Light and electron microscopic evaluation of cardinal ligaments in women with or without uterine prolapse

This study investigated light and electron microscopic findings in cardinal ligaments of women with or without uterine prolapse. Cardinal ligament samples were obtained from hysterectomy specimens of ten women with and ten women without uterine prolapse. Light microscopy showed altered connective tissue properties in eight of ten women with prolapse and in only three of ten women without prolapse (p = 0.025). The alterations included loosely arranged connective tissue fibers and less dense extracellular matrix with sparsely distributed fibroblasts. Under electron microscopy, collagen fibers were more sparsely distributed and thicker in women with prolapse. Mean diameter of collagen fibers was 61.2 +/- 11.4 nm in women with prolapse while it was 52.5 +/- 6.1 nm in women without prolapse (p < 0.001). Uterine prolapse is associated with connective tissue alterations including total amount of connective tissue components and diameter and distribution of collagen fibers.