Biomechanical properties of prolapsed or non-prolapsed vaginal tissue: impact on genital prolapse surgery

Abstract

Introduction and hypothesis: Our aim is to characterize prolapsed and non-prolapsed vaginal tissue, and thus offer a better understanding of the genital prolapse physiopathology and an improvement of surgical treatments.

Methods: Vaginal tissue was collected in 30 patients with prolapse (POP) and ten fresh cadavers without prolapse (nPOP) with a favorable advice of Ethics Committee. Uniaxial tension tests were performed. Statistical comparisons of rigidity under moderate deformation and under large deformation have been performed

Results: POP is significantly stiffer than nPOP tissue, both on anterior and posterior walls. A significant difference between POP and nPOP tissues was highlighted when anterior or posterior vaginal walls were respectively compared.

Conclusions: These results might explain the higher rate of relapse when repair is autologous, using already defective and more rigid vaginal tissue. This study suggests that it might be interesting to adapt the characteristics of prosthetic implants to the vaginal face concerned by the prolapsus.