DECREASED COLLAGEN-SYNTHESIS IN STRESS-INCONTINENT WOMEN

Objective: To determine whether there is a difference in collagen meta bolism between comparable urinary stress-incontinent and -continent wo men. Methods: Fibroblast cultures from skin biopsies were established from seven stress-incontinent and four continent women. Collagen produ ction was investigated in these cultures between. passages 3 and 7 by incubation with H-3-proline, followed by quantitation of H-3-proline a nd H-3-hydroxyproline after hydrolysis of proteins and separation by h igh-pressure liquid chromatography. The chemical amount of collagen wa s also quantitated using Sircol Red. Results: Fibroblast cultures esta blished from urinary stress-incontinent women accumulated 30% less col lagen than comparable cultures from continent women. The differences w ere statistically significant (cell layer P =.038, medium P = .004; St udent t test). These results were observed both when collagen concentr ation was measured with chemical methods and when the production of pr otein-bound H-3-hydroxyproline was quantitated. General protein synthe sis was similar in the two groups. Conclusion: Our results suggest tha t women with urinary stress incontinence have an altered connective ti ssue metabolism causing decreased collagen production, which may resul t in insufficient support of the urogenital tract.