title: Genitourinary prolapse and joint hypermobility are associated with altered type I and III collagen metabolism.
abstract: OBJECTIVE
  The aim of this study was to determine whether benign joint hypermobility (BJH) is associated with urogenital prolapse and altered collagen metabolism.
  
  
  METHODS
  43 postmenopausal women with previous vaginal hysterectomy operated due to genitourinary prolapse were recruited. Each patient was also evaluated for joint hypermobility. The collagen metabolism was studied measuring serum concentrations of type I and III procollagen aminoterminal propeptides and trivalently cross-linked carboxyterminal telopeptide of type I collagen.
  
  
  RESULTS
  Clinical joint hypermobility was found in 35% patients. Women with joint hypermobility had higher concentration of aminoterminal propeptide for type I procollagen and the values were statistically significant (P < 0.0178). Recurrent prolapse was found in 47% of the patients with BJH as compared to non-hypermobile group (25%). In this subgroup the results were statistically significant (P < 0.0085) for type III collagen. Also, the mean serum concentration for type III procollagen was significantly increased above the reference limit.
  
  
  CONCLUSIONS
  Women with joint hypermobility have more recurrent genital prolapse as compared to women with normal joint mobility. Plain hypermobility was associated with higher concentrations for type I procollagen. Patients with recurrent prolapse and joint hypermobility have significantly high concentrations for type III procollagen.
authors.affiliation: Department of Obstetrics and Gynecology, Länsi-Pohja Central Hospital, Kemi, Finland.
authors.forename: E
authors.initials: E
authors.lastname: Knuuti
authors.forename: S
authors.initials: S
authors.lastname: Kauppila
authors.forename: V
authors.initials: V
authors.lastname: Kotila
authors.forename: J
authors.initials: J
authors.lastname: Risteli
authors.forename: Ritva
authors.initials: R
authors.lastname: Nissi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D024042:Collagen Type I / Q000378:metabolism*; D024061:Collagen Type III / Q000378:metabolism*; D005260:Female; D005387:Finland / Q000453:epidemiology; D006801:Humans; D007593:Joint Instability / Q000150:complications* / Q000453:epidemiology / Q000378:metabolism; D007596:Joints / Q000502:physiology*; D008875:Middle Aged; D056887:Pelvic Organ Prolapse / Q000150:complications* / Q000453:epidemiology / Q000378:metabolism; D012008:Recurrence
chemical_list: D024042:Collagen Type I; D024061:Collagen Type III