title: Endometriosis-associated nerve fibers, peritoneal fluid cytokine concentrations, and pain in endometriotic lesions from different locations.
abstract: OBJECTIVE
  To assess the relationship between endometriotic lesions with associated nerve fibers with both pain and peritoneal fluid (PF) cytokine concentrations based on lesion location.
  
  
  METHODS
  An observational study.
  
  
  METHODS
  University hospital.
  
  
  METHODS
  Premenopausal women undergoing laparoscopy.
  
  
  METHODS
  The pain experienced by patients was recorded before surgery and ectopic endometrial tissue excised and matching PF collected during laparoscopy. Immunohistochemistry was performed on endometriotic tissue sections to identify nerve fibers and PF cytokine concentrations determined.
  
  
  METHODS
  The pain experienced by women with endometriosis, the lesion locations, and the prevalence and proximity of nerve fibers to endometriotic lesions, as well as the PF concentrations of multiple cytokines.
  
  
  RESULTS
  Lesions from the rectovaginal septum were significantly more likely to be associated with a nerve fiber and report more menstrual pain than lesions from other regions. The PF glycodelin concentrations were also significantly higher in samples with an endometriotic-associated nerve. In peritoneal endometriotic lesions significantly more menstrual pain was reported when endometriotic lesions were associated with nerve fibers, although no difference was observed between the cytokine concentrations. Ovarian endometriotic lesions were rarely associated with nerve fibers.
  
  
  CONCLUSIONS
  The presence of endometriosis-associated nerve fibers appear to be related to both the pain experienced by women with endometriosis and the concentration of PF cytokines; however, this association varies with the lesion location.
authors.affiliation: Department of Obstetrics and Gynecology, Inselspital, Berne University Hospital, University of Berne, Berne, Switzerland. brett.mckinnon@dkf.unibe.ch
authors.forename: Brett
authors.initials: B
authors.lastname: McKinnon
authors.forename: Nick A
authors.initials: NA
authors.lastname: Bersinger
authors.forename: Carlos
authors.initials: C
authors.lastname: Wotzkow
authors.forename: Michael D
authors.initials: MD
authors.lastname: Mueller
mesh_terms: D000704:Analysis of Variance; D001202:Ascitic Fluid / Q000276:immunology; D015415:Biomarkers / Q000032:analysis; D016207:Cytokines / Q000032:analysis*; D004715:Endometriosis / Q000150:complications* / Q000276:immunology / Q000473:pathology / Q000601:surgery; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006785:Hospitals, University; D006801:Humans; D007150:Immunohistochemistry; D010535:Laparoscopy; D009412:Nerve Fibers / Q000737:chemistry / Q000473:pathology*; D010049:Ovarian Diseases / Q000150:complications* / Q000276:immunology / Q000473:pathology / Q000601:surgery; D010147:Pain Measurement; D017699:Pelvic Pain / Q000209:etiology* / Q000276:immunology / Q000473:pathology; D010532:Peritoneal Diseases / Q000150:complications* / Q000276:immunology / Q000473:pathology / Q000601:surgery; D011863:Radioimmunoassay; D012002:Rectal Diseases / Q000150:complications* / Q000276:immunology / Q000473:pathology / Q000601:surgery; D013557:Switzerland; D043222:Ubiquitin Thiolesterase / Q000032:analysis; D014623:Vaginal Diseases / Q000150:complications* / Q000276:immunology / Q000473:pathology / Q000601:surgery
chemical_list: D015415:Biomarkers; D016207:Cytokines; C482860:UCHL1 protein, human; D043222:Ubiquitin Thiolesterase