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Peer-reviewedCC BY 4.0International Urogynecology Journal

Histological Microstructure and In Vitro Mechanical Properties of Postmenopausal Ewe Perineal Body With and Without Estrogen Replacement Therapy

  • Petra Kochova1
  • Lucie Hajkova Hympanova2,3,4
  • Katerina Mackova2,3,5
  • Robert Cimrman6
  • Zbynek Tonar7
  • Jan Deprest2,3,8
  • Vladimir Kalis9,10
10 affiliations
  1. 1European Centre of Excellence NTIS, Faculty of Applied Sciences, University of West Bohemia, Pilsen, Czech Republic
  2. 2Centre for Surgical Technologies, KU Leuven, Leuven, Belgium
  3. 3Department of Development and Regeneration, KU Leuven, Leuven, Belgium
  4. 4The Institute for the Care of Mother and Child, Third Faculty of Medicine, Charles University, Prague, Czech Republic
  5. 5Department of Gynecology, Obstetrics and Neonatology, General University Hospital in Prague and First Faculty of Medicine, Charles University, Prague, Czech Republic
  6. 6New Technologies Research Centre NTC, University of West Bohemia, Pilsen, Czech Republic
  7. 7Department of Histology and Embryology and Biomedical Center, Faculty of Medicine in Pilsen, Charles University, Prague, Czech Republic
  8. 8Pelvic Floor Unit, University Hospitals KU Leuven, Leuven, Belgium
  9. 9Department of Gynecology and Obstetrics, University Hospital, Pilsen, Czech Republic
  10. 10Faculty of Medicine in Pilsen, Charles University, Prague, Czech Republic
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Abstract

Introduction and Hypothesis: The objective was to assess the regional variability, mechanical properties, and histological composition of the perineal body in postmenopausal ewes with and without delayed estrogen replacement therapy (ERT), providing data relevant for pelvic floor modeling and the understanding of menopausal tissue changes.

Methods: The fibromuscular layer of the central tendon of the perineal area between the rectum and vagina was used for the study. We analyzed 24 specimens from 8 postmenopausal ewes with ERT (initiated 180 days after ovariectomy and continued for 100 days)—POST-ERT group—and 21 specimens from 7 ewes without ERT—POST group, all 280 days after ovariectomy. Uniaxial tensile tests determined the Young’s moduli in small (E0) and large (E1) deformation regions, ultimate stress, and ultimate strain. Histological stereology quantified volume fractions of collagen, elastin, smooth muscle, skeletal muscle, and adipose tissue in three regions (R1–R3). Group comparisons and regional analyses were performed using nonparametric statistics.

Results: Mechanical parameters did not differ significantly between groups (E0: 28/25 kPa; E1: 0.38/0.33 MPa; ultimate stress: 0.23/0.23 MPa; ultimate strain: 0.94/0.90 for POST-ERT/POST). ERT was associated with higher collagen (33% versus 23%, p < 0.001) and elastin (6% versus 5%, p < 0.01) content. Regional differences were minimal, with only modest variation in adipose and smooth-muscle fractions and ultimate stress between the midline and lateral regions.

Conclusions: Despite prolonged estrogen deprivation, the perineal body maintained mechanical integrity. Structural changes, particularly increased collagen and elastin after delayed ERT, suggest adaptive remodeling but do not translate into measurable biomechanical reinforcement within the studied timeframe. The results provide parameters for finite element modeling of pelvic floor disorders.

Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1007/s00192-026-06692-7.

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Cite

BibTeXRIS
BibTeX
@article{kochova2026histological,
  title = {{Histological Microstructure and In Vitro Mechanical Properties of Postmenopausal Ewe Perineal Body With and Without Estrogen Replacement Therapy}},
  author = {Petra Kochova and Lucie Hajkova Hympanova and Katerina Mackova and Robert Cimrman and Zbynek Tonar and Jan Deprest and Vladimir Kalis},
  journal = {International Urogynecology Journal},
  year = {2026},
  month = jun,
  doi = {10.1007/s00192-026-06692-7},
  url = {https://doi.org/10.1007/s00192-026-06692-7},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Histological Microstructure and In Vitro Mechanical Properties of Postmenopausal Ewe Perineal Body With and Without Estrogen Replacement Therapy
AU  - Petra Kochova
AU  - Lucie Hajkova Hympanova
AU  - Katerina Mackova
AU  - Robert Cimrman
AU  - Zbynek Tonar
AU  - Jan Deprest
AU  - Vladimir Kalis
PY  - 2026
DA  - 2026/06/08
JO  - International Urogynecology Journal
DO  - 10.1007/s00192-026-06692-7
UR  - https://doi.org/10.1007/s00192-026-06692-7
AB  - Introduction and Hypothesis: The objective was to assess the regional variability, mechanical properties, and histological composition of the perineal body in postmenopausal ewes with and without delayed estrogen replacement therapy (ERT), providing data relevant for pelvic floor modeling and the understanding of menopausal tissue changes.  Methods: The fibromuscular layer of the central tendon of the perineal area between the rectum and vagina was used for the study. We analyzed 24 specimens from 8 postmenopausal ewes with ERT (initiated 180 days after ovariectomy and continued for 100 days)—POST-ERT group—and 21 specimens from 7 ewes without ERT—POST group, all 280 days after ovariectomy. Uniaxial tensile tests determined the Young’s moduli in small (E0) and large (E1) deformation regions, ultimate stress, and ultimate strain. Histological stereology quantified volume fractions of collagen, elastin, smooth muscle, skeletal muscle, and adipose tissue in three regions (R1–R3). Group comparisons and regional analyses were performed using nonparametric statistics.  Results: Mechanical parameters did not differ significantly between groups (E0: 28/25 kPa; E1: 0.38/0.33 MPa; ultimate stress: 0.23/0.23 MPa; ultimate strain: 0.94/0.90 for POST-ERT/POST). ERT was associated with higher collagen (33% versus 23%, p < 0.001) and elastin (6% versus 5%, p < 0.01) content. Regional differences were minimal, with only modest variation in adipose and smooth-muscle fractions and ultimate stress between the midline and lateral regions.  Conclusions: Despite prolonged estrogen deprivation, the perineal body maintained mechanical integrity. Structural changes, particularly increased collagen and elastin after delayed ERT, suggest adaptive remodeling but do not translate into measurable biomechanical reinforcement within the studied timeframe. The results provide parameters for finite element modeling of pelvic floor disorders.  Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1007/s00192-026-06692-7.
SN  - 0937-3462
SN  - 1433-3023
ER  -