Matrix metalloproteinases-1, -2 expression in uterosacral ligaments from women with pelvic organ prolapse

Abstract Objective This study investigated matrix metalloproteinase-1 (MMP-1) and matrix metalloproteinase-2 (MMP-2) immunohistochemical expression in uterosacral ligament biopsies from women with pelvic organ prolapse (POP), and controls with normal pelvic support. Design Prospective observational experimental study. Setting A tertiary Urogynecology Unit and Institute of Pathology, University Hospital Split, Croatia. Population Women referred for hysterectomy for prolapse or benign gynecological disease. Methods Eighty postmenopausal women were included in the study after Ethical Committee approval and informed consent. During surgery, uterosacral ligament biopsies were obtained from patients with POP ( n  = 40) and women without evidence of pelvic floor weakening ( n  = 40). Immunohistochemistry for MMP-1 and MMP-2 was performed on formaline fixed and paraffin embedded sections. Statistical evaluations were made by Student t -test or χ 2 test. Main outcome measures Immunohistochemical expression of MMP-1 and MMP-2 in the uterosacral ligaments of women with and without genital prolapse. Results Forty women with POP and 40 controls without POP were included. The controls were matched to the women with POP in age, body mass index, parity and duration of postmenopausis. A significant increase in MMP-1 immunohistochemical expression was seen in uterosacral ligament tissue from women with POP ( P  = 0.029). In contrast, there was no difference in immunohistochemical expression of MMP-2 between women with POP and those without ( P  = 0.899). Conclusion These data suggest that MMP-1 may be marker of collagen degradation. Increased MMP-1 immunohistochemical expression in uterosacral ligaments is associated with urogenital prolapse.