Uterine Prolapse : Immunohistochemical Study of the Pelvic Ligaments

Abstract

Introduction. Uterine prolapse is a pathological condition when pelvic support system loses elasticity and the uterus descends down into the vagina, leading to pain and even protrusion of tissue from the vagina. Aim of the study. Compare morphology of pelvic ligaments in women with uterine prolapse and without it. Materials and methods. Biopsies of lig. teres uteri were taken during the reconstructive surgery from 7 women with uterine prolapse and the control group of 3 women. Tissues were stained with hematoxilin and eosin, periodic acid – Schiff method and with antibodies of bFGF, FGFR 1, VEGF, PGP 9.5, Collagen III and IV, MMP-9, microscoped at 400X magnification and evaluated semiquantitatively. Data were analysed using non-parametric statistics – Mann – Whitney U test. Results. VEGF was statistically significantly increased (U = 3.5, p = 0.022, two-tailed Mann – Whitney U test) in the prolapse group, in comparison to the control group. Other parameters did not display any statistically significant difference when comparing the two groups, however, amount of GAGs stained with periodic acid – Schiff method showed a notable tendency to decrease in the prolapse group in comparison to the control group. Conclusions. Increased number of VEGF positive endothelium indicates hypoxia and stimulation of angiogenesis in female pelvic ligaments with uterine prolapse. Tendency of GAGs to decrease in the pelvic ligaments of females with uterine prolapse suggests qualitative degradation of tissue.