Histologic and receptor analysis of primary and secondary vestibulodynia and controls: a prospective study.
OBJECTIVE
The objective of the study was to assess the association between hormone receptor densities, pain nerves, and inflammation in vestibulodynia patients.


METHODS
In a prospective study, tender and nontender biopsies from 10 primary and 10 secondary vestibulodynia patients were compared with biopsies in 4 nontender controls. Hormone receptors were evaluated using immunohistochemistry for estrogen receptor-alpha and -beta, androgen, and progesterone receptors. Inflammation, nerves, and mast cells were assessed histologically. Statistical analysis was by Fisher's exact test, analysis of variance, paired Student t test, and Wilcoxon rank test.


RESULTS
Tender sites from primary vestibulodynia had increased nerve density compared with secondary and control biopsies (P = .01). Tender sites in secondary vestibulodynia had more lymphocytes than tender primary sites and control biopsies (P < .0001). Mast cells were increased in tender sites compared with nontender and controls. There were no differences in hormone receptor expression.


CONCLUSIONS
Markers of inflammation differed between primary and secondary vestibulodynia and controls.
Goetsch
Martha F
MF
Department of Obstetrics and Gynecology, Oregon Health and Science University, Portland, OR, USA.
Morgan
Terry K
TK
Korcheva
Veselina B
VB
Li
Hong
H
Peters
Dawn
D
Leclair
Catherine M
CM
D000328:Adult; D000704:Analysis of Variance; D004958:Estradiol / Q000097:blood; D047628:Estrogen Receptor alpha / Q000378:metabolism; D047629:Estrogen Receptor beta / Q000378:metabolism; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D007249:Inflammation / Q000378:metabolism / Q000473:pathology; D008407:Mast Cells / Q000378:metabolism / Q000473:pathology; D008875:Middle Aged; D011374:Progesterone / Q000097:blood; D011446:Prospective Studies; D011944:Receptors, Androgen / Q000378:metabolism; D011980:Receptors, Progesterone / Q000378:metabolism; D056650:Vulvodynia / Q000378:metabolism* / Q000473:pathology
D047628:Estrogen Receptor alpha; D047629:Estrogen Receptor beta; D011944:Receptors, Androgen; D011980:Receptors, Progesterone; D011374:Progesterone; D004958:Estradiol