The effect of consecutive pregnancies on the ovine pelvic soft tissues: Link between biomechanical and histological components

Ann Anat. 2019 Mar:222:166-172. doi: 10.1016/j.aanat.2018.12.002. Epub 2018 Dec 21.

Abstract

Background: Pelvic organ prolapse, various types of incontinence (urinary incontinence, defecatory dysfunction), chronic cystourethritis, and sexual dysfunctions remain between the most common disorders in urogynecology. Currently, it is believed that the nature and number of births plays a major role in their development. Moreover, after these events, pelvic floor tissues may not recover to their original statuses. The close anatomical relationship among the vaginal wall, bladder and rectum often contribute to the emergence of anatomical-functional failure of adjacent organs and systems.

Basic procedures: The aim of this study was to investigate the effect of consecutive pregnancies on pelvic floor soft tissues, conducting biomechanical and histological analysis. Fifteen Swifter ewes: virgins, parous and pregnant were used. Samples, for uniaxial tension tests and histological analysis, were cut out from fresh tissue. A description of the mechanical properties of native tissue was obtained from the stress-strain curve. Histological samples were stained with Miller's Elastica staining and analyzed using ImageJ software. Collagen, elastin, and smooth muscle contents (%) were analyzed along the full wall thickness of the selected organs. The links between mechanical properties of the soft tissues and histological parameters were analyzed.

Main findings: Mechanically, vaginal wall tissue and cervix of pregnant sheep were more compliant. In contrast, bladder and rectum became stiffer and had the highest total collagen content. Parous sheep rectum and bladder were stiffer, compared to virgin sheep.

Principal conclusions: Tensile strength appears to be linked to total collagen content. Elastin and smooth muscle show a direct influence on tissue compliance.

Keywords: Animal model; Biomechanical properties; Histological components; Pelvic floor; Pregnancy; Soft tissues.

MeSH terms

  • Animals
  • Biomechanical Phenomena / physiology*
  • Cervix Uteri / anatomy & histology
  • Collagen / metabolism
  • Elasticity
  • Elastin
  • Female
  • Pelvic Organ Prolapse
  • Pelvis / anatomy & histology*
  • Pregnancy
  • Pregnancy, Animal / physiology*
  • Rectum / anatomy & histology
  • Sheep, Domestic / anatomy & histology*
  • Tensile Strength
  • Urinary Bladder / anatomy & histology
  • Vagina / anatomy & histology

Substances

  • Collagen
  • Elastin