Expression Of Neuropeptide Y In Plasm And Pelvic Tissue And Its Relationship With Pelvic Floor Dysfunction

Objective:1.To evaluate the distribution of neuropeptide Y(NPY) in the round ligaments,cardinal ligaments,uterosacral ligaments and vaginal epithelium among women with pelvic organ prolapse(POP),stress urinary incontinence(SUI),and control groups to clarify its role in the etiology development of POP and SUI.2.To observe the plasma NPY concentration in paitents with POP and SUI as well as to explore the action and meaning.Methods:1.Forty six patients were entered the study,Biopsy specimens from the round ligaments,cardinal ligaments,uterosacral ligaments and anterior vaginal epithelium which were obtained from 4 groups of patients:POP(17 samples),SUI(6 samples),POP unite with SUI(13 samples) and controls(neither POP nor SUI)(10 samples).Routine hematoxylin and eosin staining(HE staining) and immunohistochemical staining for NPY were performed. NPY was measured semiquantitatively.2.The Plasma NPY concentration was determined by radioimmunoassay(RIA),The fast blood sample was got from 60 patients which were also divided into 4 groups:POP(22 samples), SUI(10 samples),POP unite with SUI(13 samples) and controls(neither POP nor SUI)(15 samples).Results:1.In our study,the NPY immunoreactivities were identified in the round ligaments,cardinal ligaments,uterosacral ligaments and anterior vaginal epithelium,the NPY profiles were located mostly around vessels,smooth muscles and their circumference.2.In the round ligaments,NPY immunoreactive nerve were lower in POP & SUI group than control group and SUI group,however,there was no significant difference between POP group and control group.3.In the cardinal ligaments,NPY immunoreactive nerve were lower in POP group and POP & SUI group than control group and SUI group,however,there were no significant difference between SUI group and control group.4.In the uterosacral ligaments,NPY immunoreactive nerve were lower in POP group and POP& SUI group than control group and SUI group,however,there were no significant difference between SUI group and control group.5.In the anterior vaginal epithelium,NPY immunoreactive nerve were lower in POP group,SUI gruop and POP & SUI group than control group.6.In POP group and POP&SUI group,the expression of NPY in cardinal ligaments,uterosacral ligaments and anterior vaginal wall was negatively correlated with age,and no correlated with pregnant times,labor times,body mass index(BMI);the expression of NPY in round ligaments was no correlated with age,pregnant times,labor times,body mass index(BMI).In SUI group,the expression of NPY round ligaments,cardinal ligaments,uterosacral ligaments and anterior vaginal wall was no correlated with age,pregnant times,labor times,body mass index(BMI).7.The Plasma NPY concentration was significantly high in POP group,SUI group and POP & SUI group,compare to the control group.There were no significant difference within POP group,SUI group and POP & SUI group.8.In POP group,SUI group and POP & SUI group,the Plasma NPY concentration was no correlated with age,pregnant times,labor times and body mass index(BMI).9.In POP group,SUI group and POP & SUI group,the expression of NPY in anterior vaginal wall was negatively correlated with the Plasma NPY concentration;the expression of NPY in round ligaments,cardinal ligaments,uterosacral ligaments was no correlated with the Plasma NPY concentration.Conclusions:1.The denervation of ligament system and anterior vaginal epithelium may take a significant role in POP and SUI..The female with POP or POP&SUI its pelvic nerve damage is concered,the action of anterior vaginal epithelium is more outstanding than round ligaments,cardinal ligaments,uterosacral ligaments.Round ligaments take small effect.,the three groups(POP group,SUI group and POP&SUI group)its expression of NPY in anterior vaginal epithelium was obviously less than control group,we believe that anterior vaginal epithelium take on a representative action,it can represent the index of pelvic floor relaxation.2.The expression of NPY in round ligaments was no correlated with age,pregnant times, labor times,body mass index(BMI).The change of cardinal ligamentsand,uterosacral ligaments and anterior vaginal wall was negatively correlated with age,it can be conclude, Age is a important reason of pelvic damage and retrograde,nerve reduction.3.As a nerve transmitter,NPY profiles of POP and SUI patients in the round ligaments,cardinal ligaments,uterosacral ligaments and anterior vaginal epithelium were lower than in the control group.The reduction might be related to nerve damage or degeneration, resulting in a change in blood flow,atrophy,and pelvic floor laxity in patients,and then it may cause or accelerate the progress of POP and SUI.4.It may be relatived with the high plasma NPY concentration that in POP and SUI patients. In POP and SUI patients,the expression of NPY in anterior vaginal wall was negatively correlated with the plasma NPY concentration,the reason was not clearly but plasma NPY concentration may componsatory increase as the nerve damage.Plasma NPY concentration may act as one of the index to observe the POP and SUI.