Ovine multiparity is associated with diminished vaginal muscularis, increased elastic fibres and vaginal wall weakness

Implication for pelvic organ prolapse

Stuart Emmerson, Natharnia Young, Anna Rosamilia, Luke Parkinson, Sharon Lee Edwards, Aditya V. Vashi, Miranda Davies-Tuck, Jacinta White, Kirstin Elgass, Camden Lo, John Arkwright, Jerome A. Werkmeister, Caroline E. Gargett

Research output: Contribution to journalArticleResearchpeer-review

8 Citations (Scopus)

Abstract

Pelvic Organ Prolapse (POP) is a major clinical burden affecting 25% of women, with vaginal delivery a major contributing factor. We hypothesised that increasing parity weakens the vagina by altering the extracellular matrix proteins and smooth muscle thereby leading to POP vulnerability. We used a modified POP-quantification (POP-Q) system and a novel pressure sensor to measure vaginal wall weakness in nulliparous, primiparous and multiparous ewes. These measurements were correlated with histological, biochemical and biomechanical properties of the ovine vagina. Primiparous and multiparous ewes had greater displacement of vaginal tissue compared to nulliparous at points Aa, Ap and Ba and lower pressure sensor measurements at points equivalent to Ap and Ba. Vaginal wall muscularis of multiparous ewes was thinner than nulliparous and had greater elastic fibre content. Collagen content was lower in primiparous than nulliparous ewes, but collagen organisation did not differ. Biomechanically, multiparous vaginal tissue was weaker and less stiff than nulliparous. Parity had a significant impact on the structure and function of the ovine vaginal wall, as the multiparous vaginal wall was weaker and had a thinner muscularis than nulliparous ewes. This correlated with "POP-Q" and pressure sensor measurements showing greater tissue laxity in multiparous compared to nulliparous ewes.

Original languageEnglish
Article number45709
JournalScientific Reports
Volume7
DOIs
Publication statusPublished - 4 Apr 2017

Cite this

@article{f76e3577b01a46958ee1da315e79a183,
title = "Ovine multiparity is associated with diminished vaginal muscularis, increased elastic fibres and vaginal wall weakness: Implication for pelvic organ prolapse",
abstract = "Pelvic Organ Prolapse (POP) is a major clinical burden affecting 25{\%} of women, with vaginal delivery a major contributing factor. We hypothesised that increasing parity weakens the vagina by altering the extracellular matrix proteins and smooth muscle thereby leading to POP vulnerability. We used a modified POP-quantification (POP-Q) system and a novel pressure sensor to measure vaginal wall weakness in nulliparous, primiparous and multiparous ewes. These measurements were correlated with histological, biochemical and biomechanical properties of the ovine vagina. Primiparous and multiparous ewes had greater displacement of vaginal tissue compared to nulliparous at points Aa, Ap and Ba and lower pressure sensor measurements at points equivalent to Ap and Ba. Vaginal wall muscularis of multiparous ewes was thinner than nulliparous and had greater elastic fibre content. Collagen content was lower in primiparous than nulliparous ewes, but collagen organisation did not differ. Biomechanically, multiparous vaginal tissue was weaker and less stiff than nulliparous. Parity had a significant impact on the structure and function of the ovine vaginal wall, as the multiparous vaginal wall was weaker and had a thinner muscularis than nulliparous ewes. This correlated with {"}POP-Q{"} and pressure sensor measurements showing greater tissue laxity in multiparous compared to nulliparous ewes.",
author = "Stuart Emmerson and Natharnia Young and Anna Rosamilia and Luke Parkinson and Edwards, {Sharon Lee} and Vashi, {Aditya V.} and Miranda Davies-Tuck and Jacinta White and Kirstin Elgass and Camden Lo and John Arkwright and Werkmeister, {Jerome A.} and Gargett, {Caroline E.}",
year = "2017",
month = "4",
day = "4",
doi = "10.1038/srep45709",
language = "English",
volume = "7",
journal = "Scientific Reports",
issn = "2045-2322",
publisher = "Nature Publishing Group",

}

Ovine multiparity is associated with diminished vaginal muscularis, increased elastic fibres and vaginal wall weakness : Implication for pelvic organ prolapse. / Emmerson, Stuart; Young, Natharnia; Rosamilia, Anna; Parkinson, Luke; Edwards, Sharon Lee; Vashi, Aditya V.; Davies-Tuck, Miranda; White, Jacinta; Elgass, Kirstin; Lo, Camden; Arkwright, John; Werkmeister, Jerome A.; Gargett, Caroline E.

In: Scientific Reports, Vol. 7, 45709, 04.04.2017.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Ovine multiparity is associated with diminished vaginal muscularis, increased elastic fibres and vaginal wall weakness

T2 - Implication for pelvic organ prolapse

AU - Emmerson, Stuart

AU - Young, Natharnia

AU - Rosamilia, Anna

AU - Parkinson, Luke

AU - Edwards, Sharon Lee

AU - Vashi, Aditya V.

AU - Davies-Tuck, Miranda

AU - White, Jacinta

AU - Elgass, Kirstin

AU - Lo, Camden

AU - Arkwright, John

AU - Werkmeister, Jerome A.

AU - Gargett, Caroline E.

PY - 2017/4/4

Y1 - 2017/4/4

N2 - Pelvic Organ Prolapse (POP) is a major clinical burden affecting 25% of women, with vaginal delivery a major contributing factor. We hypothesised that increasing parity weakens the vagina by altering the extracellular matrix proteins and smooth muscle thereby leading to POP vulnerability. We used a modified POP-quantification (POP-Q) system and a novel pressure sensor to measure vaginal wall weakness in nulliparous, primiparous and multiparous ewes. These measurements were correlated with histological, biochemical and biomechanical properties of the ovine vagina. Primiparous and multiparous ewes had greater displacement of vaginal tissue compared to nulliparous at points Aa, Ap and Ba and lower pressure sensor measurements at points equivalent to Ap and Ba. Vaginal wall muscularis of multiparous ewes was thinner than nulliparous and had greater elastic fibre content. Collagen content was lower in primiparous than nulliparous ewes, but collagen organisation did not differ. Biomechanically, multiparous vaginal tissue was weaker and less stiff than nulliparous. Parity had a significant impact on the structure and function of the ovine vaginal wall, as the multiparous vaginal wall was weaker and had a thinner muscularis than nulliparous ewes. This correlated with "POP-Q" and pressure sensor measurements showing greater tissue laxity in multiparous compared to nulliparous ewes.

AB - Pelvic Organ Prolapse (POP) is a major clinical burden affecting 25% of women, with vaginal delivery a major contributing factor. We hypothesised that increasing parity weakens the vagina by altering the extracellular matrix proteins and smooth muscle thereby leading to POP vulnerability. We used a modified POP-quantification (POP-Q) system and a novel pressure sensor to measure vaginal wall weakness in nulliparous, primiparous and multiparous ewes. These measurements were correlated with histological, biochemical and biomechanical properties of the ovine vagina. Primiparous and multiparous ewes had greater displacement of vaginal tissue compared to nulliparous at points Aa, Ap and Ba and lower pressure sensor measurements at points equivalent to Ap and Ba. Vaginal wall muscularis of multiparous ewes was thinner than nulliparous and had greater elastic fibre content. Collagen content was lower in primiparous than nulliparous ewes, but collagen organisation did not differ. Biomechanically, multiparous vaginal tissue was weaker and less stiff than nulliparous. Parity had a significant impact on the structure and function of the ovine vaginal wall, as the multiparous vaginal wall was weaker and had a thinner muscularis than nulliparous ewes. This correlated with "POP-Q" and pressure sensor measurements showing greater tissue laxity in multiparous compared to nulliparous ewes.

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U2 - 10.1038/srep45709

DO - 10.1038/srep45709

M3 - Article

VL - 7

JO - Scientific Reports

JF - Scientific Reports

SN - 2045-2322

M1 - 45709

ER -