Department of Gynecology and Obstetrics, Ordu Training and Research Hospital, 52200 Ordu, Turkey.
Department of Gynecology and Obstetrics, Hitit Üniversitesi, 19030 Çorum Merkez, Turkey.
Medicina (Kaunas). 2024 May 16;60(5):816. doi: 10.3390/medicina60050816.
: This study aims to compare the neuromuscular structure of the vagina in women with posterior vaginal wall prolapse with the neuromuscular structure of the vagina in women without prolapse, to determine the difference, and to demonstrate the role of neuromuscular structure in the physiopathology of prolapse. : In this prospective study, women aged between 40 and 75 years who had not undergone any vaginal surgery and had not undergone any abdominal prolapse surgery were included. Thirty-one women diagnosed with rectocele on examination were included in the study group. Thirty-one patients who underwent vaginal intervention and hysterectomy for reasons other than rectocele (colposcopy, conization, etc.) without anterior or posterior wall prolapse were included in the control group. Biopsy material was obtained from the epithelium of the posterior wall of the vagina, including the fascia that fits the Ap point. Immunohistochemical staining with Protein Gene Product 9.5 and smooth muscle α-actin was performed in the pathology laboratory. The epithelial thickness measurement and smooth muscle density parameters obtained with these immunohistochemical stainings were compared between the two groups. The collected data were analyzed using the SPSS 23 package program. values less than 0.05 were considered statistically significant. : In the control group, muscle thickness and the number of nerves per mm of fascia were statistically significantly higher than in the study group ( < 0.05). : We found that smooth muscle tissue and the number of nerves per mm of fascia were decreased in posterior vaginal wall prolapse compared to the general population. Based on the correlation coefficients, age was the parameter that most affected the degree of prolapse, followed by parity, number of live births, and number of vaginal deliveries.
: 本研究旨在比较阴道后壁脱垂女性与无脱垂女性阴道的神经肌肉结构，确定差异，并展示神经肌肉结构在脱垂病理生理学中的作用。 : 在这项前瞻性研究中，纳入了年龄在 40 至 75 岁之间、未接受任何阴道手术且未接受任何腹部脱垂手术的女性。检查诊断为直肠膨出的 31 名女性被纳入研究组。31 名因阴道干预和子宫切除术而接受治疗的患者，其原因并非直肠膨出（阴道镜检查、锥形切除术等），且无前壁或后壁脱垂，被纳入对照组。从阴道后壁的上皮组织（包括与 Ap 点贴合的筋膜）获取活检材料。在病理实验室进行蛋白基因产物 9.5 和平滑肌α-肌动蛋白的免疫组织化学染色。比较两组之间这些免疫组织化学染色获得的上皮厚度测量值和平滑肌密度参数。使用 SPSS 23 包程序分析收集的数据。 值小于 0.05 被认为具有统计学意义。 : 在对照组中，肌肉厚度和每毫米筋膜的神经数量均明显高于研究组（ < 0.05）。 : 我们发现与一般人群相比，阴道后壁脱垂患者的平滑肌组织和每毫米筋膜的神经数量减少。根据相关系数，年龄是影响脱垂程度的最重要参数，其次是产次、活产数和阴道分娩数。
