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The vaginal microbial metabolites and enzyme levels were tested using the dry chemoenzymatic method. The mRNA and protein expression were tested using real-time quantitative PCR and immunohistochemistry. SPSS version 25.0 and GraphPad Prism 8.0 were performed for statistical analysis.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Compared with the non-POP group, the vaginal pH, H<jats:sub>2<\/jats:sub>O<jats:sub>2<\/jats:sub> positivity and leukocyte esterase positivity were higher in patients with POP (all <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05). Further analysis showed that patients with pelvic organ prolapse quantification (POP-Q) stage IV had higher rates of vaginal pH, H<jats:sub>2<\/jats:sub>O<jats:sub>2<\/jats:sub> positivity and leukocyte esterase positivity than those with POP-Q stage III. Additionally, the mRNA expression of decorin (DCN), transforming growth factor beta 1 (TGF-\u03b21), and matrix metalloproteinase-3 (MMP-3) in uterosacral ligament tissues were higher, whereas collagen I and III were lower. Similarly, the positive expression of MMP-3 in uterosacral ligament tissue was significantly upregulated in the POP group compared with the non-POP group (<jats:italic>p<\/jats:italic>\u2009=\u20090.035), whereas collagen I (<jats:italic>p<\/jats:italic>\u2009=\u20090.004) and collagen III (<jats:italic>p<\/jats:italic>\u2009=\u20090.019) in uterosacral ligament tissue were significantly downregulated in the POP group. Correlation analysis revealed that there was a significant correlation between vaginal microecology and collagen metabolism. In addition, MMP-3 correlated negatively with collagen I and collagen III (<jats:italic>p<\/jats:italic>\u2009=\u20090.002, <jats:italic>r<\/jats:italic>\u2009=\u2009\u22120.533; <jats:italic>p<\/jats:italic>\u2009=\u20090.002, <jats:italic>r<\/jats:italic>\u2009=\u2009\u22120.534 respectively), whereas collagen I correlated positively with collagen III (<jats:italic>p<\/jats:italic>\u2009=\u20090.001, <jats:italic>r<\/jats:italic>\u2009=\u20090.578).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Vaginal microecological dysbiosis affects the occurrence of female POP, which could be considered a novel therapeutic option.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00192-024-05759-7","type":"journal-article","created":{"date-parts":[[2024,3,15]],"date-time":"2024-03-15T12:01:54Z","timestamp":1710504114000},"page":"881-891","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Effect of Vaginal Microecological Alterations on Female Pelvic Organ Prolapse"],"prefix":"10.1007","volume":"35","author":[{"given":"Shaozhan","family":"Chen","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qiaomei","family":"Zheng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Limin","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lihong","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jinhua","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2024,3,15]]},"reference":[{"issue":"2","key":"5759_CR1","doi-asserted-by":"publisher","first-page":"287","DOI":"10.1007\/s00192-021-04717-x","volume":"33","author":"F Gould","year":"2022","unstructured":"Gould F, Carey M, Plummer E, et al. 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