Distribution of collagen type VII in connective tissues of postmenopausal stress-incontinent women

Abstract

Objective. This study aimed to disclose the distribution changes of collagen VII-immunoreactive (CVII-IR) structures in the arcus tendineus fasciae pelvis (ATFP) of postmenopausal women with stress urinary incontinence (SUI).Patients and methods. Fifty-five postmenopausal patients with a history of incontinence were examined for SUI. In patients with SUI, colposuspension was performed either after intravaginal estrogen therapy (ESTR) or without it (NON-ESTR). Age-matched patients without incontinence served as controls. During the surgery, connective tissue specimens from the ATFP and the rectus muscle external fascia (RMEF) were collected and prepared for immunohistochemistry.Results. SUI was diagnosed in 23 patients, 20 of them entered either the ESTR or the NON-ESTR group. No differences were found in the distribution of CVII-IR structures in RMEF specimens obtained from all groups. The organization of CVII-IR fibrils in the ATFP of stress-incontinent women was severely affected by degenerative processes. Within the ESTR group, the degree of CVII-IR fiber disintegration was lower.Conclusions. Connective tissue from the urogenital suspensory apparatus of women with SUI demonstrates a degenerative distribution pattern of collagen type VII fibers.