vasoactive-intestinal-peptide and Urinary-Incontinence--Stress

To study the expression of hormonal receptors, collagen, elastin, proteoglycans, and VIP in the vaginal wall of women with stress urinary incontinence (SUI).. Fifty-eight specimens of the anterior vaginal wall (28 women with SUI) were processed by Ventana immunostaining method.. Both groups were compatible for age, BMI, and obstetric history. Positive ER-α and ER-β immunoreaction was observed in 46.4% and 3.6% of SUI (43.3% and 33.3% of controls) (p < 0.05), respectively, and PR immunoreaction in 39.3% of SUI (46.7% of controls). Collagen I and III immunoreaction was observed in 28,6% and 21.4% of SUI (30.% and 36.7% of controls), respectively, and elastin, decorin, and fibromodulin immunoreaction in 10.7%, 10.7%, and 10.7% of SUI (50%, 33.3%, 33,.3% of controls) (p < 0.05), respectively. VIP immunoreaction was observed in 7.1% of SUI (36.7% of controls).. Imunoexpression of ER-P, elastin, decorin, fibromodulin, and VIP was significantly lower in SUI than controls, showing that the ER-β dependent re-modeling of the extracellular matrix of vaginal tissues is the main mechanism of SUI.

Topics: Aged; Case-Control Studies; Collagen; Collagen Type I; Collagen Type III; Decorin; Elastin; Estrogen Receptor alpha; Estrogen Receptor beta; Female; Fibromodulin; Humans; Immunohistochemistry; Middle Aged; Proteoglycans; Receptors, Progesterone; Urinary Incontinence, Stress; Vagina; Vasoactive Intestinal Peptide

To explore the alteration of collagen ultrastructure and content in uterine ligaments and paraurethral tissue and explore whether the alteration may contribute to stress urinary incontinence (SUI) and pelvic organ prolapse (POP).. The cardinal ligament, uterosacral ligament and paraurethral tissue samples were obtained from 90 subjects undergoing hysterectomy. Collagen ultrastructure was examined with transmission electron microscopy. And collagen content and expression of vasoactive intestinal peptide (VIP) were examined with immunohistochemistry.. The smooth muscle fascicles were thinner in the patients of SUI and POP. Arrangement of smooth muscle fascicles was disorderly. Fibroblast was metabolically active. The mean collagen fibril diameters in the SUI and POP groups were larger than that in the control group (P < 0.01). The mean contents of collagen I and III in the SUI and POP groups were lower than that in the control group (P < 0.01). The expression of VIP was lower (P < 0.05).. Predominance of collagen degradation during tissue repair may contribute to and promote POP and SUI. The decrease of VIP might be related with nerve damage or degeneration to cause or accelerate the progress of pelvic organ prolapse.

Topics: Collagen; Female; Humans; Middle Aged; Pelvic Floor; Pelvic Organ Prolapse; Urinary Incontinence, Stress; Vasoactive Intestinal Peptide

Perimenopausal women are at high risk for pelvic organ prolapse (POP) and stress urinary incontinence (SUI) diseases. In the present study, the expression of VIP in the vaginal epithelium of 70 perimenopausal women was correlated with the severity of POP with or without SUI.. Seventy biopsy specimens from the anterior vaginal epithelium were obtained from postmenopausal patients. Immunohistochemical labeling for vasoactive intestinal peptide (VIP) and hematoxylin and eosin staining were performed. The VIP innervation was then compared between eight patient groups. Semiquantitative analysis of VIP protein by Western blotting was performed and compared between the eight patient groups.. The results of the immunohistochemical study showed that the intensity of VIP-immunoreactivity (VIP-ir) in the eight groups was as follows (in decreasing order): Control; POPI; POP II; POP II + SUI; POP III; POP IV and POP III + SUI; and POP IV + SUI. The intensity of VIP-ir was obviously weak and similar among the POP IV, POP III + SUI, and POP IV + SUI groups. This result was validated by the Western blotting analysis. The level of the VIP peptide also deceased in POP patients and was as follows (in decreasing order): Control; POPI; POP II and POP II + SUI; POP III and POP III + SUI; and POP IV and POP IV + SUI.. The present study found that reduced VIP innervation in the vaginal epithelium of the perimenopausal women was correlated with the severity of POP with or without SUI.

Topics: Adult; Aged; Biopsy; Epithelium; Female; Humans; Middle Aged; Nerve Fibers; Pelvic Floor; Pelvic Organ Prolapse; Urinary Incontinence, Stress; Vagina; Vasoactive Intestinal Peptide

To determine the distribution of vasoactive intestinal peptide (VIP) in vaginal epithelium among women with stress urinary incontinence (SUI), pelvic organ prolapse (POP), and control groups to clarify its role in the etiology of SUI and POP.. A total of 40 biopsy specimens from anterior and posterior vaginal epithelium were obtained from 3 groups of patients: SUI, POP, and symptomatic controls. Routine hematoxylin and eosin staining and semiquantitative immunohistochemical staining for VIP were performed.. VIP was found in 27.5% of the specimens. In the control group, VIP expression was significantly higher in anterior than in posterior epithelium (P=0.046). There were no significant differences in the expression of VIP in the anterior and posterior epithelium in a comparison among the 3 groups. In the POP group, the expression of VIP was negatively correlated with age and menopause status.. There is evidence that VIP is a neurotransmitter in the vaginal epithelium. The anterior vaginal wall has a more important role than the posterior vaginal wall. Change of VIP is related to age in POP patients.

Topics: Age Factors; Biopsy; Epithelium; Female; Gene Expression Regulation; Humans; Immunohistochemistry; Menopause; Middle Aged; Urinary Incontinence, Stress; Uterine Prolapse; Vagina; Vasoactive Intestinal Peptide

Pelvic floor connective tissue degeneration is closely associated with retrogradation of its dominating nerve fibers. We hypothesized that some neuropeptides from pelvic floor tissue might be involved in the pathological progress of stress urinary incontinence (SUI) and pelvic organ prolapse (POP) in women. Thirty premenopausal and 31 postmenopausal patients participated in the study. The morphological appearance in the vaginal tissue was examined. The vasoactive intestinal peptide (VIP) and pituitary adenylate cyclase activating polypeptide-38 (PACAP) immunoreactivities (ir-VIP, ir-PACAP) were tested by immunohistochemistry and radioimmunoassay. We found that the VIP and PACAP immunostainings were weaker and sparser, and ir-VIP and ir-PACAP levels were significantly decreased in the anterior vaginal wall in the premenopausal and postmenopausal SUI or POP patients. Ir-VIP and ir-PACAP levels were reversely correlated with the age and menopausal status in the SUI or POP patients. Our data suggest that VIP and PACAP may participate in the pathophysiological process of SUI and POP.

Topics: Adult; Body Mass Index; Female; Humans; Immunohistochemistry; Middle Aged; Parity; Pituitary Adenylate Cyclase-Activating Polypeptide; Postmenopause; Pregnancy; Premenopause; Radioimmunoassay; Urinary Incontinence, Stress; Uterine Prolapse; Vagina; Vasoactive Intestinal Peptide

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