Department of Obstetric & Gynecology, Trakya University Medical Faculty, Edirne, Turkey.
Neurourol Urodyn. 2010 Mar;29(3):458-63. doi: 10.1002/nau.20779.
The aim of this study was to compare the changes in hystomorphometry and innervation of the anterior vaginal wall in women with and without anterior vaginal wall prolapse.
Eighty-nine biopsy specimens were obtained from the anterior vaginal wall of women having a cystocele repaired (stage >or=II; prolapse group, 49) and the same location in patients with no prolapse (stage <II; control group, 40). Routine H&E staining and immunohistochemical staining for protein gene product 9.5 (PGP-9.5) and smooth muscle alpha-actin (SMA) were performed for all specimens.
Number and diameter of the submucosal nerve fibers were significantly lower, submucosal distance to muscular region was significantly higher in the vaginal wall of patients with cystocele than in women with normal vaginal support. We found that there was a negative correlation between the vaginal delivery and the nerve number and diameter measurements, and positive correlation between the vaginal delivery and submucosal distance of muscular level.
Results indicate that women with a cystocele have a significantly lower total innervation and higher muscular distance of the anterior vaginal epithelium than the control subjects.
本研究旨在比较有和无前阴道壁膨出的女性前阴道壁组织形态计量学和神经支配的变化。
从接受膀胱膨出修复术（分期>或= II 期；膨出组，49 例）的女性前阴道壁和无膨出（分期< II 期；对照组，40 例）的同一位置获取 89 个活检标本。对所有标本进行常规 H&E 染色和蛋白基因产物 9.5（PGP-9.5）和平滑肌α-肌动蛋白（SMA）免疫组织化学染色。
与阴道支持正常的女性相比，膀胱膨出患者的阴道壁黏膜下神经纤维数量和直径显著降低，黏膜下至肌层的距离显著升高。我们发现，阴道分娩与神经数量和直径测量呈负相关，与肌层黏膜下距离呈正相关。
结果表明，膀胱膨出患者的前阴道上皮神经支配明显减少，肌肉距离明显增大。
