Effect of bilateral oophorectomy on wound healing of the rabbit vagina

Abramov, Yoram; Webb, Antonio R.; Botros, Sylvia M.; Goldberg, Roger P.; Sand, Peter K.

doi:10.1016/j.fertnstert.2010.08.001

Cited by 13 publications

(16 citation statements)

References 15 publications

(17 reference statements)

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“…Our study mainly focused on the latter two phases. We chose to examine healing at 4 and 21 days based on one of the only animal studies on vaginal wound healing in which tensile strength nadir and recovery to baseline occurred at these time points, respectively [7]. In contrast with Abramov et al [7], however, we did not find a significant difference in tensile strength between nonestrogenized and estrogenized animals at either 4 (not shown) or 21 days.…”

Section: Effects Of E2 On the Injured Vaginal Wallmentioning

confidence: 82%

“…The exact cause of pelvic organ prolapse is poorly understood and likely multifactorial, but several risk factors have been postulated including vaginal childbirth, aging, hypoestrogenism, menopause, genetic factors, connective tissue diseases, race, chronically increased intraabdominal pressure, smoking, and prior surgery [2,5,6]. Surgical failure has been attributed to impairment of surgical wound healing [7], suggesting a contributing molecular or genetic basis to the pathogenesis of the disease. The molecular defects in connective tissue that underlie initial failure of pelvic organ support may also contribute to failure of reconstructive pelvic surgery.…”

Section: Introductionmentioning

confidence: 99%

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Estrogen Alters Remodeling of the Vaginal Wall after Surgical Injury in Guinea Pigs1

Balgobin

Montoya

Shi

et al. 2013

Biology of Reproduction

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Loss of pelvic organ support (i.e., pelvic organ prolapse) is common in menopausal women. Surgical reconstruction of pelvic organ prolapse is plagued with high failure rates. The objective of this study was to determine the effects of estrogen on biomechanical properties, lysyl oxidase (LOX), collagen content, and histomorphology of the vagina with or without surgical injury. Nulliparous ovariectomized guinea pigs were treated systemically with either 50 μg/kg/day estradiol (E2,) or vehicle. After 2 wk, vaginal surgery was performed, and animals were treated with either beta-aminopropionitrile (BAPN, an irreversible LOX inhibitor), or vehicle to determine the role of LOX in recovery of the vaginal wall from injury with or without E2. Estradiol resulted in (i) significant growth, increased smooth muscle, and increased thickness of the vagina, (ii) increased distensibility without compromise of maximal force at failure, and (iii) increased total and cross-linked collagen. In the absence of E2, BAPN resulted in decreased collagen and vaginal wall strength in the area of the injury. In contrast, in E2-treated animals, increased distensibility, maximal forces, and total collagen were maintained despite BAPN. Interestingly, LOX mRNA was induced dramatically (9.5-fold) in the injured vagina with or without E2 at 4 days. By 21 days, however, LOX levels declined to near baseline in E2-deprived animals. LOX mRNA levels remained strikingly elevated (12-fold) at 21 days in the estrogenized vagina. The results suggest that prolonged E2 induced increases in LOX, and collagen cross-links may act to sustain a matrix environment that optimizes long-term surgical wound healing in the vagina.

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Section: Effects Of E2 On the Injured Vaginal Wallmentioning

confidence: 82%

Section: Introductionmentioning

confidence: 99%

Estrogen Alters Remodeling of the Vaginal Wall after Surgical Injury in Guinea Pigs1

Balgobin

Montoya

Shi

et al. 2013

Biology of Reproduction

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“…It has been postulated, however, that impaired wound healing may lead to recurrence of prolapse after pelvic reconstructive surgery, and that estrogen may serve as an adjunct to surgical repair. 3-6 Both the lower female genital and urinary tracts arise from the primitive urogenital sinus in which estrogen receptors (α and β) are expressed during development and in adult tissues of the vagina, urethra, bladder, and surrounding pelvic floor musculature. 7-9 Local intravaginal estrogen in postmenopausal women by any delivery system (creams, tablets, or estrogen-containing rings) is known to decrease vaginal pH, increase blood flow, improve tissue compliance, and promote vaginal cell maturity.…”

mentioning

confidence: 99%

“…10 Vaginal wound closure, scar contraction, and biomechanical recovery were shown to be significantly impaired in ovariectomized rabbits relative to estrogenized sham-operated controls. 3 In ovariectomized guinea pigs, preoperative systemic estrogen (with continued use postoperatively) resulted in significant growth, increased smooth muscle, improved vaginal thickness, increased distensibility without compromise of maximal force at failure, and increased total and cross-linked collagen that was refractory to the lathyrogenic effects of β-aminoproprionitrile. 4 In ovariectomized rats, vaginal estrogen (in doses used in the current study) was shown to be superior to systemic estrogen in terms of increasing vaginal epithelial thickness, distensibility, and total and cross-linked collagen content in the uninjured vagina.…”

mentioning

confidence: 99%

Vaginal estrogen: a dual-edged sword in postoperative healing of the vaginal wall

et al. 2017

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Objective Reconstructive surgery for pelvic organ prolapse is plagued with high failure rates possibly due to impaired healing or regeneration of the vaginal wall. Here, we tested the hypothesis that postoperative administration of local estrogen, direct injection of mesenchymal stem cells (MSCs), or both lead to improved wound healing of the injured vagina in a menopausal rat model. Methods Ovariectomized rats underwent surgical injury to the posterior vaginal wall and were randomized to treatment with placebo (n = 41), estrogen cream (n = 47), direct injection of MSCs (n = 39), or both (n = 43). Results MSCs did not survive after injection and had no appreciable effects on healing of the vaginal wall. Acute postoperative administration of vaginal estrogen altered response of the vaginal wall to injury with decreased stiffness, decreased collagen content, and decreased expression of transcripts for matrix components in the stromal compartment. Conversely, vaginal estrogen resulted in marked proliferation of the epithelial layer and increased expression of genes related to epithelial barrier function and protease inhibition. Transcripts for genes involved in chronic inflammation and adaptive immunity were also downregulated in the estrogenized epithelium. Conclusions Collectively, these data indicate that, in contrast to the reported positive effects of preoperative estrogen on the uninjured vagina, acute administration of postoperative vaginal estrogen has adverse effects on the early phase of healing of the stromal layer. In contrast, postoperative estrogen plays a positive role in healing of the vaginal epithelium after injury.

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“…Recent evidence suggests that local estrogen improves vaginal tissue quality in postmenopausal women after vaginal reconstructive surgery 71 . An animal study showed that bilateral oophorectomy and estrogen deficiency result in delayed vaginal wound healing, scar contraction and recovery of biomechanical properties 72 , and was associated with enhanced inflammation 73 . Moreover, the systemic use of estrogen after a surgical injury to guinea pigs leads to greater amounts of collagen and elevated density of elastic fibers, resulting in higher distensibility of the vagina while maintaining its tissue strength 74 .…”

Section: Factor Actionmentioning

confidence: 99%

Wound healing of the pelvic floor concerning pelvic organ prolapse – What do we know?

Terra

Ruiz‐Zapata

Kluivers

et al. 2020

Rev. Med. (São Paulo)

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O prolapso de órgão pélvico (POP) é resultado do enfraquecimento dos tecidos de sustentação e de suspensão dessa região, incluindo os músculos levantadores do ânus, a fáscia endopélvica, os ligamentos e a parede vaginal. Sabe-se que os fatores de risco mais importantes para o POP, como gravidez, parto vaginal e aumento da pressão intra-abdominal, causam lesão nos tecidos do assoalho pélvico. Assim, é possível que um processo de cicatrização imperfeito desses tecidos possa afetar sua homeostase e contribuir para o desenvolvimento do POP. Dessa forma, o objetivo deste artigo é revisar a fisiologia da cicatrização de tecidos do assoalho pélvico e discutir os fatores que interferem nesse processo. Para isso, foi feita uma revisão da literatura na base de dados do MEDLINE até 2017. Percebeu-se que, assim como na pele, a cicatrização das lesões do assoalho pélvico ocorre em quatro fases (hemostasia, inflamação, proliferação e remodelação), porém a duração de cada fase é maior nas diferentes estruturas do assoalho pélvico. Além disso, a pressão constante no assoalho pélvico está associada ao aumento da atividade da colagenase, afetando negativamente a cicatrização, enquanto o estrogênio melhora as propriedades mecânicas do tecido estirado e parece ser benéfico para a cicatrização das lesões na parede vaginal. De acordo com a literatura, os músculos, nervos, ligamentos ou parede vaginal danificados não recuperam totalmente suas características prévias. Desse modo, conclui-se que uma cicatrização imperfeita no assoalho pélvico resulta em tecidos com composição e propriedades mecânicas alteradas, o que pode levar à incidência ou progressão do POP.

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Effect of bilateral oophorectomy on wound healing of the rabbit vagina

Cited by 13 publications

References 15 publications

Estrogen Alters Remodeling of the Vaginal Wall after Surgical Injury in Guinea Pigs1

Estrogen Alters Remodeling of the Vaginal Wall after Surgical Injury in Guinea Pigs1

Vaginal estrogen: a dual-edged sword in postoperative healing of the vaginal wall

Wound healing of the pelvic floor concerning pelvic organ prolapse – What do we know?

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