vasoactive-intestinal-peptide and Uterine-Prolapse

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