[Structural-morphological changes of the connective tissue of the vaginal mucosa and perineal skin in women with stress urinary incontinence]

Urologiia. 2017 Oct;(5):15-20. doi: 10.18565/urology.2017.5.15-20.
[Article in Russian]


Aim: To investigate the morphological and structural changes in the connective tissue of the vaginal mucosa and perineal skin in women with stress urinary incontinence.

Materials and methods: From 2010 to 2013, 71 patients of reproductive age with stress incontinence were observed. The control group comprised 80 women, who also underwent biopsy of the vaginal mucosa and perineal skin. The sections of specimens were stained by Van Gieson, Mallory and Weigert. In immunohistochemical studies, rabbit antibodies specific for collagen types I, III, and IV were placed on each section.

Results: Morphological picture of the perineal skin the study group patients completely confirms the clinical manifestations and results of immunohistochemical test, broadens the notion of structural changes in tissues. According to immunohistochemical and histological examination of the vaginal mucosa, some fibrous elements in the lamina were weakly stained. Due to the decrease in the number of vessels and the destruction of their basal membranes and the basal membrane of the epithelial layer, the amount of type IV collagen was markedly reduced.

Discussion: Elastic fibers in the vaginal mucosa and skin of the perineum together with the collagen fibers are the supporting framework of the skin, and together with the interstitial substance of the above authorities lend elasticity in tension. Studies have shown that stress urinary incontinence may be the result of dysregulation of processes. For this pathology in the lamina propria of the vaginal mucosa and dermal lamina of the skin of the perineum destroyed elastic fibers and changes the ratio of collagen of various types. That is, the predominant type III collagen is type I collagen, as well as in the basal membranes, reduced the number of specific collagen type IV.

Conclusion: Mucous membrane of the vagina and perineal skin in women with a stress urinary incontinence is found to exhibit marked pathomorphological changes due to inflammatory, destructive and compensatory-adaptive processes leading to scarring of the connective tissue and alteration in the ratio of collagen content in various tissues.

Keywords: childbirth Authors declare no conflict of interests for this article; reproductive age; urinary incontinence.

MeSH terms

  • Adult
  • Female
  • Humans
  • Mucous Membrane / pathology
  • Skin / pathology*
  • Urinary Incontinence, Stress / pathology*
  • Vagina / pathology*