The effect of genital and lower urinary tract symptoms on steroid receptor expression in women with genital prolapse

Abstract

This study evaluates the expression of estrogen receptor (ER) isoforms alpha (α) and beta (β) and progesterone receptor (PR) in vaginal and periurethral tissue in women with genital prolapse in relation to genital and lower urinary tract symptoms (LUTS). Forty-seven postmenopausal women without systemic estrogen therapy underwent pelvic organ prolapse quantification and urodynamic assessment. LUTS were evaluated by CATI questionnaire. Biopsies from vaginal and periurethral tissue were obtained during prolapse surgery. The steroid receptor gene expression was measured by RT-PCR. The expression of PR in periurethral and ER β in vaginal tissue varied with prolapse extent. Nulliparous women showed a significantly higher expression of PR in periurethral tissue. Women with a positive stress test and those with overactive bladder symptoms showed a significantly lower amount of PR in vaginal tissue. Changes in PR expression in vaginal or periurethral tissue might be a marker of structural and endocrine changes.