Biomechanical and biochemical assessments for pelvic organ prolapse

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Abstract
It is generally believed that pelvic organ prolapse is multifactorial in etiology. It is still an enigma that some women develop prolapse while others with similar risk factors do not. Assessment of supports of the pelvic organs biomechanically and biochemically may provide the clinician with further insight into the etiology of this complex condition. Furthermore, biomechanical and biochemical studies may prove to be vital in the development of prostheses utilized in the augmentation of surgery for pelvic organ prolapse. When compared with clinical studies on pelvic organ prolapse, there is a paucity of recently published literature on biomechanical and biochemical studies of pelvic organ supports. The results on collagen content of vaginal/pelvic tissues in women with prolapse are variable. The amount of smooth muscle in vaginal tissue appears to be lowered in women with prolapse regardless of age compared with controls. Biomechanical analysis of prolapsed tissue in pre and postmenopausal women demonstrates only age-related differences. Further research is required to ascertain the role of connective tissue components, including smooth muscle, in the support of pelvic organs. Knowledge of biomechanical properties of normal vaginal connective tissue may enhance the development of prostheses designed for use during vaginal prolapse surgery.