Abstract
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.
Highlights
Pelvic organ prolapse (POP) is a multifactorial condition caused by damage to the supportive structures of the pelvic floor [1], which results in the descent of pelvic organs in the vagina
Pelvic organ prolapse is a multifactorial disease caused by a defect in the connective tissue or pelvic floor musculature, or a combination of the two, which results in the loss of the support provided by pelvic fascia and skeletal muscles [30,31]
We explained the role of fibroblasts and fibroblast–(myo)fibroblast transition in POP, which is a connective tissue disorder
Summary
Pelvic organ prolapse (POP) is a multifactorial condition caused by damage to the supportive structures of the pelvic floor [1], which results in the descent of pelvic organs in the vagina. Either in NTR or POP surgery with an implant, wound healing and tissue regeneration are highly needed for a successful surgical outcome, which is functional and mechanically self-sufficient pelvic tissue. This can mainly be achieved by a mild and well-orchestrated host response by triggering collagen metabolism without creating fibrotic tissue [28]. This review may lead to a better understanding of the role of fibroblasts in pelvic organ prolapse, how to optimize surgical outcomes, and how to prevent the development and progress of anatomical abnormalities involved in POP
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