Morphology of the suburethral pubocervical fascia in women with stress urinary incontinence: a comparison of histologic and MRI findings |
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Authors: | R Tunn M Rieprich O Kaufmann A Gauruder-Burmester D Beyersdorff |
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Affiliation: | (1) Department of Obstetrics and Gynecology, Charité University Hospital, Humboldt University, Berlin, Germany;(2) Department of Pathology, Charité University Hospital, Humboldt University, Berlin, Germany;(3) Department of Radiology, Charité University Hospital,, Humboldt University, Berlin, Germany;(4) German Pelvic Floor Center, Urogynecology, St. Hedwig Hospitals, Große Hamburger Str. 5–11, 10115 Berlin, Germany |
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Abstract: | To correlate MRI with histologic findings of the suburethral pubocervical fascia in women with urodynamic stress incontinence. Thirty-one women with urodynamically proven stress urinary incontinence without relevant prolapse underwent preoperative MRI. Tissue specimens obtained from the pubocervical fascia were examined immunohistochemically (types I and III collagen, smooth muscle actin) and the results compared with the MRI findings. MRI demonstrated an intact pubocervical fascia in 61.3% of the cases and a fascial defect in 38.7%. A fascial defect demonstrated by MRI was associated with a decrease in actin (P<0.09) and an increase in collagen III (P<0.01) compared to an intact fascia. In women with stress urinary incontinence, smooth muscle actin in the pubocervical fascia is decreased, changed in structure, and replaced by type III collagen. MRI allows evaluation of the pubocervical fascia and its morphologic changes. |
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Keywords: | Stress urinary incontinence Pubocervical fascia defects MRI Immunohistochemistry of collagen and smooth muscle actin |
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