Histopathological evaluation of the connective tissue of the vaginal fascia and the uterine ligaments in women with and without pelvic relaxation.

This study aimed to compare connective tissue components within the uterine ligaments histopathologically in women with and without pelvic relaxation. The tissue samples obtained from the histopathologic specimens of 24 patients with uterine descensus who underwent vaginal hysterectomy and from twenty-one patients with no pelvic relaxation, in whom total abdominal hysterectomies were performed for benign reasons, were used as the study and control groups, respectively. From each hysterectomy material, samples for histological examination were taken from the vaginal fascia and from the cardinal, the uterosacral and the round ligaments (4 samples for each patient). The amount of collagen, cellularity and elastic fibers within the connective tissue were evaluated and scored by the co-author pathologist. Mann-Whitney U and Student t tests were used for the statistical analysis. The patients with pelvic relaxation had significantly higher scores of collagen and fewer scores of cellularity within the connective tissue samples, compared with the ones without relaxation (p < 0.01, p < 0.01). It was concluded that decreased fibroblasts and increased collagen content might be the key factors associated with pelvic support disorders.