About the authors

M L Khanzadyan

Peoples’ Friendship University of Russia, Moscow, Russia

Author for correspondence.
Email: khmala@rambler.ru

T A Demura

I.M. Sechenov First Moscow State Medical University, Moscow, Russia

Email: khmala@rambler.ru

References

  1. Буянова С.Н., Щукина Н.А., Журавлёва А.С. Эффективность использования сетчатых протезов при осложнённых формах пролапса гениталий // Рос. вестн. акушера-гинеколога. - 2009. - Т. 9, №1. - С. 76-81.
  2. Кадурина Т.И., Горбунова В.Н. Дисплазия соединительной ткани. - СПб., 2009. - 701 с.
  3. Коган Е.А., Игнатова В.Е., Рухадзе Т.Н. и др. Роль ростовых факторов в развитии разных гистологических типов лейомиомы матки // Арх. патол. - 2005. - Т. 67, №3. - С. 34-38.
  4. Радзинский В.Е. Перинеология. - М.: РУДН, 2010. - 372 с.
  5. Смольнова Т.Ю., Савельев С.В., Титченко Л.И. и др. Пролапс гениталий - следствие травматичных родов или генерализованной дисплазии соединительной ткани? // Акушер. и гинекол. - 2001. - №4. - С. 50-53.
  6. Ящук А.Г. Медико-генетическое прогнозирование десценции тазового дна у женщин Уральского региона // Казанский мед. ж. - 2008. - Т. 89, №2. - С. 169-173.
  7. Bakas P., Liapis A., Salamalekis E. et al. Tension-free vaginal tape efficacy in relation to quantity of pubocervical fascia // Gynecol. Obstet. Invest. - 2004. - Vol. 3. - P. 149-152. http://dx.doi.org/10.1159/000076014
  8. Campeau L., Gorbachinsky I., Badlani G.H., Anders-son K.E. Pelvic floor disorders: linking genetic risk factors to biochemical changes // BJU Int. - 2011. - Vol. 108, N 8. - P. 1240-1247. http://dx.doi.org/10.1111/j.1464-410X.2011.10385.x
  9. Fedchenko N., Reifenrath J. Different approaches for interpretation and reporting of immunohistochemistry analysis results in the bone tissue - a review // Diagn. Pathol. - 2014. - Vol. 9. - P. 221. http://dx.doi.org/10.1186/s13000-014-0221-9
  10. Jeon M.J., Chung S.M., Choi J.R. et al. The relationship between COL3A1 exon 31 polymorphism and pelvic organ prolapse // J. Urol. - 2009. - Vol. 181, N 3. - P. 1213-1216. http://dx.doi.org/10.1016/j.juro.2008.11.027
  11. Karam J.A., Vazquez D.V., Lin V.K., Zimmern P.E. Elastin expression and elastic fibre width in the anterior vaginal wall of postmenopausal women with and without prolapse // BJU Int. - 2007. - Vol. 100, N 2. - P. 346-350. http://dx.doi.org/10.1111/j.1464-410X.2007.06998.x
  12. Liu X., Zhao Y., Pawlyk B. et al. Failure of elastic fiber homeostasis leads to pelvic floor disorders // J. Pathol. - 2006. - Vol. 168, N 2. - P. 519-528. http://dx.doi.org/10.2353/ajpath.2006.050399
  13. Sze H.M., Sherard G.B., Dolezal J.M. Pregnancy, labor, delivery, and pelvic organ prolapsed // Obstet. Gynecol. - 2002. - Vol. 100. - P. 981-986. http://dx.doi.org/10.1016/S0029-7844(02)02246-9
  14. Yucel N., Usta A., Guzin K. et al. Immunohistochemical analysis of connective tissue in patients with pelvic organ prolapsed // J. Mol. Histol. - 2013. - Vol. 44, N 1. - P. 97-102. http://dx.doi.org/10.1007/s10735-012-9456-5
  15. Yu H.Y., Yang X., Li G.H. Prospective study of the impact on lower urinary tract symptoms after pelvic organ prolapse surgery // Zhonghua fu chan ke za zhi. - 2011. - Vol. 46, N 8. - P. 570-573.

Supplementary files

Supplementary Files
Action
1. JATS XML
Download

© 2015 Khanzadyan M.L., Demura T.A.

Creative Commons License

This work is licensed
under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.




This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies