Vaginal wall weakness in parous ewes

a potential preclinical model of pelvic organ prolapse

Natharnia Young, Anna Rosamilia, John Arkwright, Joseph Lee, Miranda Davies-Tuck, Joan Melendez, Jerome Werkmeister, Caroline E. Gargett

Research output: Contribution to journalArticleResearchpeer-review

5 Citations (Scopus)

Abstract

Introduction and hypothesis: Ewes develop pelvic organ prolapse (POP) and may be a suitable model for preclinical studies evaluating cell-based therapies for POP. The aim of this study was to establish a clinical score of vaginal weakness and to compare POP Quantification System (POP-Q) values in conscious nulliparous and parous ewes and determine whether ewes are a suitable POP model. Methods: Ewes (n = 114) were examined while conscious, without sedation, and standing in a V conveyer by adapting the human POP-Q measurement. Ovine POP was defined as descent to the introitus from POP-Q points Aa 3 cm above the introitus on the anterior wall, Ap 3 cm above the introitus on the posterior wall, or increased Ba anterior wall descent above the urethra (≥0). A test–retest showed good inter- and intrarater reliability. Results: There was no evidence of tissue mobility at Aa, Ap, Ba (all −3 cm) in nulliparous ewes (n = 14). In contrast, multiparous ewes had a median of −1 and interquartile range (IQR) (−2 to 0) for Aa, [0 (−1 to 0)] for Ap and [0 (−2.75 to 0)] for Ba (n = 33; P < 0.0001 in comparison with nulliparous) ewes. Ovine vaginal displacement was seen in 50.9 % of parous ewes and was strongly associated with parity (P = 0.003). Conclusions: A modified POP-Q in conscious ewes was established showing that the vaginal wall of parous animals has similar regions of weakness as do women and may be similarly related to parity. Ewes appear to be a representative preclinical model of human vaginal prolapse.

Original languageEnglish
Pages (from-to)999 - 1004
Number of pages6
JournalInternational Urogynecology Journal
Volume28
Issue number7
DOIs
Publication statusPublished - Jul 2017

Keywords

  • Ovine model
  • Pelvic organ prolapse
  • POP-Q
  • Vagina

Cite this

@article{3dc146f2ac76457c81b29293a71035d0,
title = "Vaginal wall weakness in parous ewes: a potential preclinical model of pelvic organ prolapse",
abstract = "Introduction and hypothesis: Ewes develop pelvic organ prolapse (POP) and may be a suitable model for preclinical studies evaluating cell-based therapies for POP. The aim of this study was to establish a clinical score of vaginal weakness and to compare POP Quantification System (POP-Q) values in conscious nulliparous and parous ewes and determine whether ewes are a suitable POP model. Methods: Ewes (n = 114) were examined while conscious, without sedation, and standing in a V conveyer by adapting the human POP-Q measurement. Ovine POP was defined as descent to the introitus from POP-Q points Aa 3 cm above the introitus on the anterior wall, Ap 3 cm above the introitus on the posterior wall, or increased Ba anterior wall descent above the urethra (≥0). A test–retest showed good inter- and intrarater reliability. Results: There was no evidence of tissue mobility at Aa, Ap, Ba (all −3 cm) in nulliparous ewes (n = 14). In contrast, multiparous ewes had a median of −1 and interquartile range (IQR) (−2 to 0) for Aa, [0 (−1 to 0)] for Ap and [0 (−2.75 to 0)] for Ba (n = 33; P < 0.0001 in comparison with nulliparous) ewes. Ovine vaginal displacement was seen in 50.9 {\%} of parous ewes and was strongly associated with parity (P = 0.003). Conclusions: A modified POP-Q in conscious ewes was established showing that the vaginal wall of parous animals has similar regions of weakness as do women and may be similarly related to parity. Ewes appear to be a representative preclinical model of human vaginal prolapse.",
keywords = "Ovine model, Pelvic organ prolapse, POP-Q, Vagina",
author = "Natharnia Young and Anna Rosamilia and John Arkwright and Joseph Lee and Miranda Davies-Tuck and Joan Melendez and Jerome Werkmeister and Gargett, {Caroline E.}",
year = "2017",
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language = "English",
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Vaginal wall weakness in parous ewes : a potential preclinical model of pelvic organ prolapse. / Young, Natharnia; Rosamilia, Anna; Arkwright, John; Lee, Joseph; Davies-Tuck, Miranda; Melendez, Joan; Werkmeister, Jerome; Gargett, Caroline E.

In: International Urogynecology Journal, Vol. 28, No. 7, 07.2017, p. 999 - 1004.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Vaginal wall weakness in parous ewes

T2 - a potential preclinical model of pelvic organ prolapse

AU - Young, Natharnia

AU - Rosamilia, Anna

AU - Arkwright, John

AU - Lee, Joseph

AU - Davies-Tuck, Miranda

AU - Melendez, Joan

AU - Werkmeister, Jerome

AU - Gargett, Caroline E.

PY - 2017/7

Y1 - 2017/7

N2 - Introduction and hypothesis: Ewes develop pelvic organ prolapse (POP) and may be a suitable model for preclinical studies evaluating cell-based therapies for POP. The aim of this study was to establish a clinical score of vaginal weakness and to compare POP Quantification System (POP-Q) values in conscious nulliparous and parous ewes and determine whether ewes are a suitable POP model. Methods: Ewes (n = 114) were examined while conscious, without sedation, and standing in a V conveyer by adapting the human POP-Q measurement. Ovine POP was defined as descent to the introitus from POP-Q points Aa 3 cm above the introitus on the anterior wall, Ap 3 cm above the introitus on the posterior wall, or increased Ba anterior wall descent above the urethra (≥0). A test–retest showed good inter- and intrarater reliability. Results: There was no evidence of tissue mobility at Aa, Ap, Ba (all −3 cm) in nulliparous ewes (n = 14). In contrast, multiparous ewes had a median of −1 and interquartile range (IQR) (−2 to 0) for Aa, [0 (−1 to 0)] for Ap and [0 (−2.75 to 0)] for Ba (n = 33; P < 0.0001 in comparison with nulliparous) ewes. Ovine vaginal displacement was seen in 50.9 % of parous ewes and was strongly associated with parity (P = 0.003). Conclusions: A modified POP-Q in conscious ewes was established showing that the vaginal wall of parous animals has similar regions of weakness as do women and may be similarly related to parity. Ewes appear to be a representative preclinical model of human vaginal prolapse.

AB - Introduction and hypothesis: Ewes develop pelvic organ prolapse (POP) and may be a suitable model for preclinical studies evaluating cell-based therapies for POP. The aim of this study was to establish a clinical score of vaginal weakness and to compare POP Quantification System (POP-Q) values in conscious nulliparous and parous ewes and determine whether ewes are a suitable POP model. Methods: Ewes (n = 114) were examined while conscious, without sedation, and standing in a V conveyer by adapting the human POP-Q measurement. Ovine POP was defined as descent to the introitus from POP-Q points Aa 3 cm above the introitus on the anterior wall, Ap 3 cm above the introitus on the posterior wall, or increased Ba anterior wall descent above the urethra (≥0). A test–retest showed good inter- and intrarater reliability. Results: There was no evidence of tissue mobility at Aa, Ap, Ba (all −3 cm) in nulliparous ewes (n = 14). In contrast, multiparous ewes had a median of −1 and interquartile range (IQR) (−2 to 0) for Aa, [0 (−1 to 0)] for Ap and [0 (−2.75 to 0)] for Ba (n = 33; P < 0.0001 in comparison with nulliparous) ewes. Ovine vaginal displacement was seen in 50.9 % of parous ewes and was strongly associated with parity (P = 0.003). Conclusions: A modified POP-Q in conscious ewes was established showing that the vaginal wall of parous animals has similar regions of weakness as do women and may be similarly related to parity. Ewes appear to be a representative preclinical model of human vaginal prolapse.

KW - Ovine model

KW - Pelvic organ prolapse

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