The influence of peritoneal endometriotic lesions on the generation of endometriosis-related pain and pain reduction after surgical excision

Kaiser, Andrea; Kopf, Andreas; Gericke, Christine; Bartley, Julia; Mechsner, Sylvia

doi:10.1007/s00404-008-0921-z

Cited by 10 publications

(5 citation statements)

References 21 publications

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“…3 In addition, a significant pain reduction in women with endometriosis after excision of endometriotic lesions is described. 14 In contrast, some groups propose that the presence of nerve fibers in the endometrium is a pain mediatordependent mechanism, independent from the manifestation of endometriosis, as nerve fibers were seen in patients with painful disorders like fibroids and salpingitis. [15][16][17] Because of this discrepancy, more studies in this area should be done urgently.…”

Section: Discussionmentioning

confidence: 99%

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Influence of Nerve Growth Factor in Endometriosis-Associated Symptoms

et al. 2011

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To investigate the role of the nerve growth factor (NGF) in the development of dysmenorrhea/pelvic pain in patients with endometriosis, we performed a prospective, clinical, blind study. Peritoneal fluids (PFs) were obtained from patients with histologically proven endometriosis. Patients with endometriosis were divided into 7 different groups depending on their preoperative pain score and symptomatology: patients with no pain, patients with minimal pain (dysmenorrhea, pelvic pain, or both), and patients with severe pain (dysmenorrhea, pelvic pain, or both) and were used for the neuronal growth assay with cultured chicken dorsal root ganglia (DRG) and for Western blot analyses. Dorsal root ganglia were stained with anti-calcitonin gene-related peptide (CGRP) and anti-growth-associated protein 43 (GAP 43). Peritoneal fluids from patients with endometriosis induce neurite outgrowth. There was no significant difference in the outgrowth between the 7 pain groups. Western blot analyses showed a moderate NGF expression in the PFs from patients with endometriosis, without significant differences in the 7 pain groups. The present study suggests that the neurotrophic properties of endometriotic tissues are endometriosis- and not pain-associated.

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Section: Discussionmentioning

confidence: 99%

“…3 In addition, a significant pain reduction in women with endometriosis after excision of endometriotic lesions is described. 14…”

Section: Discussionmentioning

confidence: 99%

Influence of Nerve Growth Factor in Endometriosis-Associated Symptoms

et al. 2011

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“…There is also evidence that re-operations rates are lower after hysterectomy than after operative laparoscopy [83], probably because uterus contain a great number of neural elements that can contribute to arising and exacerbation of CPP. Moreover, treatment of DIE lesions seems to have more effectiveness in long-term pain relief [84] respect to treatment of endometriomas and superficial peritoneal endometriosis [42, 48], although Kaiser et al [85] evidenced that peritoneal endometriotic lesions could worse the pain after the first step surgery and, for this reason, suggest to pay particular attention in their excision. Surprisingly, Sutton et al [86] showed that CPP return sooner after surgery in patients with endometriosis at minimal and mild stages.…”

Section: Surgical Therapymentioning

confidence: 99%

Chronic Pelvic Pain in Endometriosis: An Overview

Triolo¹

2013

J Clin Med Res

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Chronic pelvic pain (CPP) could be considered nowadays a deep health problem that challenges physicians all over the world. This because its aetiology is still unclear, the course of the disease could vary a lot among different patients and through time in the same patient, and the response to treatments is not every time successful. Among women who underwent laparoscopy for CPP, endometriosis is found in about 1/3 of the cases, while only 25% of women with histological confirmed endometriosis are asymptomatic. A wide range of variables may exert their influence on the resulting pain syndrome in endometriosis; for example, score according to American society for reproductive medicine (rASRM), size of the sub-peritoneal and pelvic wall implants, Douglas obliteration, previous surgery. It is widely accepted nowadays that central nervous system (CNS) and peripheral nervous system (PNS) seems to influence each other and this interconnection play a key role in pain modulation. Moreover, the phenomena induced by endometriosis in the pelvis, including the breakdown of peritoneal homeostasis and the induction of the production of proinflammatory and proangiogenic cytokines, are responsible of altered innervations and modulation of pain pathways in these patients. There are many proposed medical and surgical approach to treat this painful syndrome, although there is necessity of more efforts to create new non-invasive strategies that set a more accurate diagnosis of the causes of endometriotic-related CPP, and therefore facilitate its eradication.

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“…Severe endometriosis is treated surgically, with the aim of removing as many lesions as possible [1]. However, postoperative symptomatic recurrences are frequent and repeat surgery is performed in more than 50% of all patients [2].…”

Section: Introductionmentioning

confidence: 99%