A pilot study to evaluate the clinical relevance of endometriosis-associated nerve fibers in peritoneal endometriotic lesions
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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.
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Nerve fiber density correlates with the severity of pelvic pain or dysmenorrhea.
“Mechsner et al. (2009) found that nerve fiber density correlated with severity of pelvic pain or dysmenorrhea.”
From Chronic pelvic pain and endometriosis: translational evidence of the relationship and implications (2011) · cites this paper as Mechsner et al., 2009
The ‘Nerve Fibers in Peritoneal Endometriotic Lesions’ results report that endometriosis-associated nerve fibers occurred significantly more often in patients with severe pelvic pain and/or dysmenorrhea than in those with mild symptoms. The study tested fiber occurrence across pain groups, however, rather than demonstrating a correlation between measured nerve fiber density and pain severity. (LLM, conf=0.86)
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References 30 · Cited by 107
- Authors
- Mechsner, S., Kaiser, A., Kopf, A., Gericke, C., Ebert, A., & Bartley, J.
- Affiliations
- Stiftung Charité (DE)
- Charité – Universitätsmedizin Berlin (DE)
- Vivantes Klinikum (DE)
- Corresponding author
- Mechsner, Sylvia
- Venue
- Fertility and Sterility
- Publisher
- Elsevier BV
- Published
- 2009-12
- Volume
- 92
- Issue
- 6
- Pages
- 1856-1861
- ISSN
- 0015-0282 (ISSN-L)
- OpenAlex
- W2018837546
- Cited by
- 107
- References
- 30
- Citations by year
- 2026: 7 · 2025: 2 · 2024: 2 · 2023: 5 · 2022: 4 · 2021: 11 · 2020: 10 · 2019: 3 · 2018: 6 · 2017: 7 · 2016: 5 · 2015: 11 · 2014: 4 · 2013: 7 · 2012: 10
- FWCI
- 4.81
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Fertility and Sterility (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Endometriosis Research and Treatment
- Health Sciences › Medicine › Obstetrics and Gynecology › Gynecological conditions and treatments
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Ectopic Pregnancy Diagnosis and Management
- Keywords
- endometriosis, peritoneal endometriosis, nerve fibers, chronic pelvic pain, dysmenorrhea, neurofilaments, protein gene product 9.5, premenopausal women, laparoscopic surgery
- MeSH terms
- Adult, Biopsy, Dysmenorrhea, Dyspareunia, Endometriosis, Endometrium, Female, Humans, Middle Aged, Laparoscopy, Peritoneum, Pilot Projects, Prospective Studies, Surveys and Questionnaires, Sensory Receptor Cells, Pelvic Pain, Nerve Fibers, Unmyelinated, Dysuria, Young Adult
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