Histoarchitectonics of paraurethral tissue in women with stress urinary incontinence

Abstract

Aim: to reveal morphological features of paraurethral tissue in postmenopausal women with stress urinary incontinence (SUI).Materials and Methods. A prospective cross-sectional trial was conducted, which included 30 women with SUI combined with POP-Q (Pelvic Organ Prolapse Quantification) stage I–II cystocele, aged 55 to 75 years. All patients underwent surgical treatment such as anterior colporrhaphy, cystocele plasty with own tissues, urethropexy with synthetic loop followed by morphological study of histological samples.Results. Profound alterations in architectonics of the connective tissue were revealed. Structural changes occurring in the paraurethral tissue are characterized by fragmentation of collagen and elastin fibers as well as their critically lowered thickness and volume, and destruction of strong inter-fiber bonds. This indicates about disintegration of the collagen-elastin skeleton being a part of the ligamentous apparatus involved in urinary retention.Conclusion. The study of the morphological aspects related to stress incontinence including use of immunohistochemical research methods will provide deeper insights into pathogenetic mechanisms behind such pathological condition. Thus, it will be possible to implement a personalized approach to the tactics of management and the choice of therapeutic method for patients with SUI aimed to increase in its effectiveness.