Int Neurourol J.  2015 Sep;19(3):164-170. 10.5213/inj.2015.19.3.164.

Is There a Relationship Between Pelvic Organ Prolapse and Tissue Fibrillin-1 Levels?

• Eser A
• Unlubilgin E
• Hizli F
• Acar M
• Kamalak Z
• Kosus A
• Kosus N
• Hizli D
• Gunduz E

• KMID: 2380845
• DOI: http://doi.org/10.5213/inj.2015.19.3.164

Abstract

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.

Keyword

Extracellular Matrix; Fibrillin; Pelvic Organ Prolapse

MeSH Terms

Birth Weight
Cystocele
Extracellular Matrix
Female
Gene Expression
Humans
Hysterectomy
Marfan Syndrome
Menopause
Parturition
Pelvic Floor Disorders
Pelvic Organ Prolapse*
Prolapse
Real-Time Polymerase Chain Reaction
Rectocele
Urinary Incontinence
Uterine Prolapse