Immunohistochemical age changes of vagina tissues in women with pelvic prolaps

Abstract

Research objectives: to study age-related changes in the structure of vaginal tissues in women with pelvic prolapse (PP). Materials and methods. The structure of the vaginal wall was studied in 29 women with PP, who were divided into three groups: the first group – 11 women aged of 45 in the reproductive period with regular menstrual function; the second group – 8 women aged 45–55 in perimenopause with irregular menstrual function; the third group – 10 women aged 55–65 who have been postmenopausal for more than three years. All women underwent immunohistochemical detection of the CD34 marker and vascular endothelial growth factor (VEGF), podoplanin, the number of estrogen receptors, type 1 matrix metalloproteinase (type 1 collagenase) and type 1 collagen were determined. Results. The reproductive age was characterized by an active metabolism, which was reflected in the fullness of all vaginal layers, their thickening, heterochromia of the nuclei, increased metabolism in the connective tissue and synthesis of vasculogenesis stimulators. The expression of estrogen receptors was not increased due to a sufficient concentration of estrogens in the body. Atrophic changes in the perimenopausal age were determined as the thinning of the vaginal layers, sclerotic changes, and a decrease in protein synthesis in the form of nuclear hyperchromia. The number of estrogen receptors was compensatory increased due to their deficiency. A feature of this age is vascular imbalance, which was subjectively expressed in climacteric symptoms. Atrophic and sclerotic changes were observed in the postmenopausal period in the form of thinning of the vaginal wall, hyperchromia of the nuclei, an increase in the collagen level relative to an unchanged collagenase level, a decrease in lymphatic drainage, and an increase in the number of estrogen receptors. Conclusions. This study shows that all groups of women with PP have characteristic signs associated with age changes, features of the mestral cycle and hormonal saturation of the body. Factors affecting the PP development include: in reproductive age – increased collagenase activity, in perimenopause and postmenopause – atrophic dyshormonal and dyscirculatory processes in tissues.

Keywords

• pelvic prolapse
• immunohistochemical study
• collagen
• type 1 matrix metalloproteinase
• estrogen receptors
• vegf
• cd34
• podoplanin