title: Is There a Relationship Between Pelvic Organ Prolapse and Tissue Fibrillin-1 Levels?
abstract: OBJECTIVE
  Pelvic organ prolapse is a multifactorial disorder in which extracellular matrix defects are implicated. Fibrillin-1 level is reduced in stress urinary incontinence. In Marfan syndrome, which is associated with mutations in Fibrillin-1, pelvic floor disorders are commonly observed. We hypothesize that Fibrillin-1 gene expression is altered in pelvic organ prolapse.
  
  
  METHODS
  Thirty women undergoing colporrhaphy or hysterectomy because of cystocele, rectocele, cystorectocele, or uterine prolapse were assigned to a pelvic prolapse study group, and thirty women undergone hysterectomy for nonpelvic prolapse conditions were assigned to a control group. Real-time polymerase chain reaction was conducted on vaginal tissue samples to measure the expression of Fibrillin-1. Expression levels were compared between study and control groups by Mann-Whitney U test with Bonferroni revision.
  
  
  RESULTS
  Fibrillin-1 gene expression was not significantly lower in the study group than in the control group. Similarly, no significant correlation between Fibrillin-1 levels and grade of pelvic prolapse was found. Age over 40 years (P=0.018) and menopause (P=0.027) were both associated with reduced Fibrillin-1 levels in the pelvic prolapse group, whereas the delivery of babies weighing over 3,500 g at birth was associated with increased Fibrillin-1 expression (P=0.006).
  
  
  CONCLUSIONS
  The results did not indicate a significant reduction in Fibrillin-1 gene expression in pelvic prolapse disorders; however, reduced Fibrillin-1 may contribute to increased pelvic organ prolapse risk with age and menopause. Increased Fibrillin-1 gene expression may be a compensatory mechanism in cases of delivery of babies with high birth weight. Further studies are needed for a better understanding of these observations.
authors.affiliation: Department of Obstetrics and Gynecology, Turgut Ozal University Medical School, Ankara, Turkey.
authors.forename: Ayla
authors.initials: A
authors.lastname: Eser
authors.affiliation: Department of Obstetrics and Gynecology, Etlik Zubeyde Hanim Training and Research Hospital, Ankara, Turkey.
authors.forename: Eylem
authors.initials: E
authors.lastname: Unlubilgin
authors.affiliation: Department of Urology, Dr Abdurrahman Yurtaslan Oncology Training and Research Hospital, Ankara, Turkey.
authors.forename: Fatih
authors.initials: F
authors.lastname: Hizli
authors.affiliation: Department of Medical Genetics, Turgut Ozal University Medical School, Ankara, Turkey.
authors.forename: Muradiye
authors.initials: M
authors.lastname: Acar
authors.affiliation: Department of Obstetrics and Gynecology, Nenehatun Maternity Hospital, Erzurum, Turkey.
authors.forename: Zeynep
authors.initials: Z
authors.lastname: Kamalak
authors.affiliation: Department of Obstetrics and Gynecology, Turgut Ozal University Medical School, Ankara, Turkey.
authors.forename: Aydin
authors.initials: A
authors.lastname: Kosus
authors.affiliation: Department of Obstetrics and Gynecology, Turgut Ozal University Medical School, Ankara, Turkey.
authors.forename: Nermin
authors.initials: N
authors.lastname: Kosus
authors.affiliation: Department of Obstetrics and Gynecology, Turgut Ozal University Medical School, Ankara, Turkey.
authors.forename: Deniz
authors.initials: D
authors.lastname: Hizli
authors.affiliation: Department of Medical Genetics, Turgut Ozal University Medical School, Ankara, Turkey.
authors.forename: Esra
authors.initials: E
authors.lastname: Gunduz
keywords: Extracellular Matrix; Fibrillin; Pelvic Organ Prolapse