Biochemical Composition of Collagen in Continent and Stress Urinary Incontinent Women

Abstract

This study was designed to assess the relationship between the amount of collagen type III in the pelvic supportive tissues and stress urinary incontinence (SUI) with or without pelvic relaxation. Fourteen women agreed to participate in the study: 6 had stress urinary incontinence and pelvic relaxation (group 1); 4 had no pelvic relaxation and no sign or symptoms of SUI (group 2); 4 had pelvic relaxation without SUI (group 3). All patients underwent gynecologic surgical procedures for benign pathology and at that time biopsies were taken from perineal skin, uterosacral ligaments and round ligaments of the uterus. Collagen type III content was measured in the specimens and compared between the groups. Each subject preoperatively underwent complete urodynamic workup. A t test was used for the statistical analysis. Collagen type III content was significantly reduced (p < 0.05) in the specimens from patients with SUI (group 1) as compared independently with each of the other two groups (groups 2 and 3). Tissues from women without SUI (groups 2 and 3) had a similar content of collagen type III. These findings suggest that women with SUI show an altered collagen profile in the skin, the uterosacral, and the round ligaments. This seems unrelated to secondary damage of the supportive tissues and degree of pelvic relaxation.