Backgeound: Biological basis of prolapse development and recurrence are still unclear. Aim of this observational and prospective study is to correlate clinical stage of anterior vaginal wall prolapse and anatomical recurrence to histological and metabolic characteristics of vaginal tissue. Methods: Patients undergoing surgery were divided into two groups according to anterior stage ≤II (group A) and ≥III (group B). Full-thickness excisional biopsies of the anterior vaginal wall were obtained after hysterectomy. Hystological characteristics and metalloproteinases activity (MMP-2) were analyzed. Results: Sixty-nine patients (35 group A; 34 group B) completed evaluation. Mean follow-up was 35 months. Collagen amount and organization were significantly higher in group B both in lamina propria and fascia specimens, but MMP-2 activity was significantly lower in this group. Recurrence rate of anterior compartment was 10.1%. Collagen cellularity of fascia was higher in recurrence groups. On the contrary MMP-2 activity showed a close to significant correlation to surgical success (P=0.07). Conclusions: Patients with advanced stages of prolapse have increased collagen amount associated to decreased MMP-2 activity. This suggests that connective tissue is more abundant but less metabolically active in patients with severe prolapse. A similar trend can be found in recurrences.

Manodoro, S., Spelzini, F., Cesana, M., Frigerio, M., Maggioni, D., Ceresa, C., et al. (2017). Histologic and metabolic assessment in a cohort of patients with genital prolapse: Preoperative stage and recurrence investigations. MINERVA GINECOLOGICA, 69(3), 233-238 [10.23736/S0026-4784.16.03977-0].

Histologic and metabolic assessment in a cohort of patients with genital prolapse: Preoperative stage and recurrence investigations

Manodoro, S
;
Cesana, M;Frigerio, M;Maggioni, D;Ceresa, C;Penati, C;Sicuri, M;Fruscio, R;Nicolini, G;Milani, R
2017

Abstract

Backgeound: Biological basis of prolapse development and recurrence are still unclear. Aim of this observational and prospective study is to correlate clinical stage of anterior vaginal wall prolapse and anatomical recurrence to histological and metabolic characteristics of vaginal tissue. Methods: Patients undergoing surgery were divided into two groups according to anterior stage ≤II (group A) and ≥III (group B). Full-thickness excisional biopsies of the anterior vaginal wall were obtained after hysterectomy. Hystological characteristics and metalloproteinases activity (MMP-2) were analyzed. Results: Sixty-nine patients (35 group A; 34 group B) completed evaluation. Mean follow-up was 35 months. Collagen amount and organization were significantly higher in group B both in lamina propria and fascia specimens, but MMP-2 activity was significantly lower in this group. Recurrence rate of anterior compartment was 10.1%. Collagen cellularity of fascia was higher in recurrence groups. On the contrary MMP-2 activity showed a close to significant correlation to surgical success (P=0.07). Conclusions: Patients with advanced stages of prolapse have increased collagen amount associated to decreased MMP-2 activity. This suggests that connective tissue is more abundant but less metabolically active in patients with severe prolapse. A similar trend can be found in recurrences.
Articolo in rivista - Articolo scientifico
Histology; Matrix metalloproteinases; Operative; Pelvic organ prolapse; Surgical procedures;
English
21-set-2016
2017
69
3
233
238
none
Manodoro, S., Spelzini, F., Cesana, M., Frigerio, M., Maggioni, D., Ceresa, C., et al. (2017). Histologic and metabolic assessment in a cohort of patients with genital prolapse: Preoperative stage and recurrence investigations. MINERVA GINECOLOGICA, 69(3), 233-238 [10.23736/S0026-4784.16.03977-0].
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10281/133891
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