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01.03.2019 | Original Article

First delivery and ovariectomy affect biomechanical and structural properties of the vagina in the ovine model

verfasst von: Iva Urbankova, Geertje Callewaert, Silvia Blacher, Dries Deprest, Lucie Hympanova, Andrew Feola, Laurent De Landsheere, Jan Deprest

Erschienen in: International Urogynecology Journal | Ausgabe 3/2019

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Abstract

Introduction and hypothesis

Animal models are useful for investigating the genesis of pelvic floor dysfunction and for developing novel therapies for its treatment. There is a need for an alternative large-animal model to the nonhuman primate. Therefore we studied the effects of the first vaginal delivery, ovariectomy and systemic hormonal replacement therapy (HRT) on the biomechanical and structural properties of the ovine vagina.

Methods

We examined the gross anatomical properties of nulliparous, primiparous, ovariectomized multiparous, and ovariectomized hormone-replaced multiparous sheep (six animals per group). We also harvested mid-vaginal and distal vaginal tissue to determine smooth muscle contractility and passive biomechanical properties, for morphometric assessment of the vaginal wall layers, to determine collagen and elastin content, and for immunostaining for α-smooth muscle actin and estrogen receptor-α.

Results

There were no regional differences in the nulliparous vagina. One year after the first vaginal delivery, stiffness and contractility of the distal vagina were decreased, whereas the elastin content increased. The mid-vagina of ovariectomized sheep was stiff, and its epithelium was thin and lacked glycogen. HRT decreased the stiffness of the mid-vagina by 45% but had no measurable effect on contractility or elastin content, and increased epithelial thickness and glycogen content. HRT also increased the epithelial thickness and glycogen content of the distal vagina. At this location, there were no changes in morphology or stiffness.

Conclusion

In sheep, life events including delivery and ovariectomy affect the biomechanical properties of the vagina in a region-specific way. Vaginal delivery mainly affects the distal region by decreasing stiffness and contractility. HRT can reverse the increase in stiffness of the mid-vagina observed after surgical induction of menopause. These observations are in line with scanty biomechanical measurements in comparable clinical specimens.

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Titel: First delivery and ovariectomy affect biomechanical and structural properties of the vagina in the ovine model
verfasst von: Iva Urbankova
Geertje Callewaert
Silvia Blacher
Dries Deprest
Lucie Hympanova
Andrew Feola
Laurent De Landsheere
Jan Deprest
Publikationsdatum: 01.03.2019
Verlag: Springer International Publishing
Erschienen in: International Urogynecology Journal / Ausgabe 3/2019
Print ISSN: 0937-3462
Elektronische ISSN: 1433-3023
DOI: https://doi.org/10.1007/s00192-017-3535-9

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First delivery and ovariectomy affect biomechanical and structural properties of the vagina in the ovine model