Neuromuscular morphometry of the vaginal wall in women with anterior vaginal wall prolapse.

INTRODUCTION AND HYPOTHESIS: The aim of this study was to compare the changes in hystomorphometry and innervation of the anterior vaginal wall in women with and without anterior vaginal wall prolapse.

METHODS

Eighty-nine biopsy specimens were obtained from the anterior vaginal wall of women having a cystocele repaired (stage >or=II; prolapse group, 49) and the same location in patients with no prolapse (stage <II; control group, 40). Routine H&E staining and immunohistochemical staining for protein gene product 9.5 (PGP-9.5) and smooth muscle alpha-actin (SMA) were performed for all specimens.

RESULTS

Number and diameter of the submucosal nerve fibers were significantly lower, submucosal distance to muscular region was significantly higher in the vaginal wall of patients with cystocele than in women with normal vaginal support. We found that there was a negative correlation between the vaginal delivery and the nerve number and diameter measurements, and positive correlation between the vaginal delivery and submucosal distance of muscular level.

CONCLUSIONS

Results indicate that women with a cystocele have a significantly lower total innervation and higher muscular distance of the anterior vaginal epithelium than the control subjects.