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Different stages of pelvic prolapse: morphologic and biochemical analysis of anterior vaginal wall

Italian Journal of Anatomy and Embryology
Publication Date
  • Pelvic Prolapse
  • Collagen
  • Morphology
  • Metalloproteinase
  • Anterior Vaginal Wall
  • Biology
  • Chemistry
  • Ecology
  • Medicine


IJAE Vol. 115, n. 1/2 (Supplement), 2010 125 Different stages of pelvic prolapse: morphologic and biochemical analysis of anterior vaginal wall Gabriella Nicolini1, Daniele Maggioni1, Federico Spelzini2, Stefano Manodoro2, Cecilia Ceresa1, Paola Marmiroli1 1 Dipartimento di Neuroscienze e Tecnologie Biomediche, Università degli Studi di Milano-Bicocca, Italy 2 Clinica Ostetrica e Ginecologica, Az. Osp. San Gerardo Monza, Università degli Studi di Milano-Bicocca, Italy Collagen is ubiquitous in the human body and it is the main component of con- nective tissue. Collagen is also the principal component of endopelvic fascia and it is involved in the physiopathology of female organ prolapse (POP). The role of collagen in the physiopathology of POP has been studied with conflicting results, being difficult to distinguish the cause from the effect and to standardize the samples. The turnover of connective tissue in the vaginal wall is an important process both in healthy women and in women with prolapse. MMP-1, MMP-8 and MMP-13 specifically cleave native triple collagen (I, II, III) helix, yelding two fragments. These fragments are subject to gelatinase (MMP-2 and MMP-9) degradation. MMP-2 and MMP-9 activity, may be regulated at dif- ferent levels (trascriptional and activation level) influencing the amount of collagen. Aim of this study is to find a correlation between staging of anterior vaginal wall prolapse and morphologic and biochemical (MMP-2 and MMP-9 amount) features of anterior vaginal wall. Anterior vaginal wall full thickness biopsies (eightyfive patients) including endopel- vic fascia have been collected during surgical procedures. Recurrence or vault prolapse have been ruled out. POP samples have been classified according to POP-Quantification and they have been divided in three groups: group A (controls), group B (I and II stage prolapse) and group C (III and IV stage prolapse). Each sample has been processed for both microscopic and zymography analysis.

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