title: Analysis of collagen status in premenopausal nulliparous women with genuine stress incontinence.
abstract: OBJECTIVE
  To determine if differences exist in the collagen status of premenopausal nulliparous women with genuine stress incontinence compared with continent controls.
  
  
  METHODS
  Thirty-six premenopausal nulliparous women with urodynamically-proven genuine stress incontinence were compared with 25 controls. All the women studied had a periurethral vaginal biopsy taken of approximately 30-50 mg in wet weight. This biopsy was then analysed to determine the collagen content, the type I:III collagen ratio and the collagen cross-link content.
  
  
  METHODS
  A tertiary referral urodynamic unit.
  
  
  RESULTS
  The nulliparous women with genuine stress incontinence had significantly less collagen in their tissues (P < 0.0001) compared with the continent controls. In addition, there was a decreased ratio of type I to type III collagen (P = 0.0008), and the cross-link content was also significantly reduced in the women with genuine stress incontinence (P < 0.0001).
  
  
  CONCLUSIONS
  Genuine stress incontinence is present in a significant number of women before childbirth. The aetiology of their incontinence appears to be due to a defect in their connective tissue, with both a quantitative and qualitative reduction in their collagen.
authors.affiliation: Bristol Urological Institute, Southmead Hospital, UK.
authors.forename: D P
authors.initials: DP
authors.lastname: Keane
authors.forename: T J
authors.initials: TJ
authors.lastname: Sims
authors.forename: P
authors.initials: P
authors.lastname: Abrams
authors.forename: A J
authors.initials: AJ
authors.lastname: Bailey
mesh_terms: D000293:Adolescent; D000328:Adult; D015992:Body Mass Index; D003094:Collagen / Q000378:metabolism*; D005260:Female; D006801:Humans; D008875:Middle Aged; D010298:Parity; D017697:Premenopause / Q000378:metabolism*; D014550:Urinary Incontinence, Stress / Q000378:metabolism*
chemical_list: D003094:Collagen