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Тазовые дисфункции у женщин как следствие анатомо-функциональных изменений тазового дна во время беременности и отражение адаптации к родам
Тазовые дисфункции у женщин как следствие анатомо-функциональных изменений тазового дна во время беременности и отражение адаптации к родам
Безменко А.А., Староверова А.С. Тазовые дисфункции у женщин как следствие анатомо-функциональных изменений тазового дна во время беременности и отражение адаптации к родам. Гинекология. 2024;26(4):326–330. DOI: 10.26442/20795696.2024.4.203015
© ООО «КОНСИЛИУМ МЕДИКУМ», 2024 г.
© ООО «КОНСИЛИУМ МЕДИКУМ», 2024 г.
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Аннотация
В обзоре раскрыты гормональные и биохимические изменения во время беременности, оказывающие многостороннее влияние на структуру и функцию тазового дна и являющиеся адаптационным механизмом к растяжению в момент прохождения ребенка по родовым путям. Показано, что дебют тазовых дисфункций во время беременности есть отражение этапов ремоделирования соединительной ткани. Беременность как дополнительный фактор, влияющий на функцию тазового дна, может быть триггерным механизмом к развитию пролапса тазовых органов. У беременных с недостаточной адаптацией тазового дна чаще случаются травмы во время родов, а нарушения процессов ремоделирования синтеза компонентов соединительной ткани приводят к пролапсу тазовых органов и тазовым дисфункциям в последующем. Механизм нарушения ремоделирования соединительной ткани тазового дна во время беременности остается не до конца ясным и требует дальнейшего изучения.
Ключевые слова: ремоделирование, соединительная ткань, тазовое дно, беременность
Keywords: remodeling, connective tissue, pelvic floor, pregnancy
Ключевые слова: ремоделирование, соединительная ткань, тазовое дно, беременность
________________________________________________
Keywords: remodeling, connective tissue, pelvic floor, pregnancy
Полный текст
Список литературы
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21. Jackson SR, Avery NC, Tarlton JF, et al. Changes in metabolism of collagen in genitourinary prolapse. Lancet. 1996;347(9016):1658-61. DOI:10.1016/s0140-6736(96)91489-0
22. Connell KA, Guess MK, Chen H, et al. HOXA11 is critical for development and maintenance of uterosacral ligaments and deficient in pelvic prolapse. J Clin Invest.
2008;118(3):1050-5. DOI:10.1172/jci34193
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26. Rahn DD, Ruff MD, Brown SA, et al. Biomechanical properties of the vaginal wall: effect of pregnancy, elastic fiber deficiency, and pelvic organ prolapse. Am J Obstet Gynecol. 2008;198(5):590.e1-6. DOI:10.1016/j.ajog.2008.02.022
27. Liu X, Zhao Y, Pawlyk B, et al. Failure of elastic fiber homeostasis leads to pelvic floor disorders. Am J Pathol. 2006;168(2):519-28. DOI:10.2353/ajpath.2006.050399
28. Smith P, Heimer G, Norgren A, Ulmsten U. Localization of steroid hormone receptors in the pelvic muscles. Eur J Obstet Gynecol Reprod Biol. 1993;50(1):83-5.
DOI:10.1016/0028-2243(93)90169-d
29. Kurita T, Lee KJ, Cooke PS, et al. Paracrine regulation of epithelial progesterone receptor by estradiol in the mouse female reproductive tract. Biol Reprod. 2000;62(4):821-30. DOI:10.1093/biolreprod/62.4.821. Erratum in: Biol Reprod. 2000;63(1):354.
30. Carley ME, Rickard DJ, Gebhart JB, et al. Distribution of estrogen receptors alpha and beta mRNA in mouse urogenital tissues and their expression after oophorectomy and estrogen replacement. Int Urogynecol J Pelvic Floor Dysfunct. 2003;14(2):141-5. DOI:10.1007/s00192-002-1020-5
31. Hextall A, Bidmead J, Cardozo L, Hooper R. The impact of the menstrual cycle on urinary symptoms and the results of urodynamic investigation. BJOG. 2001;108(11):1193-6. DOI:10.1111/j.1471-0528.2003.00280.x
32. Nallasamy S, Yoshida K, Akins M, et al. Steroid Hormones Are Key Modulators of Tissue Mechanical Function via Regulation of Collagen and Elastic Fibers. Endocrinology. 2017;158(4):950-62. DOI:10.1210/en.2016-1930
33. Fede C, Pirri C, Fan C, et al. Sensitivity of the fasciae to sex hormone levels: Modulation of collagen-I, collagen-III and fibrillin production. PLoS One. 2019;14(9):e0223195. DOI:10.1371/journal.pone.0223195
34. Wang S, Lü D, Zhang Z, et al. Effects of mechanical stretching on the morphology of extracellular polymers and the mRNA expression of collagens and small leucine-rich repeat proteoglycans in vaginal fibroblasts from women with pelvic organ prolapse. PLoS One. 2018;13(4):e0193456. DOI:10.1371/journal.pone.0193456
35. Molinet Coll C, Martínez Franco E, Altimira Queral L, et al. Hormonal Influence in Stress Urinary Incontinence During Pregnancy and Postpartum. Reprod Sci. 2022;29(8):2190-9. DOI:10.1007/s43032-022-00946-7
36. Lowder JL, Debes KM, Moon DK, et al. Biomechanical adaptations of the rat vagina and supportive tissues in pregnancy to accommodate delivery. Obstet Gynecol.
2007;109(1):136-43. DOI:10.1097/01.aog.0000250472.96672.6c
37. Zhao S, Sherwood OD. Monoclonal antibodies specific for rat relaxin. X. Endogenous relaxin induces changes in the histological characteristics of the rat vagina during the second half of pregnancy. Endocrinology. 1998;139(11):4726-34. DOI:10.1210/endo.139.11.6327
38. O'Boyle AL. Pelvic organ support in nulliparous pregnant and nonpregnant women. Am J Obstet Gynecol. 2003;188(1):301. DOI:10.1067/mob.2003.20. Erratum in: Am J Obstet Gynecol. 2002;187(1):99-102. DOI:10.1067/mob.2002.125734
2. Snooks SJ, Swash M, Mathers SE, Henry MM. Effect of vaginal delivery on the pelvic floor: a 5-year follow-up. Br J Surg. 1990;77(12):1358-60. DOI:10.1002/bjs.1800771213
3. Slieker-ten Hove MC, Pool-Goudzwaard AL, Eijkemans MJ, et al. Prediction model and prognostic index to estimate clinically relevant pelvic organ prolapse in a general female population. Int Urogynecol J Pelvic Floor Dysfunct. 2009;20(9):1013-21. DOI:10.1007/s00192-009-0903-0. Erratum in: Int Urogynecol J Pelvic Floor Dysfunct. 2010;21(3):387-8.
4. Chaliha C, Kalia V, Stanton SL, et al. Antenatal prediction of postpartum urinary and fecal incontinence. Obstet Gynecol. 1999;94(5 Pt. 1):689-94. DOI:10.1016/s0029-7844(99)00364-6
5. Højberg KE, Salvig JD, Winsløw NA, et al. Urinary incontinence: prevalence and risk factors at 16 weeks of gestation. Br J Obstet Gynaecol. 1999;106(8):842-50.
DOI:10.1111/j.1471-0528.1999.tb08407.x
6. Lukacz ES, Lawrence JM, Contreras R, et al. Parity, mode of delivery, and pelvic floor disorders. Obstet Gynecol. 2006;107(6):1253-60. DOI:10.1097/01.aog.0000218096.54169.34
7. Schytt E, Lindmark G, Waldenström U. Symptoms of stress incontinence 1 year after childbirth: prevalence and predictors in a national Swedish sample. Acta Obstet Gynecol Scand. 2004;83(10):928-36. DOI:10.1111/j.0001-6349.2004.00431.x
8. Weintraub AY, Glinter H, Marcus-Braun N. Narrative review of the epidemiology, diagnosis and pathophysiology of pelvic organ prolapse. Int Braz J Urol. 2020;46(1):5-14. DOI:10.1590/s1677-5538.ibju.2018.0581
9. Good MM, Solomon ER. Pelvic Floor Disorders. Obstet Gynecol Clin North Am. 2019;46(3):527-40. DOI:10.1016/j.ogc.2019.04.010
10. Jefferis H, Price N. Pelvic organ prolapse. Urogynaecology. 2020:57-82. DOI:10.1093/med/9780198829065.003.0004
11. Gelse K, Pöschl E, Aigner T. Collagens – structure, function, and biosynthesis. Adv Drug Deliv Rev. 2003;55(12):1531-46. DOI:10.1016/j.addr.2003.08.002
12. Salman MC, Ozyuncu O, Sargon MF, et al. Light and electron microscopic evaluation of cardinal ligaments in women with or without uterine prolapse. Int Urogynecol J. 2010;21(2):235-9. DOI:10.1007/s00192-009-1006-7
13. Chen Y, DeSautel M, Anderson A, et al. Collagen synthesis is not altered in women with stress urinary incontinence. Neurourol Urodyn. 2004;23(4):367-73. DOI:10.1002/nau.20006
14. Chen BH, Wen Y, Li H, Polan ML. Collagen metabolism and turnover in women with stress urinary incontinence and pelvic prolapse. Int Urogynecol J Pelvic Floor Dysfunct. 2002;13(2):80-7; discussion 87. DOI:10.1007/s001920200020
15. Trabucco E, Soderberg M, Cobellis L, et al. Role of proteoglycans in the organization of periurethral connective tissue in women with stress urinary incontinence. Maturitas. 2007;58(4):395-405. DOI:10.1016/j.maturitas.2007.09.010
16. Ulmsten U, Ekman G, Giertz G, Malmström A. Different biochemical composition of connective tissue in continent and stress incontinent women. Acta Obstet Gynecol Scand. 1987;66(5):455-7. DOI:10.3109/00016348709022054
17. Manabe Y, Yoshida Y. Collagenolysis in human vaginal tissue during pregnancy and delivery: a light and electron microscopic study. Am J Obstet Gynecol. 1986;155(5):1060-6. DOI:10.1016/0002-9378(86)90350-9
18. Daucher JA, Clark KA, Stolz DB, et al. Adaptations of the rat vagina in pregnancy to accommodate delivery. Obstet Gynecol. 2007;109(1):128-35. DOI:10.1097/01.aog.0000246798.78839.62
19. Dhital B, Gul-E-Noor F, Downing KT, et al. Pregnancy-Induced Dynamical and Structural Changes of Reproductive Tract Collagen. Biophys J. 2016;111(1):57-68. DOI:10.1016/j.bpj.2016.05.049
20. Edwall L, Carlström K, Jonasson AF. Markers of collagen synthesis and degradation in urogenital tissue from women with and without stress urinary incontinence. Neurourol Urodyn. 2005;24(4):319-24. DOI:10.1002/nau.20142
21. Jackson SR, Avery NC, Tarlton JF, et al. Changes in metabolism of collagen in genitourinary prolapse. Lancet. 1996;347(9016):1658-61. DOI:10.1016/s0140-6736(96)91489-0
22. Connell KA, Guess MK, Chen H, et al. HOXA11 is critical for development and maintenance of uterosacral ligaments and deficient in pelvic prolapse. J Clin Invest.
2008;118(3):1050-5. DOI:10.1172/jci34193
23. Drewes PG, Yanagisawa H, Starcher B, et al. Pelvic organ prolapse in fibulin-5 knockout mice: pregnancy-induced changes in elastic fiber homeostasis in mouse vagina. Am J Pathol. 2007;170(2):578-89. DOI:10.2353/ajpath.2007.060662
24. Goepel C, Thomssen C. Changes in the extracellular matrix in periurethral tissue of women with stress urinary incontinence. Acta Histochem. 2006;108(6):441-5. DOI:10.1016/j.acthis.2006.07.001
25. Klutke J, Ji Q, Campeau J, et al. Decreased endopelvic fascia elastin content in uterine prolapse. Acta Obstet Gynecol Scand. 2008;87(1):111-5. DOI:10.1080/00016340701819247
26. Rahn DD, Ruff MD, Brown SA, et al. Biomechanical properties of the vaginal wall: effect of pregnancy, elastic fiber deficiency, and pelvic organ prolapse. Am J Obstet Gynecol. 2008;198(5):590.e1-6. DOI:10.1016/j.ajog.2008.02.022
27. Liu X, Zhao Y, Pawlyk B, et al. Failure of elastic fiber homeostasis leads to pelvic floor disorders. Am J Pathol. 2006;168(2):519-28. DOI:10.2353/ajpath.2006.050399
28. Smith P, Heimer G, Norgren A, Ulmsten U. Localization of steroid hormone receptors in the pelvic muscles. Eur J Obstet Gynecol Reprod Biol. 1993;50(1):83-5.
DOI:10.1016/0028-2243(93)90169-d
29. Kurita T, Lee KJ, Cooke PS, et al. Paracrine regulation of epithelial progesterone receptor by estradiol in the mouse female reproductive tract. Biol Reprod. 2000;62(4):821-30. DOI:10.1093/biolreprod/62.4.821. Erratum in: Biol Reprod. 2000;63(1):354.
30. Carley ME, Rickard DJ, Gebhart JB, et al. Distribution of estrogen receptors alpha and beta mRNA in mouse urogenital tissues and their expression after oophorectomy and estrogen replacement. Int Urogynecol J Pelvic Floor Dysfunct. 2003;14(2):141-5. DOI:10.1007/s00192-002-1020-5
31. Hextall A, Bidmead J, Cardozo L, Hooper R. The impact of the menstrual cycle on urinary symptoms and the results of urodynamic investigation. BJOG. 2001;108(11):1193-6. DOI:10.1111/j.1471-0528.2003.00280.x
32. Nallasamy S, Yoshida K, Akins M, et al. Steroid Hormones Are Key Modulators of Tissue Mechanical Function via Regulation of Collagen and Elastic Fibers. Endocrinology. 2017;158(4):950-62. DOI:10.1210/en.2016-1930
33. Fede C, Pirri C, Fan C, et al. Sensitivity of the fasciae to sex hormone levels: Modulation of collagen-I, collagen-III and fibrillin production. PLoS One. 2019;14(9):e0223195. DOI:10.1371/journal.pone.0223195
34. Wang S, Lü D, Zhang Z, et al. Effects of mechanical stretching on the morphology of extracellular polymers and the mRNA expression of collagens and small leucine-rich repeat proteoglycans in vaginal fibroblasts from women with pelvic organ prolapse. PLoS One. 2018;13(4):e0193456. DOI:10.1371/journal.pone.0193456
35. Molinet Coll C, Martínez Franco E, Altimira Queral L, et al. Hormonal Influence in Stress Urinary Incontinence During Pregnancy and Postpartum. Reprod Sci. 2022;29(8):2190-9. DOI:10.1007/s43032-022-00946-7
36. Lowder JL, Debes KM, Moon DK, et al. Biomechanical adaptations of the rat vagina and supportive tissues in pregnancy to accommodate delivery. Obstet Gynecol.
2007;109(1):136-43. DOI:10.1097/01.aog.0000250472.96672.6c
37. Zhao S, Sherwood OD. Monoclonal antibodies specific for rat relaxin. X. Endogenous relaxin induces changes in the histological characteristics of the rat vagina during the second half of pregnancy. Endocrinology. 1998;139(11):4726-34. DOI:10.1210/endo.139.11.6327
38. O'Boyle AL. Pelvic organ support in nulliparous pregnant and nonpregnant women. Am J Obstet Gynecol. 2003;188(1):301. DOI:10.1067/mob.2003.20. Erratum in: Am J Obstet Gynecol. 2002;187(1):99-102. DOI:10.1067/mob.2002.125734
2. Snooks SJ, Swash M, Mathers SE, Henry MM. Effect of vaginal delivery on the pelvic floor: a 5-year follow-up. Br J Surg. 1990;77(12):1358-60. DOI:10.1002/bjs.1800771213
3. Slieker-ten Hove MC, Pool-Goudzwaard AL, Eijkemans MJ, et al. Prediction model and prognostic index to estimate clinically relevant pelvic organ prolapse in a general female population. Int Urogynecol J Pelvic Floor Dysfunct. 2009;20(9):1013-21. DOI:10.1007/s00192-009-0903-0. Erratum in: Int Urogynecol J Pelvic Floor Dysfunct. 2010;21(3):387-8.
4. Chaliha C, Kalia V, Stanton SL, et al. Antenatal prediction of postpartum urinary and fecal incontinence. Obstet Gynecol. 1999;94(5 Pt. 1):689-94. DOI:10.1016/s0029-7844(99)00364-6
5. Højberg KE, Salvig JD, Winsløw NA, et al. Urinary incontinence: prevalence and risk factors at 16 weeks of gestation. Br J Obstet Gynaecol. 1999;106(8):842-50.
DOI:10.1111/j.1471-0528.1999.tb08407.x
6. Lukacz ES, Lawrence JM, Contreras R, et al. Parity, mode of delivery, and pelvic floor disorders. Obstet Gynecol. 2006;107(6):1253-60. DOI:10.1097/01.aog.0000218096.54169.34
7. Schytt E, Lindmark G, Waldenström U. Symptoms of stress incontinence 1 year after childbirth: prevalence and predictors in a national Swedish sample. Acta Obstet Gynecol Scand. 2004;83(10):928-36. DOI:10.1111/j.0001-6349.2004.00431.x
8. Weintraub AY, Glinter H, Marcus-Braun N. Narrative review of the epidemiology, diagnosis and pathophysiology of pelvic organ prolapse. Int Braz J Urol. 2020;46(1):5-14. DOI:10.1590/s1677-5538.ibju.2018.0581
9. Good MM, Solomon ER. Pelvic Floor Disorders. Obstet Gynecol Clin North Am. 2019;46(3):527-40. DOI:10.1016/j.ogc.2019.04.010
10. Jefferis H, Price N. Pelvic organ prolapse. Urogynaecology. 2020:57-82. DOI:10.1093/med/9780198829065.003.0004
11. Gelse K, Pöschl E, Aigner T. Collagens – structure, function, and biosynthesis. Adv Drug Deliv Rev. 2003;55(12):1531-46. DOI:10.1016/j.addr.2003.08.002
12. Salman MC, Ozyuncu O, Sargon MF, et al. Light and electron microscopic evaluation of cardinal ligaments in women with or without uterine prolapse. Int Urogynecol J. 2010;21(2):235-9. DOI:10.1007/s00192-009-1006-7
13. Chen Y, DeSautel M, Anderson A, et al. Collagen synthesis is not altered in women with stress urinary incontinence. Neurourol Urodyn. 2004;23(4):367-73. DOI:10.1002/nau.20006
14. Chen BH, Wen Y, Li H, Polan ML. Collagen metabolism and turnover in women with stress urinary incontinence and pelvic prolapse. Int Urogynecol J Pelvic Floor Dysfunct. 2002;13(2):80-7; discussion 87. DOI:10.1007/s001920200020
15. Trabucco E, Soderberg M, Cobellis L, et al. Role of proteoglycans in the organization of periurethral connective tissue in women with stress urinary incontinence. Maturitas. 2007;58(4):395-405. DOI:10.1016/j.maturitas.2007.09.010
16. Ulmsten U, Ekman G, Giertz G, Malmström A. Different biochemical composition of connective tissue in continent and stress incontinent women. Acta Obstet Gynecol Scand. 1987;66(5):455-7. DOI:10.3109/00016348709022054
17. Manabe Y, Yoshida Y. Collagenolysis in human vaginal tissue during pregnancy and delivery: a light and electron microscopic study. Am J Obstet Gynecol. 1986;155(5):1060-6. DOI:10.1016/0002-9378(86)90350-9
18. Daucher JA, Clark KA, Stolz DB, et al. Adaptations of the rat vagina in pregnancy to accommodate delivery. Obstet Gynecol. 2007;109(1):128-35. DOI:10.1097/01.aog.0000246798.78839.62
19. Dhital B, Gul-E-Noor F, Downing KT, et al. Pregnancy-Induced Dynamical and Structural Changes of Reproductive Tract Collagen. Biophys J. 2016;111(1):57-68. DOI:10.1016/j.bpj.2016.05.049
20. Edwall L, Carlström K, Jonasson AF. Markers of collagen synthesis and degradation in urogenital tissue from women with and without stress urinary incontinence. Neurourol Urodyn. 2005;24(4):319-24. DOI:10.1002/nau.20142
21. Jackson SR, Avery NC, Tarlton JF, et al. Changes in metabolism of collagen in genitourinary prolapse. Lancet. 1996;347(9016):1658-61. DOI:10.1016/s0140-6736(96)91489-0
22. Connell KA, Guess MK, Chen H, et al. HOXA11 is critical for development and maintenance of uterosacral ligaments and deficient in pelvic prolapse. J Clin Invest.
2008;118(3):1050-5. DOI:10.1172/jci34193
23. Drewes PG, Yanagisawa H, Starcher B, et al. Pelvic organ prolapse in fibulin-5 knockout mice: pregnancy-induced changes in elastic fiber homeostasis in mouse vagina. Am J Pathol. 2007;170(2):578-89. DOI:10.2353/ajpath.2007.060662
24. Goepel C, Thomssen C. Changes in the extracellular matrix in periurethral tissue of women with stress urinary incontinence. Acta Histochem. 2006;108(6):441-5. DOI:10.1016/j.acthis.2006.07.001
25. Klutke J, Ji Q, Campeau J, et al. Decreased endopelvic fascia elastin content in uterine prolapse. Acta Obstet Gynecol Scand. 2008;87(1):111-5. DOI:10.1080/00016340701819247
26. Rahn DD, Ruff MD, Brown SA, et al. Biomechanical properties of the vaginal wall: effect of pregnancy, elastic fiber deficiency, and pelvic organ prolapse. Am J Obstet Gynecol. 2008;198(5):590.e1-6. DOI:10.1016/j.ajog.2008.02.022
27. Liu X, Zhao Y, Pawlyk B, et al. Failure of elastic fiber homeostasis leads to pelvic floor disorders. Am J Pathol. 2006;168(2):519-28. DOI:10.2353/ajpath.2006.050399
28. Smith P, Heimer G, Norgren A, Ulmsten U. Localization of steroid hormone receptors in the pelvic muscles. Eur J Obstet Gynecol Reprod Biol. 1993;50(1):83-5.
DOI:10.1016/0028-2243(93)90169-d
29. Kurita T, Lee KJ, Cooke PS, et al. Paracrine regulation of epithelial progesterone receptor by estradiol in the mouse female reproductive tract. Biol Reprod. 2000;62(4):821-30. DOI:10.1093/biolreprod/62.4.821. Erratum in: Biol Reprod. 2000;63(1):354.
30. Carley ME, Rickard DJ, Gebhart JB, et al. Distribution of estrogen receptors alpha and beta mRNA in mouse urogenital tissues and their expression after oophorectomy and estrogen replacement. Int Urogynecol J Pelvic Floor Dysfunct. 2003;14(2):141-5. DOI:10.1007/s00192-002-1020-5
31. Hextall A, Bidmead J, Cardozo L, Hooper R. The impact of the menstrual cycle on urinary symptoms and the results of urodynamic investigation. BJOG. 2001;108(11):1193-6. DOI:10.1111/j.1471-0528.2003.00280.x
32. Nallasamy S, Yoshida K, Akins M, et al. Steroid Hormones Are Key Modulators of Tissue Mechanical Function via Regulation of Collagen and Elastic Fibers. Endocrinology. 2017;158(4):950-62. DOI:10.1210/en.2016-1930
33. Fede C, Pirri C, Fan C, et al. Sensitivity of the fasciae to sex hormone levels: Modulation of collagen-I, collagen-III and fibrillin production. PLoS One. 2019;14(9):e0223195. DOI:10.1371/journal.pone.0223195
34. Wang S, Lü D, Zhang Z, et al. Effects of mechanical stretching on the morphology of extracellular polymers and the mRNA expression of collagens and small leucine-rich repeat proteoglycans in vaginal fibroblasts from women with pelvic organ prolapse. PLoS One. 2018;13(4):e0193456. DOI:10.1371/journal.pone.0193456
35. Molinet Coll C, Martínez Franco E, Altimira Queral L, et al. Hormonal Influence in Stress Urinary Incontinence During Pregnancy and Postpartum. Reprod Sci. 2022;29(8):2190-9. DOI:10.1007/s43032-022-00946-7
36. Lowder JL, Debes KM, Moon DK, et al. Biomechanical adaptations of the rat vagina and supportive tissues in pregnancy to accommodate delivery. Obstet Gynecol.
2007;109(1):136-43. DOI:10.1097/01.aog.0000250472.96672.6c
37. Zhao S, Sherwood OD. Monoclonal antibodies specific for rat relaxin. X. Endogenous relaxin induces changes in the histological characteristics of the rat vagina during the second half of pregnancy. Endocrinology. 1998;139(11):4726-34. DOI:10.1210/endo.139.11.6327
38. O'Boyle AL. Pelvic organ support in nulliparous pregnant and nonpregnant women. Am J Obstet Gynecol. 2003;188(1):301. DOI:10.1067/mob.2003.20. Erratum in: Am J Obstet Gynecol. 2002;187(1):99-102. DOI:10.1067/mob.2002.125734
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3. Slieker-ten Hove MC, Pool-Goudzwaard AL, Eijkemans MJ, et al. Prediction model and prognostic index to estimate clinically relevant pelvic organ prolapse in a general female population. Int Urogynecol J Pelvic Floor Dysfunct. 2009;20(9):1013-21. DOI:10.1007/s00192-009-0903-0. Erratum in: Int Urogynecol J Pelvic Floor Dysfunct. 2010;21(3):387-8.
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13. Chen Y, DeSautel M, Anderson A, et al. Collagen synthesis is not altered in women with stress urinary incontinence. Neurourol Urodyn. 2004;23(4):367-73. DOI:10.1002/nau.20006
14. Chen BH, Wen Y, Li H, Polan ML. Collagen metabolism and turnover in women with stress urinary incontinence and pelvic prolapse. Int Urogynecol J Pelvic Floor Dysfunct. 2002;13(2):80-7; discussion 87. DOI:10.1007/s001920200020
15. Trabucco E, Soderberg M, Cobellis L, et al. Role of proteoglycans in the organization of periurethral connective tissue in women with stress urinary incontinence. Maturitas. 2007;58(4):395-405. DOI:10.1016/j.maturitas.2007.09.010
16. Ulmsten U, Ekman G, Giertz G, Malmström A. Different biochemical composition of connective tissue in continent and stress incontinent women. Acta Obstet Gynecol Scand. 1987;66(5):455-7. DOI:10.3109/00016348709022054
17. Manabe Y, Yoshida Y. Collagenolysis in human vaginal tissue during pregnancy and delivery: a light and electron microscopic study. Am J Obstet Gynecol. 1986;155(5):1060-6. DOI:10.1016/0002-9378(86)90350-9
18. Daucher JA, Clark KA, Stolz DB, et al. Adaptations of the rat vagina in pregnancy to accommodate delivery. Obstet Gynecol. 2007;109(1):128-35. DOI:10.1097/01.aog.0000246798.78839.62
19. Dhital B, Gul-E-Noor F, Downing KT, et al. Pregnancy-Induced Dynamical and Structural Changes of Reproductive Tract Collagen. Biophys J. 2016;111(1):57-68. DOI:10.1016/j.bpj.2016.05.049
20. Edwall L, Carlström K, Jonasson AF. Markers of collagen synthesis and degradation in urogenital tissue from women with and without stress urinary incontinence. Neurourol Urodyn. 2005;24(4):319-24. DOI:10.1002/nau.20142
21. Jackson SR, Avery NC, Tarlton JF, et al. Changes in metabolism of collagen in genitourinary prolapse. Lancet. 1996;347(9016):1658-61. DOI:10.1016/s0140-6736(96)91489-0
22. Connell KA, Guess MK, Chen H, et al. HOXA11 is critical for development and maintenance of uterosacral ligaments and deficient in pelvic prolapse. J Clin Invest.
2008;118(3):1050-5. DOI:10.1172/jci34193
23. Drewes PG, Yanagisawa H, Starcher B, et al. Pelvic organ prolapse in fibulin-5 knockout mice: pregnancy-induced changes in elastic fiber homeostasis in mouse vagina. Am J Pathol. 2007;170(2):578-89. DOI:10.2353/ajpath.2007.060662
24. Goepel C, Thomssen C. Changes in the extracellular matrix in periurethral tissue of women with stress urinary incontinence. Acta Histochem. 2006;108(6):441-5. DOI:10.1016/j.acthis.2006.07.001
25. Klutke J, Ji Q, Campeau J, et al. Decreased endopelvic fascia elastin content in uterine prolapse. Acta Obstet Gynecol Scand. 2008;87(1):111-5. DOI:10.1080/00016340701819247
26. Rahn DD, Ruff MD, Brown SA, et al. Biomechanical properties of the vaginal wall: effect of pregnancy, elastic fiber deficiency, and pelvic organ prolapse. Am J Obstet Gynecol. 2008;198(5):590.e1-6. DOI:10.1016/j.ajog.2008.02.022
27. Liu X, Zhao Y, Pawlyk B, et al. Failure of elastic fiber homeostasis leads to pelvic floor disorders. Am J Pathol. 2006;168(2):519-28. DOI:10.2353/ajpath.2006.050399
28. Smith P, Heimer G, Norgren A, Ulmsten U. Localization of steroid hormone receptors in the pelvic muscles. Eur J Obstet Gynecol Reprod Biol. 1993;50(1):83-5.
DOI:10.1016/0028-2243(93)90169-d
29. Kurita T, Lee KJ, Cooke PS, et al. Paracrine regulation of epithelial progesterone receptor by estradiol in the mouse female reproductive tract. Biol Reprod. 2000;62(4):821-30. DOI:10.1093/biolreprod/62.4.821. Erratum in: Biol Reprod. 2000;63(1):354.
30. Carley ME, Rickard DJ, Gebhart JB, et al. Distribution of estrogen receptors alpha and beta mRNA in mouse urogenital tissues and their expression after oophorectomy and estrogen replacement. Int Urogynecol J Pelvic Floor Dysfunct. 2003;14(2):141-5. DOI:10.1007/s00192-002-1020-5
31. Hextall A, Bidmead J, Cardozo L, Hooper R. The impact of the menstrual cycle on urinary symptoms and the results of urodynamic investigation. BJOG. 2001;108(11):1193-6. DOI:10.1111/j.1471-0528.2003.00280.x
32. Nallasamy S, Yoshida K, Akins M, et al. Steroid Hormones Are Key Modulators of Tissue Mechanical Function via Regulation of Collagen and Elastic Fibers. Endocrinology. 2017;158(4):950-62. DOI:10.1210/en.2016-1930
33. Fede C, Pirri C, Fan C, et al. Sensitivity of the fasciae to sex hormone levels: Modulation of collagen-I, collagen-III and fibrillin production. PLoS One. 2019;14(9):e0223195. DOI:10.1371/journal.pone.0223195
34. Wang S, Lü D, Zhang Z, et al. Effects of mechanical stretching on the morphology of extracellular polymers and the mRNA expression of collagens and small leucine-rich repeat proteoglycans in vaginal fibroblasts from women with pelvic organ prolapse. PLoS One. 2018;13(4):e0193456. DOI:10.1371/journal.pone.0193456
35. Molinet Coll C, Martínez Franco E, Altimira Queral L, et al. Hormonal Influence in Stress Urinary Incontinence During Pregnancy and Postpartum. Reprod Sci. 2022;29(8):2190-9. DOI:10.1007/s43032-022-00946-7
36. Lowder JL, Debes KM, Moon DK, et al. Biomechanical adaptations of the rat vagina and supportive tissues in pregnancy to accommodate delivery. Obstet Gynecol.
2007;109(1):136-43. DOI:10.1097/01.aog.0000250472.96672.6c
37. Zhao S, Sherwood OD. Monoclonal antibodies specific for rat relaxin. X. Endogenous relaxin induces changes in the histological characteristics of the rat vagina during the second half of pregnancy. Endocrinology. 1998;139(11):4726-34. DOI:10.1210/endo.139.11.6327
38. O'Boyle AL. Pelvic organ support in nulliparous pregnant and nonpregnant women. Am J Obstet Gynecol. 2003;188(1):301. DOI:10.1067/mob.2003.20. Erratum in: Am J Obstet Gynecol. 2002;187(1):99-102. DOI:10.1067/mob.2002.125734
Авторы
А.А. Безменко, А.С. Староверова*
ФГБВОУ ВО «Военно-медицинская академия им. С.М. Кирова» Минобороны России, Санкт-Петербург, Россия
*annafrumkin@mail.ru
Kirov Military Medical Academy, Saint Petersburg, Russia
*annafrumkin@mail.ru
ФГБВОУ ВО «Военно-медицинская академия им. С.М. Кирова» Минобороны России, Санкт-Петербург, Россия
*annafrumkin@mail.ru
________________________________________________
Kirov Military Medical Academy, Saint Petersburg, Russia
*annafrumkin@mail.ru
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