CONNECTIVE TISSUE AND ETIOLOGY OF GENITOURINARY PROLAPSE

本项目的目的是确定 泌尿生殖器脱垂，一种随年龄增长而出现的常见疾病。 手术 是目前唯一确定的治疗方法 1987年， 美国治疗女性泌尿生殖器脱垂 与 更好地了解病因和发展 泌尿生殖器脱垂，预防保健可以针对高 风险群体和非手术治疗方案可以开发。 结缔组织，特别是胶原蛋白和弹性蛋白， 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 和个人习惯的差异很大， 出现脱垂。 因为结缔组织负责 机械强度和许多支持组织， 胶原交联，胶原亚型的比例，以及 总胶原蛋白含量可能使一些妇女容易发生脱垂。 产科史、排便习惯和运动方式可能 在那些容易发生筋膜炎的女性中引起泌尿生殖器脱垂 弱点 初步工作将确定确定具体的 胶原亚型的正常数量和比例 （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， 新开发的ELISA都将用于实现这一目标。 接下来，这些参数将用于比较结缔组织 泌尿生殖道脱垂妇女和正常妇女。 最后， 其它因素如交联、稳定性和附加的 结缔组织的成分（蛋白聚糖、弹性蛋白和 纤维连接蛋白）将被检查是否与 盆腔组织 通过了解泌尿生殖道脱垂的机制，高 可以识别风险群体并针对性地进行预防 干预措施，如改变产科护理， 肠道和运动习惯，并希望发展非- 手术治疗选择。

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.