Mori da Cunha Marina Gabriela M C, Mackova Katerina, Hympanova Lucie Hajkova, Bortolini Maria Augusta T, Deprest Jan
Centre for Surgical Technologies, Group Biomedical Sciences, KU Leuven, Leuven, Belgium.
Department of Development and Regeneration, Woman and Child, Group Biomedical Sciences, KU Leuven, Leuven, Belgium.
Int Urogynecol J. 2021 Jun;32(6):1331-1344. doi: 10.1007/s00192-020-04638-1. Epub 2021 Jan 23.
We aimed to summarize the knowledge on the pathogenesis of pelvic organ prolapse (POP) generated in animal models.
We searched MEDLINE, Embase, Cochrane and the Web of Science to establish what animal models are used in the study of suggested risk factors for the development of POP, including pregnancy, labor, delivery, parity, aging and menopause. Lack of methodologic uniformity precluded meta-analysis; hence, results are presented as a narrative review.
A total of 7426 studies were identified, of which 51 were included in the analysis. Pregnancy has a measurable and consistent effect across species. In rats, simulated vaginal delivery induces structural changes in the pelvic floor, without complete recovery of the vaginal muscular layer and its microvasculature, though it does not induce POP. In sheep, first vaginal delivery has a measurable effect on vaginal compliance; measured effects of additional deliveries are inconsistent. Squirrel monkeys can develop POP. Denervation of their levator ani muscle facilitates this process in animals that delivered vaginally. The models used do not develop spontaneous menopause, so it is induced by ovariectomy. Effects of menopause depend on the age at ovariectomy and the interval to measurement. In several species menopause is associated with an increase in collagen content in the longer term. In rodents there were no measurable effects of age apart of elastin changes. We found no usable data for other species.
In several species there are measurable effects of pregnancy, delivery and iatrogenic menopause. Squirrel monkeys can develop spontaneous prolapse.
我们旨在总结动物模型中产生的关于盆腔器官脱垂（POP）发病机制的知识。
我们检索了MEDLINE、Embase、Cochrane和科学网，以确定在研究POP发生的潜在危险因素（包括妊娠、分娩、产次、衰老和绝经）时使用了哪些动物模型。方法缺乏一致性使得无法进行荟萃分析；因此，结果以叙述性综述的形式呈现。
共识别出7426项研究，其中51项纳入分析。妊娠在不同物种中具有可测量且一致的影响。在大鼠中，模拟阴道分娩会引起盆底结构变化，阴道肌层及其微血管未完全恢复，不过并未诱发POP。在绵羊中，首次阴道分娩对阴道顺应性有可测量的影响；额外分娩的测量影响并不一致。松鼠猴会发生POP。对其肛提肌去神经支配会促进经阴道分娩动物的这一过程。所使用的模型不会自然绝经，因此通过卵巢切除术诱导绝经。绝经的影响取决于卵巢切除时的年龄和测量间隔。从长期来看，在几个物种中绝经与胶原蛋白含量增加有关。在啮齿动物中，除了弹性蛋白变化外，年龄没有可测量的影响。我们未找到其他物种的可用数据。
在几个物种中，妊娠、分娩和医源性绝经有可测量的影响。松鼠猴会发生自然脱垂。
