Animal models of female pelvic organ prolapse: lessons learned

Abstract

Pelvic organ prolapse is a vaginal protrusion of female pelvic organs. It has high prevalence worldwide and represents a great burden to the economy. The pathophysiology of pelvic organ prolapse is multifactorial and includes genetic predisposition, aberrant connective tissue, obesity, advancing age, vaginal delivery and other risk factors. Owing to the long course prior to patients becoming symptomatic and ethical questions surrounding human studies, animal models are necessary and useful. These models can mimic different human characteristics - histological, anatomical or hormonal, but none present all of the characteristics at the same time. Major animal models include knockout mice, rats, sheep, rabbits and nonhuman primates. In this article we discuss different animal models and their utility for investigating the natural progression of pelvic organ prolapse pathophysiology and novel treatment approaches.

Figure 1. Vaginal levels of support

The three levels are anatomically connected and continuous, providing support to the vagina and uterus by a complex interaction of connective tissue, ligaments and muscle. Reprinted with permission from the Cleveland Clinic Center for Medical Art & Photography © 2012. All Rights Reserved.