Beta-3 adrenoceptor expression in the uterosacral ligament in the postmenopausal women with pelvic organ prolapse.

ABSTRACT

AIMS: ß3-adrenoceptor (ß3-AR) agonist is known to relax the detrusor muscles. Considering that both pelvic organ prolapse (POP) and overactive-bladder (OAB) are frequently seen in the elderly population, the effect of ß3-AR agonist on the pelvic floor tissues should be investigated. As a first step, this pilot, experimental, and descriptive study was designed to investigate the presence of ß3-AR expression in the uterosacral-ligaments (USLs) in postmenopausal (PMP) women with POP. METHODS: After informed consent, PMP women undergoing hysterectomy for POP were recruited for the intraoperative collection of distal USL between 5/2016 and 8/2016. H&E analysis for the USLs and immunohistochemistry (IHC) analysis for ß3-AR and α-actin smooth muscle (SM) were carried out. Tissue composition and percentage of ß3-AR expression in the USLs were subjectively measured and the staining results were expressed as descriptive analysis. RESULTS: Total 11 USL specimens were collected and nine specimens were included for the final analysis (one specimen used for antibody concentration adjustment and one specimen failed proper staining). Under high-power-field, the USLs were composed of SM cells (81.5 ± 7.47%) and connective tissues (16.5 ± 7.9%). On IHC analysis, six out of nine specimens expressed ß3-AR with a different level of expression in SM cells in the USLs. CONCLUSIONS: The majority of distal USLs were composed of SM cells. ß3-ARs are expressed in 67% of the study specimens. Considering that both POP and OAB are frequently seen in the elderly population, the effect of ß3-AR agonist on the pelvic floor tissues should be investigated further.