Τομέας Υγείας - Μητέρας - ΠαιδιούLibrary of the School of Health Sciences
Λιάπης Άγγελος, Καθηγητής, Ιατρική, ΕΚΠΑ
Μπότσης Δημήτριος, Καθηγητής, Ιατρική, ΕΚΠΑ
Βασιλείου Ιωάννης, Καθηγητής, Ιατρική, ΕΚΠΑ
Δεληγεώρογλου Ευθύμιος, Καθηγητής, Ιατρική, ΕΚΠΑ
Βάκας Παναγιώτης, Αναπλ. Καθηγητής, Ιατρική, ΕΚΠΑ
Μπάκα Σταυρούλα-Γεωργία, Αναπλ. Καθηγήτρια, Ιατρική, ΕΚΠΑ
Λαμπρινουδάκη Ειρήνη, Αναπλ. Καθηγήτρια, Ιατρική, ΕΚΠΑ
Ανίχνευση ορμονικών υποδοχέων, κολλαγόνων και μεταλλοπρωτεϊνασών σε μετεμμηνοπαυσιακές γυναίκες με ακράτεια ούρων και χαλάρωση του πυελικού εδάφους.
Density of gonadal steroid receptors, collagen and matrix metalloproteinases in postmenopausal women diagnosed with urinary incontinence and pelvic organ prolapse.
Introduction: Pelvic organ prolapse is a common gynecological problem among postmenopausal women. This condition is often associated with urinary incontinence and causes not only health but quality of life issues as well. The aim of the research protocol in which this study was based was to investigate the potential effect of alterations in the expression of collagen types I, III, matrix metalloproteinases (MMPs) -1, -2, -9, estrogen (ERα and ERβ) and progesterone (PR) receptors of the pubocervical fascia on the pathophysiology of pelvic organ prolapse (POP) and urodynamic stress urinary incontinence (USUI) after menopause.
Materials and methods: This was a prospective clinicopathological study based on immunohistochemical methods. Forty samples were obtained from postmenopausal women with synchronous POP and USUI (Group A), forty specimens were collected from postmenopausal patients with POP only (Group B), while forty postmenopausal women without POP or USUI who underwent gynecological surgery for another benign indication formed control group (Group C). Immunohistochemistry for collagen types I, III, MMPs -1, -2, -9, ERα, ERβ and PR receptors in surgical specimens of vaginal walls and pubocervical fascia of the study group patients was performed on formaline fixed and paraffin embedded sections.
Results: There were no statistically significant differences among the three groups in terms of age, parity, or body mass index. Collagen type III as well as ERβ receptors lwere found significantly reduced among samples of Group A. Collagen type I and ER-α receptors levels were significantly reduced in Group B when compared to the control Group, while further reduction was observed in Group A. MMPs expression was significantly increased among patients with pelvic organ prolapse, in comparison with the control Group. The higher levels of MMPs expression were observed in Group A. Finally, the expression of PR receptors was similar among the three study groups.
Conclusions: It seems that lower expression of collagen type III and ER-β in the vaginal wall and around the urethra of postmenopausal women with POP is potentially involved in the pathophysiological pathways of USUI. In addition, alterations in connective tissue such as decrease of collagen type I, ΕR-α and increase of the expression of MMP -1, -2, -9 may play an important role on the pathophysiology of both POP and USUI.
Main subject category:
Urinary incontinence, Pelvic organ prolapse, Menopause, Collagen, Metalloproteinases
Grigoriadis Charalampos PhD.pdf
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