Obstetrics, Gynecology and Reproductive Sciences, Mount Sinai Medical Center/Icahn School of Medicine, New York, New York.
Anatomic Pathology, Mount Sinai Medical Center/Icahn School of Medicine, New York, New York.
Neurourol Urodyn. 2018 Sep;37(7):2135-2140. doi: 10.1002/nau.23579. Epub 2018 Apr 10.
β3-adrenoceptor (β3-AR) agonist is known to relax the detrusor muscles. Considering that both pelvic organ prolapse (POP) and overactive-bladder (OAB) are frequently seen in the elderly population, the effect of β3-AR agonist on the pelvic floor tissues should be investigated. As a first step, this pilot, experimental, and descriptive study was designed to investigate the presence of β3-AR expression in the uterosacral-ligaments (USLs) in postmenopausal (PMP) women with POP.
After informed consent, PMP women undergoing hysterectomy for POP were recruited for the intraoperative collection of distal USL between 5/2016 and 8/2016. H&E analysis for the USLs and immunohistochemistry (IHC) analysis for β3-AR and α-actin smooth muscle (SM) were carried out. Tissue composition and percentage of β3-AR expression in the USLs were subjectively measured and the staining results were expressed as descriptive analysis.
Total 11 USL specimens were collected and nine specimens were included for the final analysis (one specimen: used for antibody concentration adjustment and one specimen: failed proper staining). Under high-power-field, the USLs were composed of SM cells (81.5 ± 7.47%) and connective tissues (16.5 ± 7.9%). On IHC analysis, six out of nine specimens expressed β3-AR with a different level of expression in SM cells in the USLs.
The majority of distal USLs were composed of SM cells. β3-ARs are expressed in 67% of the study specimens. Considering that both POP and OAB are frequently seen in the elderly population, the effect of β3-AR agonist on the pelvic floor tissues should be investigated further.
β3-肾上腺素能受体(β3-AR)激动剂已知可松弛逼尿肌。鉴于盆腔器官脱垂(POP)和膀胱过度活动症(OAB)在老年人群中经常同时出现,因此应该研究β3-AR 激动剂对盆底组织的影响。作为第一步,本研究设计为初步、实验性和描述性研究,旨在调查绝经后(PMP)POP 女性的子宫骶骨韧带(USL)中是否存在β3-AR 表达。
在获得知情同意后,于 2016 年 5 月至 2016 年 8 月期间,招募接受 POP 子宫切除术的 PMP 女性进行术中采集远端 USL。对 USL 进行 H&E 分析和免疫组织化学(IHC)分析β3-AR 和α-肌动蛋白平滑肌(SM)。主观测量 USL 的组织组成和β3-AR 表达百分比,并将染色结果作为描述性分析。
共采集 11 个 USL 标本,其中 9 个标本用于最终分析(1 个标本:用于抗体浓度调整,1 个标本:未能正确染色)。在高倍视野下,USL 由 SM 细胞(81.5±7.47%)和结缔组织(16.5±7.9%)组成。在 IHC 分析中,9 个标本中的 6 个表达了β3-AR,SM 细胞中的 USL 表达水平不同。
大多数远端 USL 由 SM 细胞组成。β3-AR 在 67%的研究标本中表达。鉴于 POP 和 OAB 在老年人群中经常同时出现,应该进一步研究β3-AR 激动剂对盆底组织的影响。