Objective To compare tissue markers of collagen metabolism in the uterosacral ligaments with those in vaginal tissue in women with uterine prolapse.Design Prospective observational experimental study.Setting A tertiary urogynaecology unit.Population Women referred for hysterectomy for prolapse or benign gynaecological disease.Methods Matrix metalloproteinase (MMP)‐2 and ‐9 expression, tissue inhibitors of metalloproteinase (TIMP)‐2 expression and hydroxyproline content were measured in the uterosacral ligaments and vaginal tissue from 14 women with prolapse compared with 14 controls.Main outcome measures Levels of MMP, TIMP and hydroxyproline in the uterosacral ligaments and vaginal tissue of women with prolapse and controls.Results Fourteen women with prolapse and 14 women without prolapse (controls) were included. A significant increase in pro MMP‐2 expression was seen in vaginal tissue from women with prolapse (P < 0.05) but not activated MMP‐2, MMP‐9 and TIMP‐2. For uterosacral ligaments, the differences were not statistically significant. No significant difference in hydroxyproline content was found between control and prolapse in either tissue. Significant correlations exist in expression of pro‐MMP‐2, activated MMP‐2, MMP‐9 and TIMP‐2 in vaginal tissue with that in uterosacral ligaments.Conclusions Correlations existed between markers of collagen metabolism in the vaginal and uterosacral tissues. This suggests vaginal tissue reflects the endopelvic fascia. The changes which are more pronounced in vaginal tissue may be as a result of prolapse rather than cause.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.