Neuromuscular morphometry of the uterine ligaments and vaginal wall in women with pelvic organ prolapse.
OBJECTIVE
The aim of this study was to compare neuromuscular histomorphometry of the uterine ligaments and vaginal wall in women with and without pelvic organ prolapse.


METHODS
Biopsies were obtained from the round, uterosacral, and cardinal ligaments of the uterus and apical vaginal wall of women having pelvic organ prolapse repaired (stage ≥ II; prolapse group, 37) and the same location in patients with no prolapse (stage < II; control group, 47). Routine hematoxylin-eosin (H & E) staining and immunohistochemical staining for Protein Gene Product 9.5 (PGP 9.5) and smooth muscle α-actin were performed for all specimens.


RESULTS
Smooth muscle percentage of the uterosacral and cardinal ligaments were not significantly different in women with prolapse than in women without. In round ligament, mean smooth muscle percentage was lower than in women with normal support (81.63 ± 8.2 vs. 51.63 ± 16, P=0.000). Mean distance of the smooth muscle fibers from surface epithelium of the vaginal epithelium of the women with prolapse were significantly higher than the control group (1.679 ± 0.34 vs. 2.240 ± 0.33, P = 0.000). PGP 9.5 stained area percentage of uterine ligaments and vaginal wall tissue samples were significantly lower in women with prolapse.


CONCLUSIONS
Both total innervation of the anterior vaginal epithelium and uterine ligaments, and muscular percentage of the round ligament and vaginal wall were decreased in women with pelvic organ prolapse.
Department of Obstetric & Gynecology, Trakya University Medical Faculty, Edirne, Turkey. petekkaplan@hotmail.com
Petek Balkanli
PB
Kaplan
Ufuk
U
Usta
Hasan Ali
HA
Inal
Ebru
E
Tastekin
Tugba
T
Tastekin
Burcu
B
Tokuc
D000199:Actins / Q000378:metabolism; D000328:Adult; D001706:Biopsy; D005260:Female; D006801:Humans; D008022:Ligaments / Q000473:pathology; D008875:Middle Aged; D009130:Muscle, Smooth / Q000378:metabolism / Q000473:pathology*; D056887:Pelvic Organ Prolapse / Q000378:metabolism / Q000473:pathology*; D012404:Round Ligament of Uterus / Q000378:metabolism / Q000473:pathology*; D043222:Ubiquitin Thiolesterase / Q000378:metabolism; D014599:Uterus / Q000378:metabolism / Q000473:pathology*; D014621:Vagina / Q000378:metabolism / Q000473:pathology*
D000199:Actins; C482860:UCHL1 protein, human; D043222:Ubiquitin Thiolesterase