PURPOSE - Pelvic organ prolapse is a multifactorial disorder in which extracellular matrix defects are implicated. Fibrillin-1 level is reduced in stress urinary incontinence. In Marfan syndrome, which is associated with mutations in Fibrillin-1, pelvic floor disorders are commonly observed.
We hypothesize that Fibrillin-1 gene expression is altered in pelvic organ prolapse.
METHODS - Thirty women undergoing colporrhaphy or hysterectomy because of cystocele, rectocele, cystorectocele, or uterine prolapse were assigned to a pelvic prolapse study group, and thirty women undergone hysterectomy for nonpelvic prolapse conditions were assigned to a control group. Real-time polymerase chain reaction was conducted on vaginal tissue samples to measure the expression of Fibrillin-1. Expression levels were compared between study and control groups by Mann-Whitney U test with Bonferroni revision.
RESULTS - Fibrillin-1 gene expression was not significantly lower in the study group than in the control group. Similarly, no significant correlation between Fibrillin-1 levels and grade of pelvic prolapse was found. Age over 40 years (P=0. 018) and menopause (P=0. 027) were both associated with reduced Fibrillin-1 levels in the pelvic prolapse group, whereas the delivery of babies weighing over 3,500 g at birth was associated with increased Fibrillin-1 expression (P=0. 006).
CONCLUSIONS - The results did not indicate a significant reduction in Fibrillin-1 gene expression in pelvic prolapse disorders; however, reduced Fibrillin-1 may contribute to increased pelvic organ prolapse risk with age and menopause. Increased Fibrillin-1 gene expression may be a compensatory mechanism in cases of delivery of babies with high birth weight. Further studies are needed for a better understanding of these observations.
International neurourology journal. 2015 Sep 22 [Epub]
Ayla Eser, Eylem Unlubilgin, Fatih Hizli, Muradiye Acar, Zeynep Kamalak, Aydin Kosus, Nermin Kosus, Deniz Hizli, Esra Gunduz
Department of Obstetrics and Gynecology, Turgut Ozal University Medical School, Ankara, Turkey. , Department of Obstetrics and Gynecology, Etlik Zubeyde Hanim Training and Research Hospital, Ankara, Turkey. , Department of Urology, Dr Abdurrahman Yurtaslan Oncology Training and Research Hospital, Ankara, Turkey. , Department of Medical Genetics, Turgut Ozal University Medical School, Ankara, Turkey. , Department of Obstetrics and Gynecology, Nenehatun Maternity Hospital, Erzurum, Turkey. , Department of Obstetrics and Gynecology, Turgut Ozal University Medical School, Ankara, Turkey. , Department of Obstetrics and Gynecology, Turgut Ozal University Medical School, Ankara, Turkey. , Department of Obstetrics and Gynecology, Turgut Ozal University Medical School, Ankara, Turkey. , Department of Medical Genetics, Turgut Ozal University Medical School, Ankara, Turkey.