neuropeptide-y and Urinary-Incontinence--Stress

The purpose of this study was to explore the innervation of neuropeptide Y (NPY) in the anterior vaginal mucosa of menopausal patients suffering from pelvic organ prolapse (POP). To do this, we analyzed the distribution and expression of NPY and its correlation with the occurrence and development of POP. Changes in NPY abundance in the anterior vaginal mucosa were assessed by immunohistochemistry in tissue samples collected from 41 POP patients and 9 control subjects. We divided patients into 4 populations, designated POP IV-POP I, exhibiting decreasing levels of NPY innervation. Through multivariate regression analysis, the level of reduction in NPY innervation was shown to be associated with an increasing severity of POP disease in a statistically significant manner. In conclusion, our data reveal that as the symptoms of POP intensify, the expression of NPY in anterior vaginal mucosa decreases progressively. Menopause, in combination with stress urinary incontinence (SUI), results in a stronger effect on both nerve damage to the pelvic floor and NPY alteration, compared to other risk factors, such as parity and weight.

Topics: Aged; Female; Gene Expression Regulation; Humans; Immunohistochemistry; Menopause; Middle Aged; Mucous Membrane; Neuropeptide Y; Pelvic Floor; Pelvic Organ Prolapse; Urinary Incontinence, Stress; Vagina

To determine the role of neuropeptide Y (NPY) in anterior and posterior vaginal epithelium in the etiologic development of pelvic organ prolapse (POP) and stress urinary incontinence (SUI).. Forty biopsy specimens from anterior and posterior vaginal epithelium were obtained from 40 POP/SUI patients and controls. The specimens were stained using hematoxylin and eosin and NPY immunohistochemical staining. NPY was measured semiquantitatively and NPY mRNA expression was assessed using DNA hybridization in situ.. There were no significant differences in NPY between anterior and posterior vaginal epithelium. NPY profiles in posterior vaginal epithelium in the SUI group were significantly lower than in the POP (P<0.05) and control (P<0.05) groups. In the POP group, the NPY profile correlated negatively with advancing age and years post menopause.. The reduction in NPY in the anterior and posterior vaginal wall epithelium might be related to nerve damage or degeneration, resulting in a change in blood flow, atrophy, and pelvic floor laxity in patients with POP and SUI, especially post menopause and with advancing age.

Topics: Epithelium; Female; Humans; Immunohistochemistry; Middle Aged; Neuropeptide Y; Regional Blood Flow; Urinary Incontinence, Stress; Uterine Prolapse; Vagina

To test the hypothesis that genital prolapse may be related to peripheral nerve abnormalities, we examined the changes occurring to peptide-containing nerve processes supplying the periurethral muscles in women with stress urinary incontinence associated with prolapse.. Thirty patients with genital prolapse and 10 age-matched control subjects entered the study. All patients were evaluated by urodynamic investigations. Ten of 30 patients had pure stress urinary incontinence; none of the control subjects was incontinent. During surgery, four biopsy samples were obtained from each woman from the periurethral and perirectal muscles. The muscle sections were processed for immunohistochemistry using specific antibodies to glial (S-100 protein) and general neuronal markers (neuron-specific enolase) and neuropeptides, including neuropeptide Y, vasoactive intestinal polypeptide, and substance P. The evaluation of immunolabeled nerves was based on a semiquantitative analysis that allowed for a four-point ordinate scale score.. S-100 and neuron-specific enolase immunoreactive nerve fibers, running either singly or in small bundles, along with a dense network of neural processes containing neuropeptide Y, vasoactive intestinal polypeptide, and substance P, were found throughout the connective tissue and striated muscle of the control specimens. In contrast, in the muscle specimens from those with genitourinary prolapse, both the density and the intensity of neuropeptide Y, vasoactive intestinal polypeptide, and substance P immunoreactive nerves were markedly reduced compared with the control specimens.. The evidence of a reduced peptide-containing nerve supply to the perineal muscles provides a morphologic basis suggesting that neural abnormalities contribute to the pathogenesis of genital prolapse and urinary incontinence.

Topics: Aged; Biomarkers; Biopsy; Birth Weight; Connective Tissue; Denervation; Female; Humans; Middle Aged; Models, Neurological; Muscle, Skeletal; Nerve Tissue Proteins; Neurons; Neuropeptide Y; Neuropeptides; Obesity; Parity; Pelvic Floor; Peripheral Nervous System Diseases; Phosphopyruvate Hydratase; Postmenopause; Rectum; S100 Proteins; Substance P; Urethra; Urinary Incontinence, Stress; Uterine Prolapse; Vasoactive Intestinal Peptide