Expression of transforming growth factor-beta 1 and connective tissue growth factor in women with pelvic organ prolapse

To investigate the presence of transforming growth factor-beta 1 [TGF-beta 1] and connective tissue growth factor [CTGF] in women with pelvic organ prolapse [POP]. This study was conducted from May to December 2009. Fifty patients with POP that underwent vaginal hysterectomy in the Department of Gynecology, Renmin Hospital of Wuhan University, Hubei, Wuhan, China were enrolled in this study. They were divided into: Group 1 [n-10]; Group 2 [n=10]; and Group 3 [n=10] according to Pelvic Organ Prolapse Quantitation [POP-Q]. Meanwhile, 20 cases treated by vaginal hysterectomy for other benign gynecological diseases were selected as the control group. Immunohistochemical staining and Western blot were performed to detect the expression of TGF-beta 1 and CTGF. Immunohistochemical staining of TGF- beta 1 and CTGF were mainly expressed in the cytoplasm of fibroblast cells. The expression of TGF- beta 1 and CTGF protein was significantly negatively correlated with POP-Q stage. There were significantly positive correlations between the expression of TGF- beta 1 and CTGF protein. The expression of TGF- beta 1 protein among the 3 POP groups were all significantly lower than that of the control group, while there was no significant differences in the expression of TGF- beta 1 protein among the POP groups, excluding the comparison between Groups 1 and 3. The expression of CTGF protein in the 3 POP groups were all significantly lower than that of the control group, and significant differences were also detected among the 3 POP groups. In this study, we found that the TGF- beta 1 and CTGF protein expression may be associated with POP, especially in POP-Q stages

Mesh erosion after pelvic reconstructive surgeries

To report our experience on the erosion of polypropylene mesh used in pelvic reconstructive surgeries, and to discuss the pathological changes of mesh erosion. We conducted a retrospective study of 128 patients receiving pelvic reconstructive surgeries with polypropylene mesh from May 2006 to May 2009 in the Department of Gynecology and Obstetrics, Renmin Hospital of Wuhan University, Hubei, China. Data regarding patient demographics, operation notes, and follow up were collected. The mean follow-up time for the 128 patients was 15.2 [1.3-60] months. Seven patients were diagnosed with vaginal mesh erosion [Prolene mesh], and one of them suffered from anaphylactoid breakout related to the mesh. The mean [ +/- standard deviation] time occurring in the mesh erosion was 9.1 +/- 7.6 months. All the 7 patients were treated with surgery. Chronic inflammation was the main pathological manifestations in the eroded tissue. Most cases of polypropylene mesh erosions occur within one year postoperatively. Removal of the mesh could be the best therapy for mesh erosion. Further study is needed to determine if the polypropylene mesh induces supersensitivity