Analysis of collagen status in premenopausal nulliparous women with genuine stress incontinence

Keane, Declan; Sims, T. J.; Abrams, Paul; Bailey, Allen J.

doi:10.1111/j.1471-0528.1997.tb12055.x

Cited by 182 publications

(81 citation statements)

References 24 publications

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“…Norton et al [30] have demonstrated that joint hypermobility is a marker for collagen type and also for stress incontinence. Keane et al [19] and Jackson et al [31] have shown changes in collagen status in connective tissue analyzed from women with stress incontinence and urogenital prolapse, respectively. Collagen type is important in tensile strength and supportive tissue elasticity.…”

Section: Ultrasound Variables Ultrasound Variablesmentioning

confidence: 99%

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The effect of mode of delivery on pelvic floor functional anatomy

et al. 2007

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The objective of this study is to investigate and compare the effects of different modes of delivery on urethral sphincter volume, bladder neck mobility, and changes to levator hiatus distensibility using ultrasound imaging. This study is a prospective observational cohort study. The setting of this study is at a London teaching hospital. The population is composed of 156 women recruited in their first ongoing pregnancy. Primigravid women were recruited between 32 weeks and term. Antenatal ultrasound measurements of levator hiatus and bladder neck mobility were assessed at rest, maximum strain, and maximum valsalva using transvaginal ultrasound imaging. Urethral sphincter volume was calculated using a three-dimensional transvaginal probe. The investigations were repeated at 6 weeks and at 6 months postpartum. Total urethral sphincter volume, rhabdosphincter volume, bladder neck position at rest, and rotational mobility from maximum contraction to maximum valsalva were measured in this study. Levator hiatus area at rest and levator hiatus on valsalva and squeeze were also measured. The 156 women underwent antenatal ultrasound pelvic floor assessment. One hundred ten (71%) completed the 6-month follow-up. There were no differences in the urethral sphincter volume between the different modes of delivery. Overall, the urethral sphincter was smaller after delivery compared to the third trimester. Vaginal delivery was associated with a significantly larger levator hiatus area on valsalva antenatally and at rest, squeeze, and valsalva postnatally compared to caesarean section. Antenatal and postpartum bladder neck mobility was also significantly greater in the women who delivered vaginally. Urethral sphincter changes postpartum are independent of mode of delivery. Vaginal delivery is strongly associated with a larger, more distensible levator hiatus and a greater degree of bladder neck mobility both antenatally and postpartum.

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Section: Ultrasound Variables Ultrasound Variablesmentioning

confidence: 99%

“…Keane studied premenopausal nulliparous women with stress incontinence [19]. These women had a reduction in mature collagen, with reduced cross-linking between strands compared to continent controls.…”

Section: Introductionmentioning

confidence: 99%

The effect of mode of delivery on pelvic floor functional anatomy

et al. 2007

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“…Connective tissue studies in women suffering from SUI support the view of connective tissue defects. Keane et al [5] found reduced periurethral collagen content. Rechberger et al [6] found diminished content of collagen in the pubocervical fascia.…”

Section: Introductionmentioning

confidence: 99%

“…Rechberger et al [6] found diminished content of collagen in the pubocervical fascia. Findings of collagen defects in women suffering from SUI [5,6] appear to explain why, in many instances, biomaterials, and especially the patientÕs own fascia, provide insufficient support for the urethra.…”

Section: Introductionmentioning

confidence: 99%

A randomized comparison between monofilament and multifilament tapes for stress incontinence surgery

Rechberger

Rzeźniczuk

Skorupski

et al. 2003

International Urogynecology Journal and Pelvic Floor Dysfunctio

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Our objective was to compare monofilament and multifilament tapes positioned without tension at the midurethra for postoperative complications and cure rate. One hundred patients with stress urinary incontinence were randomly allocated into two study groups. Using identical surgical methodology, 50 patients had a monofilament tape inserted at the midurethra using the TVT delivery instrument, and another 50 a multifilament tape using the IVS delivery instrument. The only significant difference between the groups was in the incidence of postoperative urinary retention ( p=0.023). Ten patients from the monofilament group required longer than normal ('normal' means to the morning of the next day) catheterization, in contrast to only two from the multifilament group. The clinical efficacy of both procedures was equally high. Conclusions were that both tapes appear to be equally effective in the surgical treatment of SUI. The higher incidence of postoperative urinary retention in the monofilament group was most likely caused by the elastic feature of this tape.

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“…Extracellular matrix of the connective tissue is comprised of collagen and elastin fibers, glycoproteins, and proteoglycans, among which collagen fibers are the main component. A series of studies have found a significant reduction in the collagen content in the endopelvic fascia of patients with SUI [4,[7][8][9]. A reduced quantity of collagen in the connective tissue leads to a poor quality of fascia with reduced tensile strength; therefore, impairs the functional relation between fascia and muscles and causes weakness of the muscular support.…”

Section: Discussionmentioning

confidence: 99%

Changes of collagen type III and decorin in paraurethral connective tissue from women with stress urinary incontinence and prolapse

Song

Xiao

et al. 2007

Int Urogynecol J

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Thirteen premenopausal women with stress urinary incontinence (SUI), 6 with SUI and prolapse, 9 with prolapse, and 19 without prolapse were enrolled to observe the content change of collagen type III and the expression of decorin mRNA in paraurethral connective tissues. Collagen type III from transvaginal biopsies was assayed by immunohistochemical staining and decorin mRNA was detected by real-time PCR. Premenopausal women with SUI had a significantly decreased level of collagen type III. Decorin mRNA expression was significantly increased in both premenopausal SUI+prolapse group and premenopausal prolapse group reflected by the decrease of DeltaCt value compared to their corresponding controls. The results suggest that a high level of decorin mRNA might be associated with the reduced content of collagen type III, resulting in a less flexible form of extracellular matrix in the connective tissue in SUI and prolapse patients.

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Analysis of collagen status in premenopausal nulliparous women with genuine stress incontinence

Cited by 182 publications

References 24 publications

The effect of mode of delivery on pelvic floor functional anatomy

The effect of mode of delivery on pelvic floor functional anatomy

A randomized comparison between monofilament and multifilament tapes for stress incontinence surgery

Changes of collagen type III and decorin in paraurethral connective tissue from women with stress urinary incontinence and prolapse

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