PDF(Pubmed)
Abstract：
Background and Objectives: This study aims to compare the neuromuscular structure of the vagina in women with posterior vaginal wall prolapse with the neuromuscular structure of the vagina in women without prolapse, to determine the difference, and to demonstrate the role of neuromuscular structure in the physiopathology of prolapse. Materials and Methods: In this prospective study, women aged between 40 and 75 years who had not undergone any vaginal surgery and had not undergone any abdominal prolapse surgery were included. Thirty-one women diagnosed with rectocele on examination were included in the study group. Thirty-one patients who underwent vaginal intervention and hysterectomy for reasons other than rectocele (colposcopy, conization, etc.) without anterior or posterior wall prolapse were included in the control group. Biopsy material was obtained from the epithelium of the posterior wall of the vagina, including the fascia that fits the Ap point. Immunohistochemical staining with Protein Gene Product 9.5 and smooth muscle α-actin was performed in the pathology laboratory. The epithelial thickness measurement and smooth muscle density parameters obtained with these immunohistochemical stainings were compared between the two groups. The collected data were analyzed using the SPSS 23 package program. p values less than 0.05 were considered statistically significant. Results: In the control group, muscle thickness and the number of nerves per mm2 of fascia were statistically significantly higher than in the study group (p < 0.05). Conclusions: We found that smooth muscle tissue and the number of nerves per mm2 of fascia were decreased in posterior vaginal wall prolapse compared to the general population. Based on the correlation coefficients, age was the parameter that most affected the degree of prolapse, followed by parity, number of live births, and number of vaginal deliveries.
摘要：
背景与目的:本研究旨在比较阴道后壁脱垂女性阴道神经肌肉结构与无脱垂女性阴道神经肌肉结构,为了确定差异，并证明神经肌肉结构在脱垂的病理生理学中的作用。材料和方法：在这项前瞻性研究中，研究对象包括年龄在40~75岁之间,未进行任何阴道手术和腹部脱垂手术的女性.31名在检查中被诊断为直肠前突的妇女被纳入研究组。31例因直肠前突以外的原因接受阴道介入和子宫切除术的患者（阴道镜检查，锥化，等。)无前壁或后壁脱垂者纳入对照组。活检材料是从阴道后壁的上皮获得的，包括适合Ap点的筋膜。病理实验室用蛋白基因产物9.5和平滑肌α-肌动蛋白进行免疫组织化学染色。比较两组之间通过这些免疫组织化学染色获得的上皮厚度测量值和平滑肌密度参数。使用SPSS23软件包程序对收集的数据进行分析。小于0.05的p值被认为是统计学上显著的。结果:对照组,肌肉厚度和每mm2筋膜的神经数量均高于研究组（p<0.05）。结论：我们发现，与普通人群相比，阴道后壁脱垂的平滑肌组织和每mm2筋膜的神经数量减少。根据相关系数，年龄是影响脱垂程度最大的参数，其次是平价，活产婴儿的数量，和阴道分娩的数量。
