Biomechanical Properties Of Prolapsed Vaginal Tissue In Aged Women

Objective1. To assess the biomechanical properties of anterior vaginal tissue from pre-and postmenopausal women with symptomatic prolapse.2. To explore the biomechanical properties of anterior vaginal tissue from Postmenopausal prolapse women, who had used short-term local vaginal estrogen replacement treatment.MethodAnterior vaginal tissue was obtained at the time of surgery in women with symptomatic prolapse and age-matched women with normal pelvic support. They were divided into 4 groups as follows:8 postmenopausal patients with anterior vaginal symptomatic propalse and with short-term local vaginal estrogen replacement treatment before surgery (group A),9 postmenopausal patients with anterior vaginal symptomatic propalse and without estrogen replacement treatment before surgery (group B),4 postmenopausal patients without PFD(group C),6 premenopausal patients with anterior vaginal symptomatic prolapse (group D).Tissue specimens were biomechanically assessed by MTS—813.10 and we measures tissue's biomechanical properties, including stress relaxation, creep and stress-strain relationship.Results1. As to age, we found that postmenopausal patients with anterior vaginal symptomatic prolapse (group B) were significantly older than premenopausal ones (group D) (P <0.05), however, body mass index, gravity and parity in all groups generally showed no significant difference(P> 0.05).2. Biomechanical properties of premenopausal vaginal tissue with anterior vaginal symptomatic prolapse were superior to postmenopausal one, specifically as follows: stress relaxation and creep in premenopausal POP were superior to postmenopausal ones; a significantly higher elastic modulus was observed in postmenopausal vaginal tissue, the difference was statistically significant (P<0.05). 3. Biomechanical properties of postmenopausal vaginal tissue with anterior vaginal symptomatic prolapse after short-term (6 weeks)local vaginal estrogen replacement therapy or neither showed little or no difference regarding relaxation, creep and elastic modulus(P>0.05).4. Biomechanical properties of postmenopausal anterior vaginal tissue with non-PFD symptom were superior to the one with vaginal symptomatic prolapse, the specific performance:stress relaxation and creep in non-PFD were superior to anterior vaginal symptomatic prolapsed ones; a significantly higher elastic modulus was observed in postmenopausal vaginal symptomatic prolapse, the difference was statistically significant (P<0.05).Conclusion1. In this study, we found that biomechanical properties of premenopausal vaginal tissue with anterior vaginal symptomatic prolapse were superior to those of postmenopausal one, which has provided that menopause had influenced the biomechanical properties of vaginal tissue. However, this was most likely an age-related phenomenon.2. Biomechanical properties of postmenopausal vaginal tissue with anterior vaginal symptomatic prolapse after short-term (6 weeks) local vaginal estrogen replacement treatment or neither showed little or no difference, which has suggested that short-term vaginal estrogen replacement treatment cannot improve the biomechanical properties of vaginal tissue with postmenopausal vaginal symptomatic prolapse.3. Biomechanical properties of postmenopausal vaginal tissue with non-PFD symptom were superior to the one with vaginal symptomatic prolapse, which has suggested that diminished biomechanical properties was an important pathogenesis of POP.