To explore quantity of typeⅠ and Ⅲcollagen and decorin(DCN) mRNA expression in the upper portion of the anterior vaginal wall in patients with pelvic organ prolapse (POP) and stress urinary incontinence(SUI).

Transvaginal biopsies were obtained from the anterior vaginal wall in 21 cases of POP(POP group), 20 cases of POP+ SUI(POP+ SUI group) and 17 cases of normal women (control group). The concentration of typeⅠand Ⅲ collagen were determined by ELISA method. RTQ-PCR was used to verify the level of DCN mRNA.

The mean concentration extracellular matrix metabolism was significantly reduced in patients of POP group and POP+ SUI group, compared to control group(P<0.01). The DCN mRNA expression was significantly increased in pre-menopausal women of POP group and POP+ SUI group, compared to control group(P<0.05). In the post-menopausal women of POP group and POP+ SUI group, the expression of decorin was increased, but there had no significant difference compared to that of control group(P>0.05).

A decrease in quantity of collagen type Ⅰ and Ⅲ in the connective tissue of anterior vaginal wall may compromise the tensile strength and flexibility, and result in an increase susceptibility to prolapse and stress urinary incontinence. To some extent, decorin might be involved in the pathogenesis of pelvic organ prolapse and stress urinary incontinence by influencing collagen metabolism in connective tissue of pelvic floor, and weaken their support strength and elastic properties.The pathogenesis of pelvic organ prolapse in post-menopausal women is complicated.