Changes in metabolism of collagen in genitourinary prolapse
Abstract
Background Genitourinary prolapse is a common problem, the pathophysiology of which is unknown.Methods We analysed vaginal-epithelial tissue from premenopausal women with genitourinary prolapse and compared them with controls.Findings We found that genitourinary prolapse is associated with a reduction in total collagen content and a decrease in collagen solubility. Both intermediate intermolecular cross-links and advanced glycation cross-links were increased in prolapse tissue. Collagen turnover, as indicated by matrix metalloproteinase activity, was up to four times higher in prolapse tissue. Collagen-type ratios, mature cross-link pyridinoline and total elastin content were similar in both prolapse and control tissues. Increased collagenolytic activity causes loss of collagen from prolapse tissue.Interpretation Based on these findings, we have identified a probable mechanism for genitourinary prolapse. Development of agents to inhibit collagenolytic activity may help in the treatment of this condition.
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Recurrences in the anterior compartment are not entirely due to surgical failure but may reflect weak endopelvic tissue in that compartment.
“This therefore suggests that recurrences in the anterior compartment are not entirely due to surgical failure but may reflect weak endopelvic tissue in that compartment [27].”
From Risk factors for recurrence of pelvic organ prolapse after vaginal surgery among Ugandan women: a prospective cohort study (2022) · cites this paper as [27]
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- Authors
- Jackson, S. R., Eckford, S. D., Abrams, P., Avery, N. C., Tarlton, J. F., & Bailey, A. J.
- Affiliations
- Southmead Hospital (GB)
- University of Bristol (GB)
- Venue
- The Lancet
- Publisher
- Elsevier BV
- Published
- 1996-06
- Volume
- 347
- Issue
- 9016
- Pages
- 1658-1661
- ISSN
- 0099-5355 (ISSN-L)
- 0140-6736
- OpenAlex
- W2032265661
- Cited by
- 399
- References
- 14
- Citations by year
- 2026: 15 · 2025: 10 · 2024: 9 · 2023: 15 · 2022: 10 · 2021: 12 · 2020: 15 · 2019: 11 · 2018: 12 · 2017: 14 · 2016: 15 · 2015: 9 · 2014: 17 · 2013: 16 · 2012: 15
- FWCI
- 4.03
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Lancet (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Rheumatology › Pelvic floor disorders treatments
- Physical Sciences › Materials Science › Biomaterials › Collagen: Extraction and Characterization
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Cancer Research › Protease and Inhibitor Mechanisms
- Keywords
- genitourinary prolapse, collagen metabolism, collagen solubility, advanced glycation end products, intermolecular cross-links, matrix metalloproteinases, collagen turnover, collagenolytic activity, pyridinoline, elastin, vaginal epithelium, premenopausal women, tissue degeneration
- MeSH terms
- Adult, Cathepsins, Collagen, Female, Humans, Hysterectomy, Middle Aged, Solubility, Uterine Prolapse, Case-Control Studies, Premenopause
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