Shcherbina N., Alaya Lamia


About the author:

Shcherbina N., Alaya Lamia



Type of article:

Scentific article


The genital prolapse, as part of the gynecological pathology, occurs in 1.7 to 28% women one to the composition, according to different authors, from 1.7 to 28%, particularly among women older than 40 years this figure rises to 34.7%. In 85.5% of patients with genital prolapse the following symptoms occur: urinary incontinence in 70% of patients, defecation disorders in 36.5% and dyspareunia in 53.3% patients. Until today there is no consensus about the etiology and pathogenesis of the genital prolapse. However, most researchers agree that the main factor in the development of prolapse is a violation of the state of the pelvic floor. According to modern research, the leading cause of prolapse is the dyspalsia of the systemic connective tissue dysplasia (CTD). According to the literature, CTD is common in 48% cases among women with genital prolapse. CTD is a multisystem pathology with a progressive course, which is characterised by the defects in the protein synthesis or catabolic multyfunction of the components of the extracellular matrix of the connective tissue. Matrix metalloproteinases (MMPs) play a critical role in regulating the homeostasis of the extracellular matrix. MMPs are proteolytic enzymes involved in the degradation and remodeling of the connective tissue. The aim of the study was to investigate the risk factors associated with the genital prolapse in menopausal women with connective tissue dysplasia. We examined 65 women in perimenopause with genital prolapse of 1-2 stages. The patients were divided into two groups according to age and the presence of phenotypic signs of CTD and the applied treatment. Clinical characteristics and the estradiol concentration of the matrix metalloproteinase 9 (MMP-9) activity in serum were determined. Women in both groups with clinical signs of genital prolapse showed a significant (p <0,05) decrease in the estradiol concentrations compared to the physiological norm. Thus, in the group of patients with CTD symptoms the average estradiol level was 0.13 ± 0.014 nmol / L and in Group 2 - 0.27 ± 0.035 nmol / l. The elevated levels of MMP-9 were detected in the group CTD symptoms (215,11 ± 17,3 ng / ml) compared to the norm value determined among women in perimenopaus (100,0 ± 6,1 ng / ml) which confirms pathogenic role of metalloproteinases in the restructuring on the connective tissue. Patients with genital prolapse and connective tissue dysplasia show increase collagen destruction with the low levels of estradiol. The data obtained in this study allows us to consider the hyperestrogenic levels and MMP-9 activity dysfunction hypoestrogeniya violation of MMP9 activity as the risk factors for this disease in perimenopausal women. Promt response to the hormonal disorders together with the metabolic therapy significantly increases the effect of preventative and therapeutic interventions for genital prolapse.


genital prolapse, connective tissue dysplasia, the activity of matrix metalloproteinases, estrogens, complex metabolic therapy


  • 1. Балан В.Е. Принципы заместительной гормональной терапии урогенитальных расстройств / В.Е. Балан // Consilium Medium. – 2003. — №5. — С. 413-417. 
  • 2. Буянова С.Н. Некоторые аспекты патогенеза пролапса гениталий / С.Н. Буянова, С.В. Савельев, В.Л. Гришин, Т.Н. Сенчакова // Акушерство и гинекология. — 2001. — № 3 — С. 39- 41.
  • 3. Кадурина Т.И. Наследственные коллагенопатии (клиника, диагностика, лечение и диспансеризация) / Т.И. Кадурина // СПБ: Невский Диалект. — 2000. – 271 с.
  • 4. Куликовский В.Ф. Тазовый пролапс / В.Ф. Куликовский, Н.В. Олейник. — Белгород, 2004. — 300 с.
  • 5. Милковска-Дмитрова Т. Врождена соединительнотканна малостойкость у децата / Т. Милковска-Дмитрова. — София: Медицина и физкультура, 1987. — 189 с.
  • 6. Потеряева О.Н. Метод определения активности матриксных металлопротеаз в сыворотке / О.Н. Потеряева, Г.С. Русских, А.С. Чернышева, П.В. Мокрушников // Медицина и образование в Сибири, http:// — 2010. — №5.
  • 7. Радзинский В.Е. Перинеология / В.Е. Радзинский, Ю.М. Дурандин, Ч.Г. Гагаев [и др.]. — М., 2006. – С. 64-124.
  • 8. Смольнова Т.Ю. Дисплазия соединительной ткани / Т.Ю. Смольнова, Л.В. Адамян // Актуальные вопросы внутренней патологии. — Омск. – 2005. – С. 156-161.
  • 9. Carley M.E. Urinary incontinence and pelvic organ prolapse in women with Marfon or Ehlers Danlos Syndrome / M.E. Carley, J. Schaffer // Am Obstet. Gynaecol. — 2000. — May 182/5. – Р. 1021-1023.
  • 10. Deval B. Prolapse in the young women: study of risk factors / B. Deval, A. Rafii, S. Poilpot [et al.] // Gynaec. Obstet. Fertil. — 2002 – vol. 30. № 9. — P. 673-676.

Publication of the article:

«Bulletin of problems biology and medicine» Issue 2 part 1 (128), 2016 year, 135-139 pages, index UDK [618.13/.15-007.4 +616.62-222/.223]-08:618.173-018.2-007.17