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01-12-2014 | Original Article

Changes in elastin density in different locations of the vaginal wall in women with pelvic organ prolapse

Authors: Laurent de Landsheere, Silvia Blacher, Carine Munaut, Betty Nusgens, Chrystèle Rubod, Agnès Noel, Jean-Michel Foidart, Michel Cosson, Michelle Nisolle

Published in: International Urogynecology Journal | Issue 12/2014

Abstract

Introduction and hypothesis

The purpose of this study was to analyze the histomorphometric properties of the vaginal wall in women with pelvic organ prolapse (POP).

Methods

In 15 women undergoing surgery for POP, full-thickness biopsies were collected at two different sites of location from the anterior and/or posterior vaginal wall. Properties of the precervical area (POP-Q point C/D) were compared with the most distal portion of the vaginal wall (POP-Q point Ba/Bp) using histological staining and immunohistochemistry. The densities of total collagen fibers, elastic fibers, smooth muscle cells, and blood vessels were determined by combining high-resolution virtual imaging and computer-assisted digital image analysis.

Results

The mean elastin density was significantly decreased in the lamina propria and muscularis layer of the vaginal wall from the most distal portion of the prolapsed vaginal wall compared with the precervical area. This difference was statistically significant in the lamina propria for both anterior (8.4 ± 1.2 and 12.1 ± 2.0, p = 0.048) and posterior (6.8 ± 0.5 and 10.1 ± 1.4, p = 0.040) locations, and in the muscularis for the anterior (5.2 ± 0.4 and 8.4 ± 1.2, p = 0.009) vaginal wall. There were no statistically significant differences in the mean densities of collagen fibers, smooth muscle cells or blood vessels between the two locations.

Conclusions

In this study, we observed changes in elastin density in two different locations of the vaginal wall from women with POP. The histomorphometric properties of the vaginal wall can be variable from one place to another in the same patient. This result supports the existence of most vulnerable locations within the vaginal wall and the potential benefit of site-specific prolapse surgery.

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Title: Changes in elastin density in different locations of the vaginal wall in women with pelvic organ prolapse
Authors: Laurent de Landsheere
Silvia Blacher
Carine Munaut
Betty Nusgens
Chrystèle Rubod
Agnès Noel
Jean-Michel Foidart
Michel Cosson
Michelle Nisolle
Publication date: 01-12-2014
Publisher: Springer London
Published in: International Urogynecology Journal / Issue 12/2014
Print ISSN: 0937-3462
Electronic ISSN: 1433-3023
DOI: https://doi.org/10.1007/s00192-014-2431-9

ACC 2024 Congress

Springer Medicine

Changes in elastin density in different locations of the vaginal wall in women with pelvic organ prolapse

Abstract

Introduction and hypothesis

Methods

Results

Conclusions

ACC 2024 Congress

Springer Medicine

Abstract

Introduction and hypothesis

Methods

Results

Conclusions

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