The effect of laser and dynamic quadripolar radiofrequency therapies on the expression of collagenogenesis proteins in the vaginal epithelium and tissue elasticity in women with genital prolapse

Abstract

Background. Genital prolapse dramatically affects the quality of life of patients. Various sources show that the relapse rate after surgical treatment is 30 to 60%. Aim. To determine and compare the expression levels of collagen metabolism proteins before and after exposure to laser and radio frequency in the postoperative period in postmenopausal patients and to compare ultrasound elastography data to justify using these exposure methods as a rehabilitation program. Materials and methods. Histological specimens were collected from 54 patients with postmenopausal POP-Q grade 3 genital prolapse, and an ultrasound examination was made before surgery and after rehabilitation therapy. A real-time polymerase chain reaction method was used to assess the expression level of type I collagen, matrix metalloproteinases (MMP-2, MMP-9), and tissue inhibitors of metalloproteinases (TIMP-1, TIMP-2). Ultrasound examination was performed using the technology of compression elastography with the analysis of the color scale and the coefficient of tissue deformation. Results. Data were obtained on the increase in the expression of TIMP-1 by 7 times and TIMP-2 by 4 times in the radiofrequency therapy group compared to the group before treatment, as well as a 64-fold decrease in TIMP-2 expression in the vaginal tissue of women in the group after laser therapy compared to the group before treatment. A significant increase in the expression of TIMP-1 and TIMP-2 genes in vaginal tissue after radiofrequency exposure and a decrease in TIMP-2 after laser exposure demonstrate the compensatory effect of biological markers in response to energy therapy, as well as the remodeling effect of these methods. According to ultrasound, tissue elasticity in patients increased after laser and radiofrequency exposure. Conclusion. The results support using radiofrequency and laser therapy in the postoperative period as rehabilitation methods.

Keywords

• pcr
• genital prolapse
• rehabilitation
• collagen
• mmp
• timp
• expression
• mrna
• laser therapy
• radiofrequency therapy
• elastography
• ultrasound elastography
• strain-ratio