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Updated: Jun 30, 2025
Anogenital Distance and Perineal Measurements of the Pelvic Organ Prolapse POP Quantification System
Published on: September 20, 2018
Effect of Vaginal Microecological Alterations on Female Pelvic Organ Prolapse
Shaozhan Chen1,2, Qiaomei Zheng1,2, Limin Zhang1,2
1Department of Obstetrics and Gynecology, Fujian Key Laboratory of Precision Medicine for Cancer, the First Affiliated Hospital, Fujian Medical University, 20 Chazhong Road, Fuzhou, Fujian, 350005, People's Republic of China.
Introduction And Hypothesis:
The objective was to investigate the correlation between endogenous vaginal microecological alterations and female pelvic organ prolapse (POP).
Methods:
Patients who underwent vaginal hysterectomy were retrospectively analyzed as the POP group (n = 30) and the non-POP group (n = 30). The vaginal microbial metabolites and enzyme levels were tested using the dry chemoenzymatic method. The mRNA and protein expression were tested using real-time quantitative PCR and immunohistochemistry. SPSS version 25.0 and GraphPad Prism 8.0 were performed for statistical analysis.
Results:
Compared with the non-POP group, the vaginal pH, H2O2 positivity and leukocyte esterase positivity were higher in patients with POP (all p < 0.05). Further analysis showed that patients with pelvic organ prolapse quantification (POP-Q) stage IV had higher rates of vaginal pH, H2O2 positivity and leukocyte esterase positivity than those with POP-Q stage III. Additionally, the mRNA expression of decorin (DCN), transforming growth factor beta 1 (TGF-β1), and matrix metalloproteinase-3 (MMP-3) in uterosacral ligament tissues were higher, whereas collagen I and III were lower. Similarly, the positive expression of MMP-3 in uterosacral ligament tissue was significantly upregulated in the POP group compared with the non-POP group (p = 0.035), whereas collagen I (p = 0.004) and collagen III (p = 0.019) in uterosacral ligament tissue were significantly downregulated in the POP group. Correlation analysis revealed that there was a significant correlation between vaginal microecology and collagen metabolism. In addition, MMP-3 correlated negatively with collagen I and collagen III (p = 0.002, r = -0.533; p = 0.002, r = -0.534 respectively), whereas collagen I correlated positively with collagen III (p = 0.001, r = 0.578).
Conclusions:
Vaginal microecological dysbiosis affects the occurrence of female POP, which could be considered a novel therapeutic option.
Insights
Altered vaginal microecology, indicated by higher pH and enzyme levels, is linked to female pelvic organ prolapse (POP). This suggests vaginal dysbiosis impacts POP development and may offer new treatment avenues.
Area of Science:
- Gynecology
- Microbiology
- Biochemistry
Background:
- Pelvic organ prolapse (POP) is a common condition affecting women's health.
- The role of vaginal microecological balance in POP pathogenesis is not fully understood.
Purpose of the Study:
- To investigate the correlation between endogenous vaginal microecological alterations and the occurrence of female pelvic organ prolapse (POP).
Main Methods:
- Retrospective analysis of 60 patients (30 POP, 30 non-POP) undergoing vaginal hysterectomy.
- Vaginal microbial metabolites and enzyme levels assessed via dry chemoenzymatic method.
- mRNA and protein expression in uterosacral ligament tissues analyzed using RT-qPCR and immunohistochemistry.
Main Results:
- Patients with POP exhibited higher vaginal pH, H2O2 positivity, and leukocyte esterase positivity compared to controls.
- POP-Q stage IV patients showed significantly higher rates of these vaginal markers than stage III.
- Uterosacral ligament tissues in POP patients had increased MMP-3 and decreased Collagen I and III expression.
- Significant negative correlations were found between MMP-3 and collagen levels, and a positive correlation between Collagen I and III.
Conclusions:
- Vaginal microecological dysbiosis is associated with the development of female pelvic organ prolapse.
- These findings suggest that alterations in vaginal microecology play a role in POP.
- Targeting vaginal microecology could represent a novel therapeutic strategy for POP.
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