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Published on: April 30, 2021
Identification of a vaginal pacemaker: An immunohistochemical and morphometric study
A Shafik1, A A Shafik, O El Sibai
1Department of Surgery and Experimental Research, Faculty of Medicine, Cairo University, Cairo, Egypt. shafik@ahmedshafik.com
Summary
Vaginal electric waves originate from interstitial cells of Cajal (ICCs) in the upper posterior vagina. This study identified a specific ICC center, suggesting it drives caudal wave propagation.
Area of Science:
- Reproductive Biology
- Gastrointestinal Physiology
- Smooth Muscle Physiology
Background:
- Vaginal electric waves are observed to propagate caudally.
- The origin of these waves remains unclear.
- Interstitial cells of Cajal (ICCs) are known pacemakers in various smooth muscle tissues.
Purpose of the Study:
- To investigate the hypothesis that vaginal electric waves originate from a center of interstitial cells of Cajal (ICCs) in the proximal vagina.
- To identify the specific location and density of ICCs within the vaginal wall.
Main Methods:
- Immunohistochemical analysis using C-kit, a specific ICC marker, on vaginal wall specimens from 23 cadavers.
- Morphometric studies and image analysis to quantify C-kit positive cells.
- Comparison of ICC distribution in different regions and muscle layers of the vagina.
Main Results:
- C-kit positive cells, indicative of ICCs, were detected in the vaginal smooth muscle.
- A significantly higher concentration of ICCs was found in the upper posterior vaginal wall compared to other regions (p < 0.0001).
- ICCs were more abundant in the circular muscle layer than the longitudinal muscle layer (p < 0.05).
Conclusions:
- The upper posterior vaginal wall serves as a primary center for interstitial cells of Cajal (ICCs).
- This ICC-rich region is suggested to be the origin of vaginal electric waves.
- The findings support the role of ICCs in the generation and caudal spread of vaginal electrical activity.
