Expression level of matrix metalloproteinases -1, -2 and -9 associated with pelvic organ prolapse: experimental analytical study of round ligaments of Congolese women in two hospitals from the city of Kananga in Democratic Republic of Congo.

Introduction: pelvic organ prolapse is a pathology of ligamentous connective tissues and matrix metalloproteinases are the main actors responsible for tissue remodeling by degrading connective tissue. The objective of this present study is to determine the expression rate of matrix metalloproteinases-1, -2 and -9 in prolapsed round ligaments and identify the types of matrix metalloproteinases most determining in the appearance of pelvic organs prolapse in in two pilot hospitals of Saint-Georges and of Bon-Berger of the city of Kananga in the Democratic Republic of Congo.

Methods: we conducted an analytical experimental study based on immunohistochemical examination of round ligaments of 100 consenting patients divided in two groups with and without pelvic organ prolapse treated in the gynecology departments of Bon-Berger hospitals in Tshikaji and Saint-Georges in Katoka in city of Kananga, from January 1^st to July 31^st, 2023. Non-probability convenience sampling helped us select cases. The ANOVA test, the Chi-square test, and the logistic regression with adjustment are used in the statistical analyses.

Results: the average age of our patients with pelvic organ prolapse was 57.18 (SD: 8.17) years, and their average parity was 7.76 (SD: 1.04) delivery. This average parity was significantly increased compared to those of patients without prolapse. The expression rate of matrix metalloproteinases-1, -2, and -9 is significantly high in prolapsed round ligaments with a respective mean immunoreactive of 44.10± 22.04% (P=0.001), 39.46± 24.10% (P=0.001), and 39.34± 20.89% (P=0.001). Positive immunoreactivities to matrix metalloproteinases-1, -2, and -9 are significantly noted in patients with prolapse. There was a significant association between positive immunoreactivities to matrix metalloproteinase-1 (AOR 5.40, 95% CI: 0.981-29.794, P: 0.044) and matrix metalloproteinase-9 (AOR: 6.205, 95% CI: 1.467-26.239, P: 0.013) with the appearance of pelvic organs prolapses in the city of Kananga.

Conclusion: the expression level of matrix metalloproteinases is increased in patients with pelvic organ prolapse and is associated with this condition, matrix metalloproteinases-1 and -9 are associated with the occurrence of pelvic organ prolapse. These results will serve as a basis for experimental research studies of inhibitory evidence of estrogens and progesterone on these matrix metalloproteinases in our city with a view to adding these hormones as a means of preventing pelvic organs prolapse in women at risk in our city of Kananga.