盆底器官脱垂妇女阴道前壁Ⅰ、Ⅲ型胶原及代谢变化的研究
|
摘要
目的
通过对盆底器官脱垂(pelvic organ prolapse,POP)妇女阴道前壁组织中Ⅰ、Ⅲ型胶原含量及其代谢标志物(Ⅰ型前胶原羧基末端前肽,PⅠCP;Ⅰ型胶原交联羧基末端肽,ICTP;Ⅲ型前胶原氨基末端肽,PⅢNP)水平的检测及其相关性的研究;阐述POP患者阴道前壁组织的胶原代谢所发生的改变,以分析Ⅰ、Ⅲ型胶原代谢变化与POP发生的关系。
方法
收集在我院妇产科行阴道前壁修补术患者的阴道前壁组织,予匀浆后,应用酶联免疫吸附法(ELISA)检测绝经前POP组(16例)、绝经前对照组(19例)、绝经后POP组(18例)、绝经后对照组(10例)共4组63例患者阴道前壁组织中Ⅰ、Ⅲ型胶原含量及其二者代谢标志性产物PⅠCP、ICTP及PⅢNP的含量水平。
结果
1.绝经后POP组和绝经后对照组在年龄方面高于绝经前POP组和绝经前对照(P＜0.05),余产次、体重指数等一般情况在各组间均无明显差异(P＞0.05)。
2.绝经前POP组及绝经后POP组患者阴道前壁组织中Ⅰ型胶原含量均明显低于相应对照组(P＜0.05),其降低幅度分别为21.3%和24.1%。
3.绝经前后POP组患者阴道前壁组织中PⅠCP平均水平较对应的对照组稍高,但二者无明显差异(P＞0.05);绝经前组组织ICTP含量明显高于绝经前对照组(P＜0.05),绝经后POP患者较绝经后对照组亦明显升高(P＜0.05)。
4.绝经前POP组与绝经后POP组妇女阴道前壁组织中Ⅲ型胶原含量均较相应对照组显著降低(P＜0.05),其降低幅度分别为29.70%和29.18%。
5.绝经前及绝经后POP妇女阴道前壁组织中PⅢNP含量亦明显低于相应对照组(P＜0.05)。
6.相关性分析的结果:绝经前、后组中阴道壁Ⅰ型胶原含量的减少与ICTP表达量的增加显著相关(绝经前组r=-0.876,P＜0.01;绝经后组r=-0.842,P＜0.01);Ⅲ型胶原与PⅢNP相关性分析的结果:Ⅲ型胶原与PⅢNP呈正相关(绝经前组r=0.732,P＜0.01;绝经后组r=0.713,P＜0.01)。
7.不同脱垂程度的POP组Ⅰ、Ⅲ型胶原及代谢标志产物之间的比较结果,绝经前、后组中仅轻型与重型POP患者阴道前壁组织中的Ⅰ、Ⅲ型胶原及ICTP水平比较均有统计学差异(P＜0.05),PⅠCP在不同脱垂程度的绝经前、后组中均无显著差异(P＞0.05)。
结论
1.POP患者阴道前壁组织中Ⅰ型胶原含量均明显减少,提示POP患者阴道前壁组织中Ⅰ型胶原含量减少与POP的发生有关。
2.绝经前和绝经后POP患者阴道前壁ICTP含量明显增加均与Ⅰ型胶原表达量明显减少呈显著相关,而PⅠCP变化不明显,提示POP患者阴道前壁组织Ⅰ型胶原蛋白减少可能是由于局部Ⅰ型胶原合成代谢无明显变化,主要为降解增多所致。
3.POP患者阴道前壁组织中Ⅲ型胶原含量均明显减少,提示POP患者阴道前壁组织中Ⅲ型胶原含量减少也参与了POP的发生。
4.绝经前和绝经后POP患者阴道前壁PⅢNP含量减少均与Ⅲ型胶原表达量明显减少呈显著相关,提示POP患者阴道前壁组织Ⅲ型胶原蛋白减少可能是由于局部Ⅲ型胶原合成代谢明显减少为主。
5.不同脱垂程度的POP患者阴道前壁组织Ⅰ、Ⅲ型胶原及代谢标志物含量比较,绝经、后组患者阴道前壁组织中的Ⅰ、Ⅲ型胶原及ICTP水平在轻型与重型间有显著差异,但中型-重型、轻型-中型之间均无明显差异,PⅠCP及绝经前PⅢNP各型间无明显差异,可提示POP发展到中至重型时盆底Ⅰ、Ⅲ型胶原代谢改变己呈完全不可逆性,轻型脱垂是POP妇女最佳治疗阶段,POP的治疗尤其是保守治疗要趁早进行。
OBJECTIVE: The aim is to investigate the content of type I &III collagen and their synthesis and degradation products including carboxyterminal propeptide of type I procollagen (PICP), carboxyterminal telopeptide of type I collagen (ICTP) and aminotermimal propeptide of type III procollagen (PIIINP) in anterior wall of vaginal tissue, and to explore whether the metabolic changes in anterior vaginal tissue could contribute to the etiology of pelvic organ prolapse(POP).
METHODS: Transvaginal biopsies were obtained from anterior vaginal tissue in premenopausal and postmenopausal patients with POP and comparable premenopausal and postmenopausal control groups during transvaginal operations. Sixty-three women participated in the study. They were divided into 4 groups as follows: 16premenopausal patients with POP (group 1), 19 premenopausal patients with neither UI(urinary incontinence) nor POP (group 2), 18 postmenopausal patients with POP(group 3), 10 postmenopausal patients with neither UI nor POP (group 4).The concentration of type I & III collagen, PICP, ICTP and PIIINP in specimen were biochemically detected by enzyme linked immunosorbent assay (ELISA commercial kits), followed by tissue specimen homogenization.
RESULTS: The content of type I collagen in premenopausal POP group and postmenopausal POP group are significantly lower than that in the control groups(-21.28% and -24.06%, respectively). The content of ICTP reduced significantly both in premenopausal POP group and in postmenopausal POP group. High relativity was found in the variability of type I collagen and ICTP, the correlation coefficient of them was -0.876 (P<0.05) of the premenopausal groups and -0.842 (P<0.05) of the postmenopausal groups. Compared to premenopausal controls and postmenopausal control group, the mean' concentration of PICP was higher in POP groups, premenopausal or postmenopausal, but the difference between them was not statistically significant (P>0.05).
There was significant difference in the level of type III collagen between the POP groups and control groups whether in premenopausal patients or in postmenopausal patients(-29.70% and -29.18%, respectively, P<0.05). Compared to the control groups, the concentration of PIIINP was also significantly lower in POP patients, whether in premenopausal group or postmenopausal group. Significant positive correlation was found between type III collagen and PIIINP (premenopausal groups: r =0.732 ; postmenopausal groups: r =0.713 ).
Significant differences of premenopausal groups' content of type I collagen , type III collagen and ICTP were found only between slight stage and gravis stage(P<0.05), while among the postmenopausal groups the content of I collagen , type III collagen , ICTP and PIIINP were found significances between slight stage and between gravis stage(P<0.05). No significant difference was found in varies stages of PICP, whether in premenopausal or in postmenopausal groups(P>0.05).
As to age, parity and menopausal time, we found that postmenopausal POP patients (group 3) had significantly older age when compared to premenopausal patients with POP(groupl).
CONCLUSION: The content of type I &IIIcollagen in anterior vaginal tissue are significantly lower in premenopausal and postmenopausal women with POP, while the expression of ICTP significantly elevated and PIIINP significantly reduced. We also found a strong correlation between the quantity of type I collagen and ICTP, and between type III collagen and PIIINP in anterior vaginal tissue, suggesting that collagen metabolism altered in pelvic organ prolapse patients. Increased degradation of type I collagen and less synthesis of type III collagen should result in a decreased concentration of collagen, a less flexible form of extracellular matrix, also suggesting a connective tissue with impaired mechanical function. Those tissues probably were less elastic and less strong, more likely to be broken, which suggested that the degeneration of biomechanical properties in pelvic support construction might lead to the occurrence of POP.
As to different stage of POP, slight stage and gravis stage had much more significant differences, which suggested that the slight stage maybe the best curable opportunity, especially for the conservative therapy.
Also, we found that postmenopausal patients with POP (group 3) had significantly older age and much longer postmenopausal time, when compared to premenopausal patients in group 1. Basing on these investigations, we could reached the conclusion that the collagen metabolism in anterior vaginal tissue in postmenopausal patients with POP might be modulated by aging process and reproductive hormones, which suggested that age and the level of estrogen might be involved in the pathogenesis of POP postmenopausally.
通过对盆底器官脱垂(pelvic organ prolapse,POP)妇女阴道前壁组织中Ⅰ、Ⅲ型胶原含量及其代谢标志物(Ⅰ型前胶原羧基末端前肽,PⅠCP;Ⅰ型胶原交联羧基末端肽,ICTP;Ⅲ型前胶原氨基末端肽,PⅢNP)水平的检测及其相关性的研究;阐述POP患者阴道前壁组织的胶原代谢所发生的改变,以分析Ⅰ、Ⅲ型胶原代谢变化与POP发生的关系。
方法
收集在我院妇产科行阴道前壁修补术患者的阴道前壁组织,予匀浆后,应用酶联免疫吸附法(ELISA)检测绝经前POP组(16例)、绝经前对照组(19例)、绝经后POP组(18例)、绝经后对照组(10例)共4组63例患者阴道前壁组织中Ⅰ、Ⅲ型胶原含量及其二者代谢标志性产物PⅠCP、ICTP及PⅢNP的含量水平。
结果
1.绝经后POP组和绝经后对照组在年龄方面高于绝经前POP组和绝经前对照(P＜0.05),余产次、体重指数等一般情况在各组间均无明显差异(P＞0.05)。
2.绝经前POP组及绝经后POP组患者阴道前壁组织中Ⅰ型胶原含量均明显低于相应对照组(P＜0.05),其降低幅度分别为21.3%和24.1%。
3.绝经前后POP组患者阴道前壁组织中PⅠCP平均水平较对应的对照组稍高,但二者无明显差异(P＞0.05);绝经前组组织ICTP含量明显高于绝经前对照组(P＜0.05),绝经后POP患者较绝经后对照组亦明显升高(P＜0.05)。
4.绝经前POP组与绝经后POP组妇女阴道前壁组织中Ⅲ型胶原含量均较相应对照组显著降低(P＜0.05),其降低幅度分别为29.70%和29.18%。
5.绝经前及绝经后POP妇女阴道前壁组织中PⅢNP含量亦明显低于相应对照组(P＜0.05)。
6.相关性分析的结果:绝经前、后组中阴道壁Ⅰ型胶原含量的减少与ICTP表达量的增加显著相关(绝经前组r=-0.876,P＜0.01;绝经后组r=-0.842,P＜0.01);Ⅲ型胶原与PⅢNP相关性分析的结果:Ⅲ型胶原与PⅢNP呈正相关(绝经前组r=0.732,P＜0.01;绝经后组r=0.713,P＜0.01)。
7.不同脱垂程度的POP组Ⅰ、Ⅲ型胶原及代谢标志产物之间的比较结果,绝经前、后组中仅轻型与重型POP患者阴道前壁组织中的Ⅰ、Ⅲ型胶原及ICTP水平比较均有统计学差异(P＜0.05),PⅠCP在不同脱垂程度的绝经前、后组中均无显著差异(P＞0.05)。
结论
1.POP患者阴道前壁组织中Ⅰ型胶原含量均明显减少,提示POP患者阴道前壁组织中Ⅰ型胶原含量减少与POP的发生有关。
2.绝经前和绝经后POP患者阴道前壁ICTP含量明显增加均与Ⅰ型胶原表达量明显减少呈显著相关,而PⅠCP变化不明显,提示POP患者阴道前壁组织Ⅰ型胶原蛋白减少可能是由于局部Ⅰ型胶原合成代谢无明显变化,主要为降解增多所致。
3.POP患者阴道前壁组织中Ⅲ型胶原含量均明显减少,提示POP患者阴道前壁组织中Ⅲ型胶原含量减少也参与了POP的发生。
4.绝经前和绝经后POP患者阴道前壁PⅢNP含量减少均与Ⅲ型胶原表达量明显减少呈显著相关,提示POP患者阴道前壁组织Ⅲ型胶原蛋白减少可能是由于局部Ⅲ型胶原合成代谢明显减少为主。
5.不同脱垂程度的POP患者阴道前壁组织Ⅰ、Ⅲ型胶原及代谢标志物含量比较,绝经、后组患者阴道前壁组织中的Ⅰ、Ⅲ型胶原及ICTP水平在轻型与重型间有显著差异,但中型-重型、轻型-中型之间均无明显差异,PⅠCP及绝经前PⅢNP各型间无明显差异,可提示POP发展到中至重型时盆底Ⅰ、Ⅲ型胶原代谢改变己呈完全不可逆性,轻型脱垂是POP妇女最佳治疗阶段,POP的治疗尤其是保守治疗要趁早进行。
OBJECTIVE: The aim is to investigate the content of type I &III collagen and their synthesis and degradation products including carboxyterminal propeptide of type I procollagen (PICP), carboxyterminal telopeptide of type I collagen (ICTP) and aminotermimal propeptide of type III procollagen (PIIINP) in anterior wall of vaginal tissue, and to explore whether the metabolic changes in anterior vaginal tissue could contribute to the etiology of pelvic organ prolapse(POP).
METHODS: Transvaginal biopsies were obtained from anterior vaginal tissue in premenopausal and postmenopausal patients with POP and comparable premenopausal and postmenopausal control groups during transvaginal operations. Sixty-three women participated in the study. They were divided into 4 groups as follows: 16premenopausal patients with POP (group 1), 19 premenopausal patients with neither UI(urinary incontinence) nor POP (group 2), 18 postmenopausal patients with POP(group 3), 10 postmenopausal patients with neither UI nor POP (group 4).The concentration of type I & III collagen, PICP, ICTP and PIIINP in specimen were biochemically detected by enzyme linked immunosorbent assay (ELISA commercial kits), followed by tissue specimen homogenization.
RESULTS: The content of type I collagen in premenopausal POP group and postmenopausal POP group are significantly lower than that in the control groups(-21.28% and -24.06%, respectively). The content of ICTP reduced significantly both in premenopausal POP group and in postmenopausal POP group. High relativity was found in the variability of type I collagen and ICTP, the correlation coefficient of them was -0.876 (P<0.05) of the premenopausal groups and -0.842 (P<0.05) of the postmenopausal groups. Compared to premenopausal controls and postmenopausal control group, the mean' concentration of PICP was higher in POP groups, premenopausal or postmenopausal, but the difference between them was not statistically significant (P>0.05).
There was significant difference in the level of type III collagen between the POP groups and control groups whether in premenopausal patients or in postmenopausal patients(-29.70% and -29.18%, respectively, P<0.05). Compared to the control groups, the concentration of PIIINP was also significantly lower in POP patients, whether in premenopausal group or postmenopausal group. Significant positive correlation was found between type III collagen and PIIINP (premenopausal groups: r =0.732 ; postmenopausal groups: r =0.713 ).
Significant differences of premenopausal groups' content of type I collagen , type III collagen and ICTP were found only between slight stage and gravis stage(P<0.05), while among the postmenopausal groups the content of I collagen , type III collagen , ICTP and PIIINP were found significances between slight stage and between gravis stage(P<0.05). No significant difference was found in varies stages of PICP, whether in premenopausal or in postmenopausal groups(P>0.05).
As to age, parity and menopausal time, we found that postmenopausal POP patients (group 3) had significantly older age when compared to premenopausal patients with POP(groupl).
CONCLUSION: The content of type I &IIIcollagen in anterior vaginal tissue are significantly lower in premenopausal and postmenopausal women with POP, while the expression of ICTP significantly elevated and PIIINP significantly reduced. We also found a strong correlation between the quantity of type I collagen and ICTP, and between type III collagen and PIIINP in anterior vaginal tissue, suggesting that collagen metabolism altered in pelvic organ prolapse patients. Increased degradation of type I collagen and less synthesis of type III collagen should result in a decreased concentration of collagen, a less flexible form of extracellular matrix, also suggesting a connective tissue with impaired mechanical function. Those tissues probably were less elastic and less strong, more likely to be broken, which suggested that the degeneration of biomechanical properties in pelvic support construction might lead to the occurrence of POP.
As to different stage of POP, slight stage and gravis stage had much more significant differences, which suggested that the slight stage maybe the best curable opportunity, especially for the conservative therapy.
Also, we found that postmenopausal patients with POP (group 3) had significantly older age and much longer postmenopausal time, when compared to premenopausal patients in group 1. Basing on these investigations, we could reached the conclusion that the collagen metabolism in anterior vaginal tissue in postmenopausal patients with POP might be modulated by aging process and reproductive hormones, which suggested that age and the level of estrogen might be involved in the pathogenesis of POP postmenopausally.
引文
[1]Salter SA,Batra RS,Rohrer TE,et al.Striae and pelvic relaxation:two disorders of connective tissue with a strong association[J].J Invest Dermatol,2006,126(8):1745-1748.
[2].吴美琼,郑坚毅,朱丽萍.11938例已婚妇女妇科普查分析报告[J].中国实用妇科与产科杂志,1999,15(4):254-255.
[3]唐颖英.14180例已婚妇女妇科普查情况分析[J].医学文选,2001,20(5):690-691.
[4]莫玉瑶,赵小平,韦向军等.桂林市社区妇女病普查普治效果分析[J].肿瘤防治杂志,2001,8(2):120-122.
[5]翟风利.12496名已婚纺织女工妇科疾病普查[J].中国工业医学杂志,2003,16(4):239-240.
[6]曾晓琴.广州市芳村区1995-2002年妇女生殖道健康状况分析[J].中国初级卫生保健,2003,17(2):49-50.
[7]李哲刚.82945例农村妇女生殖健康状况分析[J].国际医药卫生导报,2003,9(7):115-117.
[8]郑漪霖.子宫脱垂的防治[J].实用老年医学,1996,10(5):201-202.
[9]Sze EH,Sherard GB 3rd,Dolezal JM.Pregnancy,labor,delivery,and pelvic organ prolapse[J].Obstet Gynecol,2002,100(5 Pt 1):981-986.
[10]Edwall BL,Carlstrom K,Jonasson AF.Markers of collagen synthesis and degradation in urogenital tissue from women with and without stress urinary incontinence[J].Neurourol Urodyn,2005,24(4):319-324.
[11]宋今丹,章静波,陈誉华.医学细胞分子生物学[M].第1版,北京:人民卫生出版社,2003:63-66.
[12]顾其胜,蒋丽霞.胶原与临床医学[M].第1版,上海:第二军医大学出版社,2003:45-47.
[13] Bump RC, Mattiasson A, Bo K, et al. The standardization of terminology of female pelvic organ prolapse and pelvic floor dysfunction. Am J Obstet Gynecol, 1996, 175(1): 10-17.
[14] Petros PE , Ulmsten U. An integral theory of female urinary incontinence [J]. Acta Obstetricia et Gynecological Scandinavica, 1990, 69:suppl 153:1-79.
[15] Petros PE. The female pelvic floor-function,dysfunction and management according to the integral theory [M]. Springer Medizin Verlag Heidelberg, 2004: 1-12.
[16] Petros PP, Ulmsten U. An anatomical classification—a new paradigm for management of female lower urinary tract dysfunction [J]. Eur J Obstet . Gynecol Reprod Biol, 1998, 80(1): 87-94.
[17] Jackson SR, Avery NC, Tarlton JF, et al. Changes in metabolism of collagen in genitourinary prolapse [J]. Lancet, 1996, 347(9016): 1658-1561.
[18] Buchanan S, Robertson GW, Hocking PM. Relationships between vaginal collagen, plasma oestradiol and uterine prolapse in turkeys [J]. Res Vet Sci, 1999, 67(2):153-157.
[19] Takano CC, Girao MJ, Sartori MG, et al. Analysis of collagen in parametrium and vaginal apex of women with and without uterine prolapse[J].Int Urogynecol J Pelvic Floor Dysfunct, 2002, 13(6):342-345.
[20] Goepel C, Hefler L, Methfessel HD, et al. Periurethral connective tissue status of postmenopausal women with genital prolapse with and without stress incontinence [J]. Acta Obstet Gynecol Scand, 2003, 82(7):659-664.
[21] Wong MY, Harmanli OH, Agar M, et al. Collagen content of nonsupport tissue in pelvic organ prolapse and stress urinary incontinence [J]. Am J Obstet Gynecol, 2003, 189(6): 1597-1600.
[22] Soderberg MW, Falconer C, Bystrom B, et al. Young women with genital prolapse has a low collagen concentration[J].Acta Obstet Gynecol Scand,2004,83(12):1193-1198.
[23]Drutz HP,Alarab M.Pelvic organ prolapse:demographics and future growth prospects[J].Int Urogynecol J Pelvic Floor Dysfunct,2006,17 Suppl 1:S6-9.
[24]Barbiero EC,Sartori MG,Girao MJ,et al.Analysis of type Ⅰ collagen in the parametrium of women with and without uterine prolapse,according to hormonal status[J].Int Urogynecol J Pelvic Floor Dysfunct,2003,14(5):331-334.
[25]孙智晶 郎景和,等.胶原状态与压力性尿失禁的病因学研究[J].中国妇产科临床杂志,2004,5(1):6-9.
[26]Chen BH,Wen Y,Li H,et al.Collagen Metabolism and Turnover in Women with Stress Urinary Incontinence and Pelvic Prolapse[J].Int Urogynecol J,2002,13(2):80-87.
[27]Gabriel B,Watermann D,Hancke K,et al.Increased expression of matrix metalloproteinase 2 in uterosacral ligaments is associated with pelvic organ prolapse[J].Int Urogynecol J Pelvic Floor Dysfunct,2006,17(5):478-482.
[28]Bai SW,Choe BH,Kim JY,et al.Pelvic organ prolapse and connective tissue abnormalities in Korean women[J].J Reprod Med,2002,47(3):231-234.
[29]Ewies AA,Al-Azzawi F,Thompson J.Changes in extracellular matrix proteins in the cardinal ligaments of post-menopausal women with or without prolapse:a computerized immunohistomorphometric analysis[J].Hum Reprod,2003,18(10):2189-2195.
[30]Gabriel B,Denschlag D,Gobel H,et al.Uterosacral ligament in postmenopausal women with or without pelvic organ prolapse[J].Int Urogynecol J Pelvic Floor Dysfunct,2005,16(6):475-479.
[31]Phillips CH,Anthony F,Benyon C,et al.Collagen metabolism in the uterosacral ligaments and vaginal skin of women with uterine prolapse[J]. BJOG, 2006 , 113(1):39-46.
[32] Meyer S, Hohlfeld P, Achtari C, et al. Birth trauma: Short and long term effects of forceps delivery compared with spontaneous delivery on various pelvic floor parameters[J]. Br JObstet Gynaecol, 2000, 107(11): 1360-1365.
[33] Swift SE. The distribution of pelvic organ support in a population of female subjects seen for routine gynecologic health care [J]. Am J Obstet Gynecol, 2000, 183(2):277-285.
[34] Dietz HP. Pelvic floor trauma following vaginal delivery [J]. Curr Opin Obstet Gynecol, 2006, 18(5):528-537.
[35] Tegerstedt G, Maehie S M, Nyren O, et al. Preyalence of symptomatic pelvic organ prolapse in a Swedish population [J]. Int Urogynecol J Pelvic Floor Dysfunct, 2005, 16(6): 497-503.
[36] Lukacz ES, Lawrence JM, Contreras R, et al. Parity, mode of delivery, and pelvic floor disorders [J]. Obstet Gynecol, 2006, 107(6):1253-1260.
[37] Dietz HP, Eldridge A, Grace M, et al. Pelvic organ descent in young nulligravid women[J], Am JObstet Gynecol, 2004, 191(1):95-100.
[38] Chi en WH, Tseng MR, Lin YH. Acute pelvic organ prolapse in an 11-month-old infant [J]. Int Urogynecol J Pelvic Floor Dysfunct, 2006, 17(5):548-549.
[39] Carley ME, Schaffer J. Urinary incontinence and pelvic organ prolapse in women with Manfanorhlers or Ehlers-Danlos syndrome[J].Am J Obstet Gynecol, 2000, 182(5): 1021-1023.
[40] Brizzolara S, Grandinetti A , Mor J. Percentage of hysterectomy for pelvic organ prolapse in five ethnic groups. Int Urogynecol J Pelvic Floor Dysfunct, 2002, 13(6):372-376.
[41]Jack GS,Nkolova G,Vilain E,et al.Familial transmission of genitovaginal prolapse[J].Int Urogynecol J Pelvic Floor Dysfunct,2006,17(5):498-501.
[42]Buchsbaum GM,Duecy EE,Kerr LA,et al.Pelvic organ prolapse in nulliparous women and their parous sisters.Obstet Gynecol,2006,108(6):1388-1393.
[43]Lang JH,Zhu L,Sun ZJ,et al.Estrogen levels an d estrogen receptors in patients with stress urinary incontinence and pelvic organ prolapse[J].Int J Gynaecol Obstet,2003,80(1):35-39.
[44]Rosenfeld CS,Wagner JS,Roberts RM,et al.Intraovarian actions of oestrogen[J].Reproduction,2001,122(2):215-226.
[45]Dick GM.The pure anti-oestrogen ICI 182,780(Faslodex)activates large conductance Ca(++)-activated K(+)channels in smooth muscle[J].Br J Pharmacol,2002,136(7):961-964.
[46]Clark AL,Slayden OD,Hettrich K,et al.Estrogen increases collagen Ⅰ and Ⅲ mRNA expression in the pelvic support tissues of the rhesus macaque[J].Am J Obstet Gynecol,2005,192(5):1523-1529.
[47]Moalli PA,Talarico LC,Sung VW,et al.Impact of menopause on collagen subtypes in the arcus tendineous fasciae pelvis[J].Am J Obstet Gynecol,2004,190(3):620-627.
[48]王玉珍,杨萍,梁志清.盆底器官脱垂及其病因学研究进展[J].西北国防医学杂志,2006,27(3):216-318.
[49]Marinkovic SP,Stanton SL.Incontinence an d voiding difficulties associated with prolapse[J].J Urol,2004,171(3):1021-1028.
[50]Swift S,Woodman P,0'Boyle A,et al.Pelvic organ support study(POSST):the distribution,clinical definition,and epidemiologic condition of pelvic organ support defects[J].Am J Obstet Gynecol,2005,192(3):795-806.
[51] Nimmi ME. Fibrillar collagens: their biosynthesis, molecular structure, and mode of assembly [M]. Zern MA, Reid LM, eds. Extracellular Matrix. New York: Marcel Dekker; 1993: 121-148.
[52] Goh JT. Biomechanical and biochemical assessments for pelvic organ prolapse [J]. Curr Opin Obstet Gynecol, 2003, 15(5):391-394.
[53] Goh JT. Biomechanical Properties of Prolapsed Vaginal Tissue in Pre and Postmenopausal Women [J]. Int Urogynecol J Pelvic Floor Dysfunct, 2002, 13(2):76-79.
[54] Cosson M, Lambaudie E, Boukerrou M. A biomechanical study of the strength of Vaginal tissues Results on 16 post-menopausal patients presenting with genital prolapse [J]. Eur J Obstet Gynecol Reprod Biol, 2004,112(2):201-205.
[55] Cosson M, Boukerrou M, Lambaudie E, et al. Biomechanics of stress distribution and resistance biological tissues: why use prostheses for the treat of genital prolapse [J]? J Gynecol Obstet Biol Reprod, 2003, 32(4):329-337.
[56] Lei L, Song Y, Chen R. Biomechanical properties of prolapsed vaginal tissue in pre- and postmenopausal women [J]. Int Urogynecol J Pelvic Floor Dysfunct, 2006 Oct 6; [Epub ahead of print].
[57] Liapis A, Bakas P, Pafitri A, et al. Changes in collagen type III in female patients with genuine stress incontinence and pelvic floor prolapse [J]. Eur J Obstet Gynecol Reprod Biol, 2001, 97(1):76-79.
[58] Ewies AA, Al-Azzawi F, Thompson J. Changes in extracellular matrix proteins in the cardinal ligaments of post-menopausal women with or without prolapse: a computerized immunohistomorphometric analysis [J]. Hum Reprod, 2003, 18(10):2189-2195.
[59] Moalli PA, Shand SH, Zyczynski HM, et al. Remodeling of vaginal connective tissue in patients with prolapse [J]. Obstet Gynecol, 2005, 106(5 Pt 1):953-963.
[60] Lin SY, Tee YT, Ng SC, et al. Changes in the extracellular matrix in the anterior vagina of women with or without prolapse [J]. Int Urogynecol J Pelvic Floor Dysfunct, 2007, 18(1):43-48.
[1]宋今丹,章静波,陈誉华.医学细胞分子生物学[M].第1版,北京:人民卫生出版社,2003:63-66.
[2]顾其胜,蒋丽霞.胶原与临床医学[M].第1版,上海:第二军医大学出版社,2003:45-47.
[3]Bergman A,Elia G,Cheung D,et al.Biochemical composition of collagen in continent and stress urinary incontinent women[J].Gynecol Obstet Invest,1994,37:48-51.
[4]Keane DP,Sims TJ,Abrams P,et al.Analysis of collagen status in premenopausal nulliparous women with genuine stress incontinence[J].Br J Obstet Gynaecol,1997,104(9):994-998.
[5]Rechberger T,Postawski K,Jakowicki JA,et al.Role of fascial collagen in stress urinary incontinence[J].Am J Obstet Gynecol,1998,179(6 Pt 1):1511-1514.
[6]Liapis A,Bakas R Pafiti A,et al.Changes in the quantity of collagen type Ⅰ in women with genuine stress incontinence[J].Urol Res,2000,28(5):323-326.
[7]Liapis A,Bakas P,Pafitri A,et al.Changes in collagen type Ⅲ in female patients with genuine stress incontinence and pelvic floor prolapse[J].Eur J Obstet Gynecol Reprod Biol,2001,97:76-79.
[8]Goepel C,Hefler L,Methfessel HD,et al.Periurethral connective tissue status of postmenopausal women with genital prolapse with and without stress incontinence[J].Acta Obstet Gynecol Scand,2003,82(7):659-664.
[9]Wong MY,Harmanli OH,Agar M,et al.Collagen content of nonsupport tissue in pelvic organ prolapse and stress urinary incontinence[J].Am J Obstet Gynecol,2003,189(6):1597-1600.
[10]Chen Y,DeSautel M,Anderson A,et al.Collagen synthesis is not altered in women with stress urinary incontinence[J].Neurourol Urodyn,2004,23(4):367-373.
[11]Keane DP,Sims TJ,Abrams P,et al.Analysis of collagen status in premenopausal nulliparous women with genuine stress incontinence[J].Br J Obstet Gynaecol,1997,104(9):994-998.
[12]Falconer C,Ekman G,Malmstrom A,et al.Decreased collagen synthesis in stress incontinent women[J].Obstet Gynecol,1994,84:583-586.
[13]Falconer C,Ekman G,Ulmsten U,et al.Changes in paraurethral connective tissue at menopause are counteracted by estrogen[J].Maturitas,1996,24:197-204.
[14]孙智晶 郎景和,朱兰,等.胶原状态与压力性尿失禁的病因学研究[J].中国妇产科临床杂志,2004,5(1):6-9.
[15]Chen BH,Wen Y,Li H,et al.Collagen Metabolism and Turnover in Women with Stress Urinary Incontience and Pelvic Prolapse[J].Int Urogynecol J,2002,13(2):80-87.
[16]Chen BH,Wen Y,Zhang Z,et al.Menstrual phase-dependent gene expression differences in periurethra vaginal tissue from women with stress incontinence.Am J Obstet Gynecol,2003,189(1):89-97.
[17]Lin YB,Song YF.Expression and clinical significance of decorin in stress urinary incontinence[J].Zhonghua Fu Chan Ke Za Zhi,2005,40(8):508-510.
[18]Falconer C,Ekman-Ordeberg G,Blomgren B,et al.Paraurethral connective tissue in stress incontinent women after menopause [J]. Acta Obstet Gynecol Scand, 1998, 77(1):95-100.
[19] Cor A, Barbic M, Kralj B. Differences in the quantity of elastic fibres and collagen type I and type III in endopelvic fascia between women with stress urinary incontinence and controls [J]. Urol Res, 2003, 31(2):61-65.
[20] Gabriel B, Denschlag D, Gobel H, et al. Uterosacral ligament in postmenopausal women with or without pelvic organ prolapse [J]. Int Urogynecol J Pelvic Floor Dysfunct, 2005,16(6):475-479.
[21] Falconer C, Blomgren B, Johansson O, et al. Different organization of collagen fibrils in stress incontinent women of fertile age [J]. Acta Obstet Gynecol Scand, 1998, 77(1):87-94.
[22] Edwall BL, Carlstrom K, Jonasson AF. Markers of collagen synthesis and degradation in urogenital tissue from women with and without stress urinary incontinence [J]. Neurourol Urodyn, 2005, 24(4):319-324.
[23] Kim S, Harvey MA, Johnston S. A review of the epidemiology and pathophysiology of pelvic floor dysfunction: do racial differences matter [J]? J Obstet Gynaecol Can, 2005,27(3):251-259.
[24] Jack GS, Nkolova G, Vilain E, et al. Familial tranmission of genitovaginal prolapse [J]. Int Urogynecol J Pelvic Floor Dysfunct, 2006,17(5):498-501.
[25] Buchsbaum GM, Duecy EE, Kerr LA, et al. Pelvic organ prolapse in nulliparous women and their parous sisters [J]. Obstet Gynecol, 2006, 108(6):1388-1393
[2].吴美琼,郑坚毅,朱丽萍.11938例已婚妇女妇科普查分析报告[J].中国实用妇科与产科杂志,1999,15(4):254-255.
[3]唐颖英.14180例已婚妇女妇科普查情况分析[J].医学文选,2001,20(5):690-691.
[4]莫玉瑶,赵小平,韦向军等.桂林市社区妇女病普查普治效果分析[J].肿瘤防治杂志,2001,8(2):120-122.
[5]翟风利.12496名已婚纺织女工妇科疾病普查[J].中国工业医学杂志,2003,16(4):239-240.
[6]曾晓琴.广州市芳村区1995-2002年妇女生殖道健康状况分析[J].中国初级卫生保健,2003,17(2):49-50.
[7]李哲刚.82945例农村妇女生殖健康状况分析[J].国际医药卫生导报,2003,9(7):115-117.
[8]郑漪霖.子宫脱垂的防治[J].实用老年医学,1996,10(5):201-202.
[9]Sze EH,Sherard GB 3rd,Dolezal JM.Pregnancy,labor,delivery,and pelvic organ prolapse[J].Obstet Gynecol,2002,100(5 Pt 1):981-986.
[10]Edwall BL,Carlstrom K,Jonasson AF.Markers of collagen synthesis and degradation in urogenital tissue from women with and without stress urinary incontinence[J].Neurourol Urodyn,2005,24(4):319-324.
[11]宋今丹,章静波,陈誉华.医学细胞分子生物学[M].第1版,北京:人民卫生出版社,2003:63-66.
[12]顾其胜,蒋丽霞.胶原与临床医学[M].第1版,上海:第二军医大学出版社,2003:45-47.
[13] Bump RC, Mattiasson A, Bo K, et al. The standardization of terminology of female pelvic organ prolapse and pelvic floor dysfunction. Am J Obstet Gynecol, 1996, 175(1): 10-17.
[14] Petros PE , Ulmsten U. An integral theory of female urinary incontinence [J]. Acta Obstetricia et Gynecological Scandinavica, 1990, 69:suppl 153:1-79.
[15] Petros PE. The female pelvic floor-function,dysfunction and management according to the integral theory [M]. Springer Medizin Verlag Heidelberg, 2004: 1-12.
[16] Petros PP, Ulmsten U. An anatomical classification—a new paradigm for management of female lower urinary tract dysfunction [J]. Eur J Obstet . Gynecol Reprod Biol, 1998, 80(1): 87-94.
[17] Jackson SR, Avery NC, Tarlton JF, et al. Changes in metabolism of collagen in genitourinary prolapse [J]. Lancet, 1996, 347(9016): 1658-1561.
[18] Buchanan S, Robertson GW, Hocking PM. Relationships between vaginal collagen, plasma oestradiol and uterine prolapse in turkeys [J]. Res Vet Sci, 1999, 67(2):153-157.
[19] Takano CC, Girao MJ, Sartori MG, et al. Analysis of collagen in parametrium and vaginal apex of women with and without uterine prolapse[J].Int Urogynecol J Pelvic Floor Dysfunct, 2002, 13(6):342-345.
[20] Goepel C, Hefler L, Methfessel HD, et al. Periurethral connective tissue status of postmenopausal women with genital prolapse with and without stress incontinence [J]. Acta Obstet Gynecol Scand, 2003, 82(7):659-664.
[21] Wong MY, Harmanli OH, Agar M, et al. Collagen content of nonsupport tissue in pelvic organ prolapse and stress urinary incontinence [J]. Am J Obstet Gynecol, 2003, 189(6): 1597-1600.
[22] Soderberg MW, Falconer C, Bystrom B, et al. Young women with genital prolapse has a low collagen concentration[J].Acta Obstet Gynecol Scand,2004,83(12):1193-1198.
[23]Drutz HP,Alarab M.Pelvic organ prolapse:demographics and future growth prospects[J].Int Urogynecol J Pelvic Floor Dysfunct,2006,17 Suppl 1:S6-9.
[24]Barbiero EC,Sartori MG,Girao MJ,et al.Analysis of type Ⅰ collagen in the parametrium of women with and without uterine prolapse,according to hormonal status[J].Int Urogynecol J Pelvic Floor Dysfunct,2003,14(5):331-334.
[25]孙智晶 郎景和,等.胶原状态与压力性尿失禁的病因学研究[J].中国妇产科临床杂志,2004,5(1):6-9.
[26]Chen BH,Wen Y,Li H,et al.Collagen Metabolism and Turnover in Women with Stress Urinary Incontinence and Pelvic Prolapse[J].Int Urogynecol J,2002,13(2):80-87.
[27]Gabriel B,Watermann D,Hancke K,et al.Increased expression of matrix metalloproteinase 2 in uterosacral ligaments is associated with pelvic organ prolapse[J].Int Urogynecol J Pelvic Floor Dysfunct,2006,17(5):478-482.
[28]Bai SW,Choe BH,Kim JY,et al.Pelvic organ prolapse and connective tissue abnormalities in Korean women[J].J Reprod Med,2002,47(3):231-234.
[29]Ewies AA,Al-Azzawi F,Thompson J.Changes in extracellular matrix proteins in the cardinal ligaments of post-menopausal women with or without prolapse:a computerized immunohistomorphometric analysis[J].Hum Reprod,2003,18(10):2189-2195.
[30]Gabriel B,Denschlag D,Gobel H,et al.Uterosacral ligament in postmenopausal women with or without pelvic organ prolapse[J].Int Urogynecol J Pelvic Floor Dysfunct,2005,16(6):475-479.
[31]Phillips CH,Anthony F,Benyon C,et al.Collagen metabolism in the uterosacral ligaments and vaginal skin of women with uterine prolapse[J]. BJOG, 2006 , 113(1):39-46.
[32] Meyer S, Hohlfeld P, Achtari C, et al. Birth trauma: Short and long term effects of forceps delivery compared with spontaneous delivery on various pelvic floor parameters[J]. Br JObstet Gynaecol, 2000, 107(11): 1360-1365.
[33] Swift SE. The distribution of pelvic organ support in a population of female subjects seen for routine gynecologic health care [J]. Am J Obstet Gynecol, 2000, 183(2):277-285.
[34] Dietz HP. Pelvic floor trauma following vaginal delivery [J]. Curr Opin Obstet Gynecol, 2006, 18(5):528-537.
[35] Tegerstedt G, Maehie S M, Nyren O, et al. Preyalence of symptomatic pelvic organ prolapse in a Swedish population [J]. Int Urogynecol J Pelvic Floor Dysfunct, 2005, 16(6): 497-503.
[36] Lukacz ES, Lawrence JM, Contreras R, et al. Parity, mode of delivery, and pelvic floor disorders [J]. Obstet Gynecol, 2006, 107(6):1253-1260.
[37] Dietz HP, Eldridge A, Grace M, et al. Pelvic organ descent in young nulligravid women[J], Am JObstet Gynecol, 2004, 191(1):95-100.
[38] Chi en WH, Tseng MR, Lin YH. Acute pelvic organ prolapse in an 11-month-old infant [J]. Int Urogynecol J Pelvic Floor Dysfunct, 2006, 17(5):548-549.
[39] Carley ME, Schaffer J. Urinary incontinence and pelvic organ prolapse in women with Manfanorhlers or Ehlers-Danlos syndrome[J].Am J Obstet Gynecol, 2000, 182(5): 1021-1023.
[40] Brizzolara S, Grandinetti A , Mor J. Percentage of hysterectomy for pelvic organ prolapse in five ethnic groups. Int Urogynecol J Pelvic Floor Dysfunct, 2002, 13(6):372-376.
[41]Jack GS,Nkolova G,Vilain E,et al.Familial transmission of genitovaginal prolapse[J].Int Urogynecol J Pelvic Floor Dysfunct,2006,17(5):498-501.
[42]Buchsbaum GM,Duecy EE,Kerr LA,et al.Pelvic organ prolapse in nulliparous women and their parous sisters.Obstet Gynecol,2006,108(6):1388-1393.
[43]Lang JH,Zhu L,Sun ZJ,et al.Estrogen levels an d estrogen receptors in patients with stress urinary incontinence and pelvic organ prolapse[J].Int J Gynaecol Obstet,2003,80(1):35-39.
[44]Rosenfeld CS,Wagner JS,Roberts RM,et al.Intraovarian actions of oestrogen[J].Reproduction,2001,122(2):215-226.
[45]Dick GM.The pure anti-oestrogen ICI 182,780(Faslodex)activates large conductance Ca(++)-activated K(+)channels in smooth muscle[J].Br J Pharmacol,2002,136(7):961-964.
[46]Clark AL,Slayden OD,Hettrich K,et al.Estrogen increases collagen Ⅰ and Ⅲ mRNA expression in the pelvic support tissues of the rhesus macaque[J].Am J Obstet Gynecol,2005,192(5):1523-1529.
[47]Moalli PA,Talarico LC,Sung VW,et al.Impact of menopause on collagen subtypes in the arcus tendineous fasciae pelvis[J].Am J Obstet Gynecol,2004,190(3):620-627.
[48]王玉珍,杨萍,梁志清.盆底器官脱垂及其病因学研究进展[J].西北国防医学杂志,2006,27(3):216-318.
[49]Marinkovic SP,Stanton SL.Incontinence an d voiding difficulties associated with prolapse[J].J Urol,2004,171(3):1021-1028.
[50]Swift S,Woodman P,0'Boyle A,et al.Pelvic organ support study(POSST):the distribution,clinical definition,and epidemiologic condition of pelvic organ support defects[J].Am J Obstet Gynecol,2005,192(3):795-806.
[51] Nimmi ME. Fibrillar collagens: their biosynthesis, molecular structure, and mode of assembly [M]. Zern MA, Reid LM, eds. Extracellular Matrix. New York: Marcel Dekker; 1993: 121-148.
[52] Goh JT. Biomechanical and biochemical assessments for pelvic organ prolapse [J]. Curr Opin Obstet Gynecol, 2003, 15(5):391-394.
[53] Goh JT. Biomechanical Properties of Prolapsed Vaginal Tissue in Pre and Postmenopausal Women [J]. Int Urogynecol J Pelvic Floor Dysfunct, 2002, 13(2):76-79.
[54] Cosson M, Lambaudie E, Boukerrou M. A biomechanical study of the strength of Vaginal tissues Results on 16 post-menopausal patients presenting with genital prolapse [J]. Eur J Obstet Gynecol Reprod Biol, 2004,112(2):201-205.
[55] Cosson M, Boukerrou M, Lambaudie E, et al. Biomechanics of stress distribution and resistance biological tissues: why use prostheses for the treat of genital prolapse [J]? J Gynecol Obstet Biol Reprod, 2003, 32(4):329-337.
[56] Lei L, Song Y, Chen R. Biomechanical properties of prolapsed vaginal tissue in pre- and postmenopausal women [J]. Int Urogynecol J Pelvic Floor Dysfunct, 2006 Oct 6; [Epub ahead of print].
[57] Liapis A, Bakas P, Pafitri A, et al. Changes in collagen type III in female patients with genuine stress incontinence and pelvic floor prolapse [J]. Eur J Obstet Gynecol Reprod Biol, 2001, 97(1):76-79.
[58] Ewies AA, Al-Azzawi F, Thompson J. Changes in extracellular matrix proteins in the cardinal ligaments of post-menopausal women with or without prolapse: a computerized immunohistomorphometric analysis [J]. Hum Reprod, 2003, 18(10):2189-2195.
[59] Moalli PA, Shand SH, Zyczynski HM, et al. Remodeling of vaginal connective tissue in patients with prolapse [J]. Obstet Gynecol, 2005, 106(5 Pt 1):953-963.
[60] Lin SY, Tee YT, Ng SC, et al. Changes in the extracellular matrix in the anterior vagina of women with or without prolapse [J]. Int Urogynecol J Pelvic Floor Dysfunct, 2007, 18(1):43-48.
[1]宋今丹,章静波,陈誉华.医学细胞分子生物学[M].第1版,北京:人民卫生出版社,2003:63-66.
[2]顾其胜,蒋丽霞.胶原与临床医学[M].第1版,上海:第二军医大学出版社,2003:45-47.
[3]Bergman A,Elia G,Cheung D,et al.Biochemical composition of collagen in continent and stress urinary incontinent women[J].Gynecol Obstet Invest,1994,37:48-51.
[4]Keane DP,Sims TJ,Abrams P,et al.Analysis of collagen status in premenopausal nulliparous women with genuine stress incontinence[J].Br J Obstet Gynaecol,1997,104(9):994-998.
[5]Rechberger T,Postawski K,Jakowicki JA,et al.Role of fascial collagen in stress urinary incontinence[J].Am J Obstet Gynecol,1998,179(6 Pt 1):1511-1514.
[6]Liapis A,Bakas R Pafiti A,et al.Changes in the quantity of collagen type Ⅰ in women with genuine stress incontinence[J].Urol Res,2000,28(5):323-326.
[7]Liapis A,Bakas P,Pafitri A,et al.Changes in collagen type Ⅲ in female patients with genuine stress incontinence and pelvic floor prolapse[J].Eur J Obstet Gynecol Reprod Biol,2001,97:76-79.
[8]Goepel C,Hefler L,Methfessel HD,et al.Periurethral connective tissue status of postmenopausal women with genital prolapse with and without stress incontinence[J].Acta Obstet Gynecol Scand,2003,82(7):659-664.
[9]Wong MY,Harmanli OH,Agar M,et al.Collagen content of nonsupport tissue in pelvic organ prolapse and stress urinary incontinence[J].Am J Obstet Gynecol,2003,189(6):1597-1600.
[10]Chen Y,DeSautel M,Anderson A,et al.Collagen synthesis is not altered in women with stress urinary incontinence[J].Neurourol Urodyn,2004,23(4):367-373.
[11]Keane DP,Sims TJ,Abrams P,et al.Analysis of collagen status in premenopausal nulliparous women with genuine stress incontinence[J].Br J Obstet Gynaecol,1997,104(9):994-998.
[12]Falconer C,Ekman G,Malmstrom A,et al.Decreased collagen synthesis in stress incontinent women[J].Obstet Gynecol,1994,84:583-586.
[13]Falconer C,Ekman G,Ulmsten U,et al.Changes in paraurethral connective tissue at menopause are counteracted by estrogen[J].Maturitas,1996,24:197-204.
[14]孙智晶 郎景和,朱兰,等.胶原状态与压力性尿失禁的病因学研究[J].中国妇产科临床杂志,2004,5(1):6-9.
[15]Chen BH,Wen Y,Li H,et al.Collagen Metabolism and Turnover in Women with Stress Urinary Incontience and Pelvic Prolapse[J].Int Urogynecol J,2002,13(2):80-87.
[16]Chen BH,Wen Y,Zhang Z,et al.Menstrual phase-dependent gene expression differences in periurethra vaginal tissue from women with stress incontinence.Am J Obstet Gynecol,2003,189(1):89-97.
[17]Lin YB,Song YF.Expression and clinical significance of decorin in stress urinary incontinence[J].Zhonghua Fu Chan Ke Za Zhi,2005,40(8):508-510.
[18]Falconer C,Ekman-Ordeberg G,Blomgren B,et al.Paraurethral connective tissue in stress incontinent women after menopause [J]. Acta Obstet Gynecol Scand, 1998, 77(1):95-100.
[19] Cor A, Barbic M, Kralj B. Differences in the quantity of elastic fibres and collagen type I and type III in endopelvic fascia between women with stress urinary incontinence and controls [J]. Urol Res, 2003, 31(2):61-65.
[20] Gabriel B, Denschlag D, Gobel H, et al. Uterosacral ligament in postmenopausal women with or without pelvic organ prolapse [J]. Int Urogynecol J Pelvic Floor Dysfunct, 2005,16(6):475-479.
[21] Falconer C, Blomgren B, Johansson O, et al. Different organization of collagen fibrils in stress incontinent women of fertile age [J]. Acta Obstet Gynecol Scand, 1998, 77(1):87-94.
[22] Edwall BL, Carlstrom K, Jonasson AF. Markers of collagen synthesis and degradation in urogenital tissue from women with and without stress urinary incontinence [J]. Neurourol Urodyn, 2005, 24(4):319-324.
[23] Kim S, Harvey MA, Johnston S. A review of the epidemiology and pathophysiology of pelvic floor dysfunction: do racial differences matter [J]? J Obstet Gynaecol Can, 2005,27(3):251-259.
[24] Jack GS, Nkolova G, Vilain E, et al. Familial tranmission of genitovaginal prolapse [J]. Int Urogynecol J Pelvic Floor Dysfunct, 2006,17(5):498-501.
[25] Buchsbaum GM, Duecy EE, Kerr LA, et al. Pelvic organ prolapse in nulliparous women and their parous sisters [J]. Obstet Gynecol, 2006, 108(6):1388-1393