期刊
AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY
卷 190, 期 3, 页码 620-627出版社
MOSBY-ELSEVIER
DOI: 10.1016/j.ajog.2003.08.040
关键词
arcus tendineous fasciae pelvis; menopause; vaginal wall prolapse; collagen
资金
- NICHD NIH HHS [HD01261-02] Funding Source: Medline
Objective: The arcus tendineous fasciae pelvis (ATFP) provides support to the anterior vagina. The objective of this study was to determine the impact of menopause on the structural components of the ATFP. Study design: Biopsy specimens of the ATFP were obtained from 10 premenopausal, 5 postmenopausal, and 12 postmenopausal women on hormone therapy. Scanning confocal microscopy of fluorescent micrographs was used to define the amount of collagen subtypes, smooth muscle, and elastin. Collagen fiber orientation was determined by scanning electron microscopy. Results: The ATFP is comprised primarily of parallel bundles of type III collagen fibers (84%), an intermediate amount of elastin (13%), and very little smooth muscle. The ratio of collagen I/ (III + V ) was decreased in postmenopausal not on hormones relative to premenopausal women (P = .04) due to a 75% decrease in collagen I (P= .046). The decrease in collagen I and change in collagen ratios was not present in women on hormone therapy. Comparison of the amounts of elastin and smooth muscle showed no difference in the ATFP of premenopausal and postmenopausal women. Conclusion: Menopause in the absence of hormone therapy is associated with a decrease in quantity of collagen I in the ATFP resulting in a decrease in the ratio of-collagen I/(III + V). This may compromise the tensile strength and an increase susceptibility to anterior vaginal wall prolapse. (C) 2004 Elsevier Inc. All rights reserved.
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