title: Changes in the rheological behavior of the vagina in women with pelvic organ prolapse.
abstract: OBJECTIVE
  Pelvic organ prolapse is a common condition impacting the quality of life of millions of women worldwide. Although vaginal estrogen is widely used in women with prolapse, little is known regarding estrogen's benefits on the biomechanical properties of vaginal tissue. Here, we aimed to examine the effect of prolapse on the biomechanical properties of the vagina and determine alterations in vaginal mechanics in the presence and absence of hormone therapy (HT).
  
  
  METHODS
  We characterized the viscoelastic properties of vaginal biopsies from age-matched premenopausal women without (n = 12) and with prolapse (n = 8) and postmenopausal women with prolapse on (n = 18) and off HT (n = 9). Utilizing a single-lap shear testing protocol, full-thickness anterior vaginal biopsies were subjected to ±10% shear strain over a range of frequencies (1-90 Hz). This applied energy is either dissipated (viscous) or stored (elastic) as a function of frequency due to compositional or structural differences in the tissue.
  
  
  RESULTS
  Prolapsed tissue was more stiff (higher complex modulus) under shear deformation resulting from increases in both elastic (elastic modulus) and viscous (loss modulus) contributions, with non-prolapsed premenopausal women being the least stiff. Postmenopausal women with prolapse currently on HT were the most stiff of all the groups.
  
  
  CONCLUSIONS
  These data suggest that prolapsed tissue has an increased elastic contribution likely resulting from changes in biochemical constituents, and hormones increase the viscous contribution of prolapsed tissue. Overall, this study design characterized the viscoelastic properties of vaginal biopsies and may be utilized to conduct longitudinal studies to better understand the mechanisms of prolapse development and progression.
authors.affiliation: Musculoskeletal Research Center, Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA.
authors.forename: Andrew
authors.initials: A
authors.lastname: Feola
authors.forename: Robert
authors.initials: R
authors.lastname: Duerr
authors.forename: Pamela
authors.initials: P
authors.lastname: Moalli
authors.forename: Steven
authors.initials: S
authors.lastname: Abramowitch
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018450:Disease Progression; D055119:Elastic Modulus; D005260:Female; D006801:Humans; D008875:Middle Aged; D056887:Pelvic Organ Prolapse / Q000473:pathology / Q000503:physiopathology*; D012212:Rheology; D014621:Vagina / Q000473:pathology / Q000503:physiopathology*