Strength of round and uterosacral ligaments: a biomechanical study.

PURPOSE: To investigate the tensile biomechanical properties of round and uterosacral ligaments. METHODS: Tissue samples were obtained from 15 female cadavers without pelvic organ prolapse. Uniaxial tensile tests were performed to obtain stiffness and maximum stress of round and uterosacral ligaments. Correlations were calculated using the Pearson correlation coefficient. Statistical differences between groups were tested using Student's paired and unpaired t test. RESULTS: There was a great variability in the measurements of stiffness and maximum stress in pelvic ligaments. The round ligaments demonstrated stiffness of 9.1 ± 1.6 MPa (mean ± SEM) (ranging from 2 to 25.6 MPa) and maximum stress of 4.3 ± 0.7 MPa (ranging from 1.2 to 11.5 MPa). The stiffness of the uterosacral ligaments was 14.1 ± 1.4 MPa (ranging from 5.7 to 26.1 MPa) with maximum stress of 6.3 ± 0.8 MPa (ranging from 2.2 to 11.9 MPa). There was a strong positive correlation between stiffness and maximum stress in female pelvic ligaments (ρ = 0.851; p < 0.001). The uterosacral ligaments demonstrated higher stiffness and maximum stress compared to the round ligaments (p = 0.006 and p = 0.034; respectively). Age, body mass index and menopausal status were not associated with the biomechanical proprieties of round and uterosacral ligaments. Nulliparous women had lower uterosacral stiffness (15.5 ± 1.3 vs. 10 ± 1.8 MPa; p = 0.033) and maximum stress (8.2 ± 0.9 vs. 4.2 ± 1.1 MPa; p = 0.028) compared to parous women. CONCLUSION: The uterosacral ligaments are significantly more resistant than round ligaments. Parturition seems to enhance the stiffness and maximum stress of the ligaments.

The relationship between the Trp 64 Arg polymorphism of the beta 3-adrenoceptor gene and idiopathic overactive bladder.

OBJECTIVE: The purpose of this study was to verify the association between the Trp 64 Arg polymorphism and idiopathic overactive bladder (OAB) syndrome. STUDY DESIGN: A case-control study was conducted with 218 women. The case group consisted of 49 patients with OAB symptoms; the control group included 169 women without urinary symptoms. The studied polymorphism was detected by restriction fragment length polymorphism analysis. The χ(2) test was used to compare categoric data, with a significance level of 5%. Numeric data were compared with the use of the parametric t test or nonparametric Mann-Whitney U test. RESULTS: The distribution of the polymorphism in the investigated women was digested homozygous T allele 69.75%, heterozygotes 29.8%, and homozygous A allele 0.45%. A comparison between the groups showed higher prevalence of the digested homozygous T allele genotype in women with OAB syndrome (P = .001). Multiple logistic regression analysis identified that a family history of OAB syndrome was an independent risk factor for OAB syndrome. CONCLUSION: The Trp 64 Arg polymorphism was associated with OAB syndrome in the Brazilian population.