Immunohistochemical Expression of Hormonal Receptors, Collagen, Elastin, and Proteoglycans in Genuine Urinary Incontinence.

Purpose: To study the expression of hormonal receptors, collagen, elastin, proteoglycans, and VIP in the vaginal wall of women with stress urinary incontinence (SUI). Materials and Methods: Fifty-eight specimens of the anterior vaginal wall (28 women with SUI) were processed by Ventana immunostaining method. Results: Both groups were compatible for age, BMI, and obstetric history. Positive ER-alpha and ER-beta immunoreaction was observed in 46.4% and 3.6% of SUI (43.3% and 33.3 % of controls) (p < 0.05), respectively, and PR immunoreaction in 39.3% of SUI (46.7% of controls). Collagen I and III immunoreaction was observed in 28,6% and 21.4 % of SUI (30.% and 36.7% of controls), respectively, and elastin, decorin, and fibromodulin immunoreaction in 10.7 %, 10.7%, and 10.7% of SUI (50%, 33.3%, 33,.3% of controls) (p < 0.05), respectively. VIP immunoreaction was observed in 7.1% of SUI (36.7% of controls). Conclusion: Immunoexpression of ER-beta, elastin, decorin, fibromodulin, and VIP was significantly lower in SUI than controls, showing that the ER-beta dependent re-modeling of the extracellular matrix of vaginal tissues is the main mechanism of SUI.