Abstract
Introduction: Pelvic organ prolapse is defined as abnormal protrusion of the pelvic organ beyond its normal anatomical site. It occurs due to the structural weakness of the connective tissue that plays a role in supporting the uterus on the pelvic floor, specifically elastin and collagen. Our study evaluated the effect of vitamin D [1,25(OH)2D3] in preventing pelvic organ prolapse by aggregating elastin and collagen expression.
 Material and Methods: A true experimental research was carried out by assessing the cell cultures of sacro-uterine ligament from female patients who underwent hysterectomy. The cell cultures were divided into groups that were exposed to vitamin D at different concentrations of 100 µM, 200 µM, 400 µM, 800 µM, and control without any exposure. The expression of elastin and collagen was subsequently analyzed using immunofluorescence and ELISA method.
 Results: This study showed that exposure to vitamin D significantly affected elastin expression (p-value <0.05). The concentration found to be the most effective to induce elastin expression is at 400 µM. Vitamin D also significantly affected the collagen expression (p-value <0.05), with the concentration found to be the most effective to induce collagen expression is at 800 µM.
 Conclusion: This study suggested that vitamin D had a significant positive effect of increasing extracellular matrix expression and potentially become a preventive agent for pelvic organ prolapse. Vitamin D is widely available in tropical countries like Indonesia, so this preparation is considered very easy for Indonesian women to apply.
Highlights
Pelvic organ prolapse is defined as abnormal protrusion of the pelvic organ beyond its normal anatomical site
This study showed that exposure to vitamin D significantly affected elastin expression (p-value
This study suggested that vitamin D had a significant positive effect of increasing extracellular matrix expression and potentially become a preventive agent for pelvic organ prolapse
Summary
Pelvic organ prolapse is defined as abnormal protrusion of the pelvic organ beyond its normal anatomical site. Pelvic organ prolapse (POP) or genitourinary prolapse is defined as the abnormal protrusion of the pelvic organ beyond its normal anatomical confines [1]. It is a common health problem affecting women that is related to the impairment of life quality. Pelvic organ prolapse happens mostly among elderly women because of the major decline of women’s body function along with the number of parity and aging process, including the weakening of pelvic organ support structures, such as ligaments [2]. The prevalence of 41% was reported in 50-79 years old women, which was divided into 34% cystocele, 19% rectocele, and 14% uterine prolapse [5]
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