title: A pilot study to evaluate the clinical relevance of endometriosis-associated nerve fibers in peritoneal endometriotic lesions.
abstract: OBJECTIVE
  To investigate the clinical relevance of endometriosis-associated nerve fibers in the development of endometriosis-associated symptoms.
  
  
  METHODS
  Prospective nonrandomized study.
  
  
  METHODS
  University hospital endometriosis center.
  
  
  METHODS
  Fifty-one premenopausal patients underwent surgical laparoscopy because of chronic pelvic pain, dysmenorrhea, or for ovarian cysts. Endometriosis was diagnosed in 44 patients.
  
  
  METHODS
  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.
  
  
  RESULTS
  Peritoneal endometriosis-associated nerve fibers were found significantly more frequently in group A than in group B (82.6% vs. 33.3%).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Endometriosis Research Center Charité, Department of Gynaecology, Charité, Campus Benjamin Franklin, Berlin, Germany. sylvia.mechsner@charite.de
authors.forename: Sylvia
authors.initials: S
authors.lastname: Mechsner
authors.forename: Andrea
authors.initials: A
authors.lastname: Kaiser
authors.forename: Andreas
authors.initials: A
authors.lastname: Kopf
authors.forename: Christine
authors.initials: C
authors.lastname: Gericke
authors.forename: Andreas
authors.initials: A
authors.lastname: Ebert
authors.forename: Julia
authors.initials: J
authors.lastname: Bartley
mesh_terms: D000328:Adult; D001706:Biopsy; D004412:Dysmenorrhea / Q000473:pathology / Q000601:surgery; D004414:Dyspareunia / Q000473:pathology / Q000601:surgery; D053159:Dysuria / Q000473:pathology / Q000601:surgery; D004715:Endometriosis / Q000473:pathology* / Q000601:surgery; D004717:Endometrium / Q000473:pathology*; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008875:Middle Aged; D036421:Nerve Fibers, Unmyelinated / Q000473:pathology*; D017699:Pelvic Pain / Q000473:pathology*; D010537:Peritoneum / Q000294:innervation; D010865:Pilot Projects; D011446:Prospective Studies; D011984:Sensory Receptor Cells / Q000473:pathology*; D011795:Surveys and Questionnaires; D055815:Young Adult