Expression And Significance Of VIP And MVD In The Uterine Ligament System Of Pelvic Floor Dysfunction

objective:Measure the expression of vasoactive intestinal peptide(VIP)and micro vascular density (MVD) in the uterosacral ligament and cardinal ligament among women with pelvic organ prolapse (POP),stress urinary incontinence (SUI) and control groups,discuss the alteration of VIP and MVD in POP and SUI, to clarify their roles in the etiology development of POP and SUI.Methods:Immunohistochemistry were performed to measure the expression of VIP and MVD in the uterosacral ligament and cardinal ligament among women with POP, POP&SUI and control groups.Results:1 In our study,the VIP immunoreactivities were identified in the uterosacral ligament and cardinal ligament,the VIP profiles were located mostly around vessels and their circumference.2 There was no significant difference of VIP immunoreactivities between the uterosacral ligament and the cardinal ligament.VIP immunoreactivities nerves were lower in POP group and POP & SUI group than control group (P<0.05),and the VIP immunoreactivities were correlated with the ponderance standard of POP, the VIP immunoreactivities nerves were lower in III-1V group thanⅠ～Ⅱgroup (P<0.05).However,there were no significant difference between POP group and POP&SUI group (P>0.05)3 There was no significant difference of MVD between the uterosacral ligament and the cardinal ligament.MVD was lower in POP group and POP & SUI group than control group (P<0.05),and MVD was correlated with the ponderance standard of POP, MVD was lower inⅢ-Ⅳgroup thanⅠ-Ⅱgroup (P＜0.05).However,there were no significant difference between POP group and POP&SUI group (P>0.05)4 The expression of VIP in the uterosacral ligament and cardinal ligament was negatively correlated with age,but not correlated with body mass index (BMI),pregnant times or labor times.The expression of MVD was not correlated with age, body mass index (BMI),pregnant times or labor times.In POP group and POP & SUI group,MVD was higher of VIP positiver than negativer, MVD was positively correlated with the expression of VIP.Conclusions:1 The decrease of VIP in the uterosacral ligament and cardinal ligament was correlated with POP, we believe that the denervation of ligament system may take a significant role in PFD. When POP was serious,VIP immunoreactivities nerves were lower.The decrease of VIP was correlated with the standard of ponderance. However,the decrease of VIP was not correlated with that whether the patients have SUI,that means the theory of SUI was not correlated with the nerve damage of ligament system.2 MVD in the uterosacral ligament and cardinal ligament was lower in POP group and POP & SUI group than the control group.When POP was serious,MVD was lower,that means the decrease of MVD was correlated with the standard of ponderance.The reduction might be related to nerve damage or degeneration,resulting in a change in blood flow,atrophy,and pelvic floor laxity in patients,and then it may cause or accelerate the progress of PFD.The decrease of MVD was not correlated with SUI,that means the theory of SUI was not correlated with the decrease of micro vascular.3 The change of VIP in the uterosacral ligament and cardinal ligament was negatively correlated with age,it can be conclude that age is an important reason of pelvic damage or retrograde, which results neurotransmitter reduce. MVD was positively correlated with the expression of VIP,that means the decrease of MVD is the result of nerve damage.