Liapis A, Bakas P, Pafiti A, Frangos-Plemenos M, Arnoyannaki N, Creatsas G
2nd Department of Obstetrics and Gynecology, Aretaieio Hospital, University of Athens, Athens, Greece.
Eur J Obstet Gynecol Reprod Biol. 2001 Jul;97(1):76-9. doi: 10.1016/s0301-2115(00)00478-4.
Objective of this study was to determine possible changes in the quantity of type III collagen in women with genuine stress incontinence (GSI) and with pelvic relaxation or not.
Ninety-four women participated in the study and they were divided in to three groups as follow: 34 patients with GSI and pelvic relaxation (group 1), 32 patients with pelvic relaxation but without GSI (group 2) and 28 patients with neither pelvic relaxation nor GSI (group 3). All the women underwent a complete pre-operative urodynamic evaluation. The presence of collagen type III was determined by immunohistochemical technique. The X-test was used for statistical analysis. A P<0.05 was considered statistically significant.
Collagen type III was significantly reduced (p<0.05) in patients with GSI and pelvic relaxation in both sites of biopsy (group 1), compared to patients in groups 2 and 3. Specimens from women without GSI (group 2 and group 3) had a similar density of collagen type III in both sites of biopsy.
In this study, we found that women with GSI had less collagen type III around the urethra regardless of the degree of pelvic relaxation. It appears that collagen has a significant role in the maintenance of urinary continence but the mechanism by which collagen metabolism is altered remains unknown.
本研究的目的是确定真性压力性尿失禁（GSI）且伴有或不伴有盆腔松弛的女性中III型胶原蛋白数量的可能变化。
94名女性参与了本研究，她们被分为以下三组：34例GSI且伴有盆腔松弛的患者（第1组），32例伴有盆腔松弛但无GSI的患者（第2组），以及28例既无盆腔松弛也无GSI的患者（第3组）。所有女性均接受了完整的术前尿动力学评估。通过免疫组织化学技术确定III型胶原蛋白的存在。采用X检验进行统计分析。P<0.05被认为具有统计学意义。
与第2组和第3组患者相比，第1组中GSI且伴有盆腔松弛的患者在两个活检部位的III型胶原蛋白均显著减少（p<0.05）。无GSI的女性（第2组和第3组）的标本在两个活检部位的III型胶原蛋白密度相似。
在本研究中，我们发现无论盆腔松弛程度如何，GSI女性尿道周围的III型胶原蛋白较少。看来胶原蛋白在维持尿失禁方面具有重要作用，但胶原蛋白代谢改变的机制尚不清楚。
