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The role of smooth muscle in the pathogenesis of pelvic organ prolapse—an immunohistochemical and morphometric analysis of the cervical third of the uterosacral ligament

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Abstract

The uterosacral ligament (USL) is part of the pelvic floor connecting the uterus to the dorsal body wall and stabilizing it. In samples obtained from hysterectomy patients, the smooth muscle component of the cervical third of the USL was studied by smooth muscle actin (SMA) immunohistochemistry as indicator for structural abnormalities and by morphometric determination of nuclear size as measure for the functional state. From a total of 40 patients, 18 were matched according to age, parity, and premenopausal status. Immunohistochemistry showed a granular patchy distribution of SMA in the pelvic organ prolapse (POP) group. In patients with POP, the size of smooth muscle cell nuclei was significantly reduced in comparison to patients without POP (25.45 ± 1.92 μm2 vs 28.87 ± 2.92 μm2, p < 0.05). We conclude that the smooth muscle component of the USL is impaired in POP patients, indicating a possible role of smooth muscle in the pathogenesis of POP.

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Acknowledgements

The authors would like to thank Leokardia Macher and Ingrid Epple for the excellent technical support and Matthias Renz for the nuclear measurements.

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Authors and Affiliations

  1. Institute of Anatomy, Department of Experimental Embryology, University of Tuebingen, Tuebingen, Germany

    Thomas Shiozawa, Matthias Oppitz & Andreas Kirschniak

  2. Department of Obstetrics and Gynecology, University of Tuebingen, Calwerstr. 7, 72076, Tuebingen, Germany

    Christl Reisenauer, Tanja Fehm & Ulrich Drews

  3. Department of Dermatology, Section of Dermatologic Oncology, University of Tuebingen, Tuebingen, Germany

    Christian Busch

  4. Department of General, Visceral and Transplantation Surgery, University of Tuebingen, Tuebingen, Germany

    Andreas Kirschniak

Authors
  1. Christl Reisenauer
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  2. Thomas Shiozawa
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  3. Matthias Oppitz
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  4. Christian Busch
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  5. Andreas Kirschniak
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  7. Ulrich Drews
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Correspondence to Ulrich Drews.

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Christl Reisenauer and Thomas Shiozawa contributed equally to this publication.

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Reisenauer, C., Shiozawa, T., Oppitz, M. et al. The role of smooth muscle in the pathogenesis of pelvic organ prolapse—an immunohistochemical and morphometric analysis of the cervical third of the uterosacral ligament. Int Urogynecol J 19, 383–389 (2008). https://doi.org/10.1007/s00192-007-0447-0

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  • DOI: https://doi.org/10.1007/s00192-007-0447-0

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