CONNECTIVE TISSUE AND ETIOLOGY OF GENITOURINARY PROLAPSE

这个项目的目的是要确定 生殖器脱垂，随着女性年龄的增长，这是一种常见的情况。外科手术 是目前治疗这种疾病的唯一有效方法， 在1987年，有379,000例大型外科手术 美国对女性生殖器脱垂情况的调查。使用 更好地了解心绞痛的病因和发展 泌尿生殖系统脱垂，预防性护理可针对高位 可以开发风险群体和非手术治疗方案。 结缔组织，尤其是胶原和弹性蛋白，支持 最有希望解释泌尿生殖系统的发展 脱垂，特别是为什么有相同病史的女性 个人习惯在多大程度上是不同的 会发展成脱垂。因为结缔组织负责 机械强度和许多支持组织，在 胶原蛋白的交联度、胶原蛋白亚型的比例以及 总胶原蛋白含量可能会使一些女性容易脱垂。 产科病史、排便习惯和锻炼方式 在那些有筋膜倾向的女性中引起生殖道脱垂 软弱。 初步工作将建立确定具体情况的方法 胶原蛋白亚型的参数和正常含量及比例 (i和iii)在涉及骨盆支撑的结构中。 免疫荧光研究、化学提取方法和 新开发的酶联免疫吸附试验将全部用于实现这一目标。 接下来，这些参数将用于比较结缔组织 在患有生殖器脱垂的女性和正常女性中。最后， 其他因素，如交联性、稳定性和其他 结缔组织的成分(蛋白多糖、弹性蛋白和 纤维连接蛋白)将被检查是否与腹股沟突出有关 盆腔组织。 通过了解泌尿生殖系统脱垂的机制，高 可以识别风险组并将其作为预防性目标 干预措施，如产科护理的变更、修改 大便和运动习惯，希望能养成非 手术治疗的选择。

The intent of this project is to determine the mechanisms of genitourinary prolapse, a common condition as women age. Surgery is currently the only definitive treatment for this condition, and 379,000 major surgical procedures were done in 1987 in the U.S. for conditions of genitourinary prolapse in women. With better understanding of the etiology and development of genitourinary prolapse, preventative care can be directed at high risk groups, and non-surgical treatment options can be developed. Connective tissue, especially collagen and elastin, holds the most promise for explaining the development of genitourinary prolapse, especially why women with the same medical histories and personal habits differ greatly in the degree to which prolapse develops. Because connective tissue is responsible for mechanical strength and many supportive tissues, alterations in collagen cross-linking, proportions of collagen sub-types, and total collagen content may predispose some women to prolapse. Obstetric history, bowel habits, and exercise patterns may then cause genitourinary prolapse in those women prone to fascial weakness. Initial work will establish methods for determining specific parameters and normal amount and proportion of collagen sub-types (I and III) in structures involved in pelvic support. Immunofluroescent studies, chemical extraction methods, and a newly developed ELISA will all be used to achieve this goal. Next, these parameters will be used to compare connective tissue in women with genitourinary prolapse and normal women. Finally, other factors such as cross-linking, stability, and additional components of connective tissue (proteoglycans, elastin, and fibronectin) will be examined for association with herniation of pelvic tissues. By understanding the mechanisms of genitourinary prolapse, high risk groups can be identified and targeted for preventative interventions such as alterations in obstetric care, modification of bowel and exercise habits, and hopefully development of non- surgical treatment options.