Innervation of endometrium and myometrium in women with painful adenomyosis and uterine fibroids

Zhang, Xinmei; Lu, Bangchun; Huang, Xiufeng; Xu, Hong; Zhou, Caiyun; Lin, Jizhen

doi:10.1016/j.fertnstert.2009.03.026

Cited by 86 publications

(70 citation statements)

References 51 publications

(70 reference statements)

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“…PGP9.5-positive nerve fibers have been found in endometrium in women with pain, whether they have endometriosis, uterine fibroids or adenomyosis, and to correlate with the severity of pain symptoms in these three disorders [10,11].…”

Section: Resultsmentioning

confidence: 99%

“…Many studies have assessed the role of endometrial nerve fibers detection as a diagnostic modality for endometriosis which is surly simpler and less invasive than laparoscopy and initial results were reassuring [7][8][9].Conversely, many previous studies found that nerve fibers are found in relation to pain regardless the gynecological disease and declined its role in diagnosis of endometriosis [10,11].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Endometrial Nerve Fibers Detection in Women with Different Gynecological Pathologies: A Cross Sectional Study

Elbohoty¹,

Maeboud²,

Elsaid³

2016

Gynecol Obstet

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Objective: To show the existence and density of endometrial nerve fibers in endometriosis and other gynecological pathologies and their relation to pain. Methods:This cross-sectional study involved 325 women planned to have gynecologic surgeries at Ain Shams University Maternity Hospital from December 2010 to February 2014. The diagnosis was adenomyosis, uterine fibroid, endometrial hyperplasia or carcinoma, polycystic ovarian syndrome (PCOS), ovarian tumors and endometriosis. Endometrial tissue was obtained during hysterectomy or with a curette and then immunostained with the pan neuronal marker anti PGP 9.5 to detect the endometrial nerve fibers and to quantify their density if present.Results: Endometrial nerve fibers were detected in all cases of endometriosis and 13.7% of other pathologies except PCOS (p<0.001). Pain was the only independent factor associated with the presence of endometrial nerve fibers (OR 14.5; 95%CI: 6.7-31.2). Type of pain was not related to the presence of endometrial nerve fibers (p=0.668). The nerve fiber density is strongly correlated with pain scores (r=0.479, p<0.001).

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Endometrial Nerve Fibers Detection in Women with Different Gynecological Pathologies: A Cross Sectional Study

Elbohoty¹,

Maeboud²,

Elsaid³

2016

Gynecol Obstet

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“…Presently, several autoantibodies have been demonstrated in the serum of endometrial patients including anti-α-enolase, anti-PDKI1L, antisyntaxin 5 auto antibodies [19]. Indeed antiendometrial antibody essay has shown to have a positive predictive value of 88% when used before laparoscopy in the diagnosis of endometriosis [20]. However while measuring the immunological titres is useful, the concern is the fact that these autoantibodies can be found in unaffected women and men.…”

Section: Investigations In Gynecology Research and Womens Healthmentioning

confidence: 99%

The Role of Biomarkers in the Early Diagnosis of Endometriosis

Worku¹

2017

IGRWH

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Endometriosis is a chronic gynecological problem which is frequent within the general population. Due to its varied presentations there is often a vast delay in diagnosis incurring a large amount of psychological and physical harm with infertility being unfortunate sequelae. Whilst improvements have been made with regards to the treatment of endometriosis, diagnosis remains challenging for clinicians with traditional investigations yielding poor results. This review will consider potential biomarkers and investigations for the early diagnosis of endometriosis.

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“…Dabei zeigten sich ausschließlich bei symptomatischen Patientinnen Nervenfasern (PGP-9.5-positiv) in der Funktionalis, bei asymptomatischen Patientinnen konnten keine Nervenfasern gefunden werden. Unter Einbeziehung von Patientinnen mit EM allein oder in Kombination mit einer Adenomyosis uteri ließ sich bei starken Schmerzen sogar eine hinsichtlich der Schmerzintensität zunehmende Nervenfaserdichte nachweisen [40]. Somit müssten die zuvor vorgestellten Daten dringend in einer prospektiven Studie mit größerer Fallzahl an Hysterektomiepräparaten überprüft werden, wobei das Vorliegen einer Endometriosis genitalis externa, einer Adenomyosis uteri und von Myomen sowie die klinische Symptomatik (Dysmenorrhö, Unterbauchschmerzen) Berücksichtigung finden sollten.…”

Section: Ist Das Vorkommen Von Endometrialen Nervenfasern Emabhängig?unclassified

“…Weiterhin werden von umgebenden Zellen wie Makrophagen und Mastzellen Histamine, PG, Serotonin, Bradykinin, IL, vaskulärer endothelialer Wachstumsfaktor (VEGF), TGF-β, TNF-α und NGF freigesetzt [4,12,33,41]. Als Reaktion können die sensiblen Nervenfaserendigungen, stimuliert durch inflammatorische Prozesse, Neurotransmitter wie SP, CGRP, Endothelin, Histamin, Glutamat, PG und VIP als inflammatorische Antwort freisetzen [20,21,40] und so zum einen die Aktivierung der Makrophagen und Mastzellen unterhalten und zum anderen die weitere Einwanderung von Immunzellen fördern. Daraus resultiert eine neurogene inflammatorische Reaktion, die Interaktionen der EM-Komponenten (Läsion, Immunzellen und Nervenfasern) führen zu Schmerzen und zum Einsprossen von Nerven in diese Areale (.…”

Section: Neuromodulation In Emläsionenunclassified