Histology of the vaginal wall in women with pelvic organ prolapse: a literature review

Abstract

Introduction and hypothesis The pathophysiology of pelvic organ prolapse (POP) is incompletely understood. The purpose of this study is to describe the current knowledge about histology of the vaginal wall and its possible involvement in the pathogenesis of pelvic organ prolapse. Methods Eligible studies were selected through a MEDLINE search covering January 1986 to December 2012. The research was limited to English-language publications. Results Investigations of changes in the vaginal tissue that occur in women with genital prolapse are currently still limited and produced contrary results. The heterogeneity of the patients and the control groups in terms of age, parity and hormonal status, of the localization of biopsies and the histological methods as well as the lack of validation of the quantification procedures do not allow clear and definitive conclusions to be drawn. Conclusions This review shows that current knowledge of the histological changes observed in women with POP are inconclusive and relatively limited. More studies are needed in this specific field to better understand the mechanisms that lead to POP.

Morphological and Functional Changes in the Vagina following Critical Lifespan Events in the Ewe

“…In multiparous ewes, the density increased in the middle vagina, a trend also observed in 2 other studies [34,40]. Clinical observations we cannot really give, as the few studies on elastin in clinical vaginal specimens we are aware of, are in women with POP and urinary incontinence [35]. We have no explanation why the neuronal stain was comparable between groups.…”

“…There are clinical data on collagen content in the vaginal wall of women that is from patients who are symptomatic and have anatomical abnormalities. Again, the findings are very discordant between studies investigating POP [35,36]. Other studies focus on the vagina of women with stress urinary incontinence [37] and on the impact of estrogen therapy on incontinence in postmenopausal women [38].…”

Regional Variation in Tissue Composition and Biomechanical Properties of Postmenopausal Ovine and Human Vagina

“…The vaginal wall consists of four layers, of which its major components have been quantified in several studies, however, it is difficult to compare existing studies given the range of techniques used; histology, immunohistochemistry and biomechanical analyses, and that the exact origin of the tissue is often not stated [21]. Many studies have relied on immunohistochemistry, which can only be regarded as semi-quantitative.…”

A nonlinear-elastic constitutive model for soft connective tissue based on a histologic description: Application to female pelvic soft tissue

“…The orcein staining percentage was defined as the area stained with orcein divided by the total area of the section. Image processing and measurements were performed using the image analysis toolbox included in MATLAB (7.9) software (Mathworks, Inc.) [40].…”