Study On Transforming Growth Factorβ₁ And Estrogen Receptor And Collagen Ⅰ,Ⅲ In Pelvic Floor Tissues For Postmenopausal Female Stress Urinary Incontinence

Background and Objective:Stress urinary incontinence (SUI) is a common disease that affects seriously the quality of life of middle and old age women.20% of middle and old age women suffer from different degrees of SUI. Pelvic organs prolapse (POP) which has close relationship with SUI is common clinical gynecologic problem also. The pathophysiology is not clear now. More postmenopausal femal suffering this disease,it suggestive that there is relationship between estrogen and SUI. Estrogen must combine with estrogen receptor ,if it work well .Recently there are lots of studies show collagen is very important in SUI. There are less collagen in pelvic tissue of SUI. Transforming Growth Factor-β₁ is a important factor in forming fibre. It help tissue grow more collagen The aim of this study is to explore the relationship between estrogen receptor and transforming growth factorβ₁ and collagen I,III with the occurrence of stress urinary incontinence(SUI)through analysis on estrogen receptor and transforming growth factorβ₁(TGF-β₁) and collagen I,III in paries anterior vaginase.Materials and Methods:1. Materials:SUI group—30 patients,postmenopause;POP group—28 patients, postmenopause ;normal group—30 patients, menopause. All of them were not accepted endocrine therapy in three months and agree with clinical diagnostic levels.2. Methods: The biopsy specimens in anterior vaginal wall were obtained from 88 subjects undergoing hysterectomia, tension-free vagina tape(TVT), Burch procedures, who were assigned in to control, pelvic organ prolapse (POP) and SUI groups. The histological structures in paries anterior vaginase were examined with routine HE staining. ER and TGF-β₁ and collagen I,III in structures in paries anterior vaginase was evaluated by immunohistochemical staining.Results: 1. ER positive staining in paries anterior vaginase was 1.66% in SUI group, 1.73% in POP group, 2.64% in contral group , respectively. It was significantly lower in SUI group and POP group than that in control group(p<0. 05) ,and it wasn't significantly lower in SUI group than that in POP group (p>0. 05) rate.2. TGF-β₁ positive staining rate in paries anterior vaginase was 20.00% in SUI group, 14.30% in POP group,93.33% in contral group ,respectively. It was significantly lower in SUI group and POP group than that in control group(p<0.05) ,and it wasn't significantly lower in SUI group than that in POP group (p>0.05) rate.3. Collagen I positive staining luminance in paries anterior vaginase was 98.62±0. 28 in SUI group, 98.15±0. 40 in POP group, 100.03±0. 27 in contral group , respectively. It was significantly lower in SUI group and POP group than that in control group(p<0.05) ,and it wasn't significantly lower in SUI group than that in POP group (p>0.05) rate, collagen HI positive staining luminance in paries anterior vaginase was 98.46±0.35 in SUI group, 98.23±0.18 in POP group, 100.12±0.42 in contral group , respectively. It was significantly lower in SUI group and POP group than that in control group(p<0.05) ,and it wasn't significantly lower in SUI group than that in POP group (p>0.05) rate.4.There is direct correlation between ER and Collagen I,III.Conclusions:1. ER decline in anterior vaginal wall of postmenopause SUI patients. ER decline cause anterior vaginal wall atrophic and anterior vaginal wall can not support urethra helping it keeping normal. ER decline correlated with SUI in postmenopause patients.2. TGF-β₁ decline in anterior vaginal wall of postmenopause SUI patients. TGF-β₁ decline cause anterior vaginal wall atrophic and anterior vaginal wall can not support urethra helping it keeping normal. TGF-β₁ decline correlated with SUI in menopause patients.3. Collagen I,III decline in anterior vaginal wall of postmenopause . SUI patients. Collagen I,III decline cause anterior vaginal wall atrophic and anterior vaginal wall can not support urethra helping it keeping normal., Collagen I,III decline correlated with SUI in menopause patients.