title: The role of smooth muscle in the pathogenesis of pelvic organ prolapse--an immunohistochemical and morphometric analysis of the cervical third of the uterosacral ligament.
abstract: The uterosacral ligament (USL) is part of the pelvic floor connecting the uterus to the dorsal body wall and stabilizing it. In samples obtained from hysterectomy patients, the smooth muscle component of the cervical third of the USL was studied by smooth muscle actin (SMA) immunohistochemistry as indicator for structural abnormalities and by morphometric determination of nuclear size as measure for the functional state. From a total of 40 patients, 18 were matched according to age, parity, and premenopausal status. Immunohistochemistry showed a granular patchy distribution of SMA in the pelvic organ prolapse (POP) group. In patients with POP, the size of smooth muscle cell nuclei was significantly reduced in comparison to patients without POP (25.45+/-1.92 microm(2) vs 28.87+/-2.92 microm(2), p<0.05). We conclude that the smooth muscle component of the USL is impaired in POP patients, indicating a possible role of smooth muscle in the pathogenesis of POP.
authors.affiliation: Department of Obstetrics and Gynecology, University of Tuebingen, Calwerstr. 7, 72076 Tuebingen, Germany. christl.reisenauer@med.uni-tuebingen.de
authors.forename: Christl
authors.initials: C
authors.lastname: Reisenauer
authors.forename: Thomas
authors.initials: T
authors.lastname: Shiozawa
authors.forename: Matthias
authors.initials: M
authors.lastname: Oppitz
authors.forename: Christian
authors.initials: C
authors.lastname: Busch
authors.forename: Andreas
authors.initials: A
authors.lastname: Kirschniak
authors.forename: Tanja
authors.initials: T
authors.lastname: Fehm
authors.forename: Ulrich
authors.initials: U
authors.lastname: Drews
mesh_terms: D000199:Actins / Q000378:metabolism*; D000328:Adult; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008022:Ligaments / Q000737:chemistry / Q000473:pathology*; D008875:Middle Aged; D009130:Muscle, Smooth / Q000737:chemistry / Q000473:pathology*; D012447:Sacrum; D014596:Uterine Prolapse / Q000378:metabolism / Q000473:pathology*; D014599:Uterus
chemical_list: D000199:Actins