Relationship between endometriotic foci and nerves in rectovaginal endometriotic nodules
Abstract
The histological relationships between fibrotic tissue, endometriotic foci and nerves in the rectovaginal septum endometriotic or adenomyotic nodule were studied. This is considered to be one of the most severe forms of deep endometriosis. Masson's trichrome staining for fibrosis detection and immunohistochemistry with the S100 monoclonal antibody for nerve detection were performed in 28 rectovaginal endometriotic nodules from patients presenting with severe dysmenorrhoea and deep dyspareunia (23 patients with no other endometriotic location or potential cause of pain at laparoscopy and ultrasonography; five patients with multiple pelvic endometriotic localizations and other potential causes of pain at laparoscopy). Patients were allocated to two groups on the basis of their preoperative pain scores for pelvic pain, dysmenorrhoea and deep dyspareunia (group 1, score >7; group 2, score < or =7). For each symptom, the mean number of nerves and endometriotic lesions per high-power field and the mean largest diameter of the lesions were not statistically different in groups 1 and 2. The mean percentages of nerves located within the fibrosis of the nodule and within endometriotic lesions were significantly higher in group 1 than in group 2. Among nerves located within endometriotic lesions, there was a significantly higher proportion showing intraneurial and perineurial invasion by endometriosis in group 1 than in group 2. In rectovaginal endometriotic nodules, there was a close histological relationship between nerves and endometriotic foci, and between nerves and the fibrotic component of the nodule. We postulate that such topographical relationships could at least partially explain the strong association between this lesion and pain.
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Endometriosis lesions may cause pain by compressing or infiltrating nearby nerves.
“Lesions may produce pain by compressing or infiltrating nerves near lesions”
From Chronic pelvic pain and endometriosis: translational evidence of the relationship and implications (2011) · cites this paper as Anaf et al., 2000
Several authors have reported the presence of nerve fibers in endometriotic lesions.
“Several authors have reported the presence of nerve fibers in endometriotic lesions.”
From Defining Future Directions for Endometriosis Research: Workshop Report From the 2011 World Congress of Endometriosis in Montpellier, France (2013) · cites this paper as [78]
There is a close histological relationship between deep endometriotic lesions and nerves by perineural and intraneural invasion.
“It has been demonstrated that there is a close histological relationship between deep endometriotic lesions and nerves (Fig. 1) by means of perineural and intraneural invasion (mechanical nerve injury by nerve invasion) and that patients with the highest pain scores display significantly more neural invasion by endometriosis than patients with lower pain scores (8).”
From Pain, mast cells, and nerves in peritoneal, ovarian, and deep infiltrating endometriosis (2006) · cites this paper as [8]
Patients with the highest pain scores display significantly more neural invasion by endometriosis than patients with lower pain scores.
“It has been demonstrated that there is a close histological relationship between deep endometriotic lesions and nerves (Fig. 1) by means of perineural and intraneural invasion (mechanical nerve injury by nerve invasion) and that patients with the highest pain scores display significantly more neural invasion by endometriosis than patients with lower pain scores (8).”
From Pain, mast cells, and nerves in peritoneal, ovarian, and deep infiltrating endometriosis (2006) · cites this paper as [8]
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- Authors
- Anaf, V.
- Affiliations
- Université Libre de Bruxelles (BE)
- Corresponding author
- Anaf, V.
- Venue
- Human Reproduction
- Publisher
- Oxford University Press (OUP)
- Published
- 2000-08-01
- Volume
- 15
- Issue
- 8
- Pages
- 1744-1750
- ISSN
- 0268-1161 (ISSN-L)
- 1460-2350
- OpenAlex
- W2138118457
- Semantic Scholar
- 1fe27ccbe1299e02633b5f91cebb13edf16ebeb4
- Cited by
- 333
- References
- 22
- Citations by year
- 2026: 12 · 2025: 11 · 2024: 13 · 2023: 8 · 2022: 10 · 2021: 16 · 2020: 21 · 2019: 13 · 2018: 9 · 2017: 9 · 2016: 13 · 2015: 26 · 2014: 24 · 2013: 24 · 2012: 16
- FWCI
- 4.01
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Human Reproduction (publishedVersion)
- PubMed (publishedVersion)
- Dépôt institutionnel de l'Université libre de Bruxelles (Université Libre de Bruxelles) (submittedVersion)
- 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
- deep infiltrating endometriosis, perineural invasion, fibrosis, dysmenorrhea, deep dyspareunia, pelvic pain, adenomyosis, rectovaginal septum
- MeSH terms
- Adult, Dysmenorrhea, Dyspareunia, Endometriosis, Endometrium, Female, Fibrosis, Humans, Pain, Postoperative, Postoperative Pain, Laparoscopy, Vagina, Pelvic Pain
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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