The effect of genital and lower urinary tract symptoms on steroid receptor expression in women with genital prolapse.
OBJECTIVE
This study evaluates the expression of estrogen receptor (ER) isoforms alpha (α) and beta (β) and progesterone receptor (PR) in vaginal and periurethral tissue in women with genital prolapse in relation to genital and lower urinary tract symptoms (LUTS).


METHODS
Forty-seven postmenopausal women without systemic estrogen therapy underwent pelvic organ prolapse quantification and urodynamic assessment. LUTS were evaluated by CATI questionnaire. Biopsies from vaginal and periurethral tissue were obtained during prolapse surgery. The steroid receptor gene expression was measured by RT-PCR.


RESULTS
The expression of PR in periurethral and ER β in vaginal tissue varied with prolapse extent. Nulliparous women showed a significantly higher expression of PR in periurethral tissue. Women with a positive stress test and those with overactive bladder symptoms showed a significantly lower amount of PR in vaginal tissue.


CONCLUSIONS
Changes in PR expression in vaginal or periurethral tissue might be a marker of structural and endocrine changes.
Department of Obstetrics and Gynecology, University Medical Center, Johannes Gutenberg-University Mainz, Langenbeckstrasse 1, 55131, Mainz, Germany. skala@uni-mainz.de
Christine Elisabeth
CE
Skala
Ilka Brigitte
IB
Petry
Stefan
S
Albrich
Alexander
A
Puhl
Gert
G
Naumann
Heinz
H
Koelbl
D000368:Aged; D000369:Aged, 80 and over; D047628:Estrogen Receptor alpha / Q000235:genetics / Q000378:metabolism*; D047629:Estrogen Receptor beta / Q000235:genetics / Q000378:metabolism*; D005260:Female; D058869:Gynecological Examination; D006801:Humans; D008875:Middle Aged; D053158:Nocturia / Q000150:complications / Q000378:metabolism; D010298:Parity; D056887:Pelvic Organ Prolapse / Q000150:complications / Q000378:metabolism* / Q000473:pathology; D011312:Pressure; D012333:RNA, Messenger / Q000378:metabolism*; D011980:Receptors, Progesterone / Q000235:genetics / Q000378:metabolism*; D011795:Surveys and Questionnaires; D014521:Urethra / Q000378:metabolism* / Q000503:physiopathology; D053201:Urinary Bladder, Overactive / Q000150:complications / Q000378:metabolism; D014550:Urinary Incontinence, Stress / Q000150:complications / Q000378:metabolism; D053202:Urinary Incontinence, Urge / Q000150:complications / Q000378:metabolism; D014563:Urodynamics; D014621:Vagina / Q000378:metabolism*
D047628:Estrogen Receptor alpha; D047629:Estrogen Receptor beta; D012333:RNA, Messenger; D011980:Receptors, Progesterone