Role of Fibroblasts and Myofibroblasts on the Pathogenesis and Treatment of Pelvic Organ Prolapse

Pelvic organ prolapse (POP) is a multifactorial connective tissue disorder caused by damage to the supportive structures of the pelvic floor, leading to the descent of pelvic organs in the vagina. In women with POP, fibroblast function is disturbed or altered, which causes impaired collagen metabolism that affects the mechanical properties of the tissue. Ideal surgical repair, either native tissue repair or POP surgery using an implant, aims to create a functional pelvic floor that is load-bearing, activating fibroblasts to regulate collagen metabolism without creating fibrotic tissue. Fibroblast function plays a crucial role in the pathophysiology of POP by directly affecting the connective tissue quality. On the other hand, fibroblasts determine the success of the POP treatment, as the fibroblast-to-(myo)fibroblast transition is the key event during wound healing and tissue repair. In this review, we aim to resolve the question of cause and result for the fibroblasts in the development and treatment of POP. This review may contribute to preventing the development and progress of anatomical abnormalities involved in POP and to optimizing surgical outcomes.

Automated summary

Pelvic organ prolapse (POP) is a connective tissue disorder that occurs due to damage to the supportive structures of the pelvic floor, causing pelvic organs to descend into the vagina. The impaired function of fibroblasts results in disrupted collagen metabolism and affects tissue mechanics. Surgical repair aims to create a load-bearing functional pelvic floor by activating fibroblasts to regulate collagen metabolism without fibrotic tissue formation. Fibroblast function plays a crucial role in the pathophysiology of POP and determines the success of treatment.