LABORATORIAL AND IMMUNOHISTOCHEMICAL PREDICTORS OF RECURRENT GENITAL PROLAPSE

Abstract

The aim of research was to analyze the histologic and histochemical condition of vaginal fascia, to compare it to biochemical markers of collagen disintegration and clinical signs of undifferentiated connective tissue dysplasia in patients with recurrent genital prolapse.The research included 107 patients with recurrent genital prolapse using clinical, phenotypical, laboratory and immunohistochemical assessment. Mean age was 52 ± 3.6 years. Clinically light form of UCTD was found in 14.9 % of patients (1a subgroup), moderate form - in 73.8 % (1b subgroup), severe form - in 11.2 % (1c subgroup).In samples of control group no signs of protein dystrophy were found, muscular fibers were structured. In samples of 1a subgroup some focal homogenized bundles of collagen fibers were found. Immunohistochemistry showed prevalence of type I collagen with focal incorporations of types III and IV.Samples of 1b subgroup showed moderate muscular proliferation. In immunohistochemistry considerable proliferation of type III and IV collagen were revealed, including vascular walls.In subgroup 1c samples showed disorderly located and irregularly stained coarse-fibered collagen. Immunohistochemistry showed type IV collagen all over the surface of samples. Increased level of hydroxyproline in serum were highly relevant to results of immunohistochemical analysis and clinical signs of genital prolapse. Complex assessment of laboratory markers, clinical signs and results of immunohistochemistry helps to verify diagnosis of UCTD.

Keywords

• genital prolapse
• recurrence
• undifferentiated connective tissue dysplasia
• immunohistochemistry