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Fertil Steril. 2009 Dec;92(6):1856-61. doi: 10.1016/j.fertnstert.2008.09.006. Epub 2008 Nov 5.

A pilot study to evaluate the clinical relevance of endometriosis-associated nerve fibers in peritoneal endometriotic lesions.

Author information

1
Endometriosis Research Center Charité, Department of Gynaecology, Charité, Campus Benjamin Franklin, Berlin, Germany. sylvia.mechsner@charite.de

Abstract

OBJECTIVE:

To investigate the clinical relevance of endometriosis-associated nerve fibers in the development of endometriosis-associated symptoms.

DESIGN:

Prospective nonrandomized study.

SETTING:

University hospital endometriosis center.

PATIENT(S):

Fifty-one premenopausal patients underwent surgical laparoscopy because of chronic pelvic pain, dysmenorrhea, or for ovarian cysts. Endometriosis was diagnosed in 44 patients.

INTERVENTION(S):

The preoperative and postoperative pain scores were determined using a standardized questionnaire with a visual analogue scale from 1-10. Patients with peritoneal endometriosis were divided into two groups depending on their preoperative pain score: group A with a pain score of at least 3 or more and group B with a pain score of 2 or less. Patients without peritoneal endometriosis were classified as group C and patients without endometriosis were classified as group D. Immunohistochemical analysis of neurofilament and protein gene product 9.5 were used for nerve fiber detection. Occurrence of endometriosis-associated nerve fibers was correlated with the severity of pelvic pain and/or dysmenorrhea.

RESULT(S):

Peritoneal endometriosis-associated nerve fibers were found significantly more frequently in group A than in group B (82.6% vs. 33.3%).

CONCLUSION(S):

The present study suggests that the presence of endometriosis-associated nerve fibers in the peritoneum is important for the development of endometriosis-associated pelvic pain and dysmenorrhea.

[Indexed for MEDLINE]

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