Pelvic floor disorders: linking genetic risk factors to biochemical changes

BJU Int. 2011 Oct;108(8):1240-7. doi: 10.1111/j.1464-410X.2011.10385.x. Epub 2011 Aug 26.


Pelvic floor disorders (PFDs) such as stress urinary incontinence (SUI) and pelvic organ prolapse (POP) may share a common pathophysiological process related to pelvic floor tissue laxity and loss of support. We reviewed recent literature on observed biochemical changes in women with SUI and POP, linking them to genetic predisposition. We found that studies of pelvic tissues showed differences between control subjects and women with POP and SUI in collagen and elastin structure at a molecular and fibrillar level. Studies were heterogeneous but showed a trend towards decreased collagen and elastin content. The contribution of matrix metalloproteinases to increased collagenolysis can be related to genetic polymorphisms present in higher frequency in women with PFD. Extracellular matrix (ECM) protein turnover plays a role in the development of POP and SUI, but much remains to be understood of this complex dynamic interplay of enzymes, proteins and molecules. Genotyping of candidate genes participating in ECM formation will elucidate the missing link between the manifestation of the disease and the biochemical changes observed systematically, in addition to those in the pelvic floor.

Publication types

  • Review

MeSH terms

  • Collagen / genetics
  • Collagen / metabolism
  • Elastin / genetics
  • Elastin / metabolism
  • Extracellular Matrix / metabolism
  • Female
  • Genetic Predisposition to Disease
  • Humans
  • Matrix Metalloproteinases
  • Pelvic Floor / pathology*
  • Pelvic Organ Prolapse / genetics*
  • Pelvic Organ Prolapse / metabolism
  • Risk Factors
  • Urinary Incontinence, Stress / genetics*
  • Urinary Incontinence, Stress / metabolism


  • Collagen
  • Elastin
  • Matrix Metalloproteinases