title: [The morphological substrate and pathogenetic mechanisms of pelvic pain syndrome in endometriosis].
abstract: OBJECTIVE
  To study the origin and morphological substrate of pain syndrome in deep infiltrating endometriosis involving the bowel.
  
  
  METHODS
  The investigation was conducted using the intraoperative material (resected portions of the large and small bowels, appendix) obtained from 40 women diagnosed as having deep infiltrating endometriosis involving the bowel, which was accompanied by pain syndrome. Paraffin sections were immunohistochemically examined using the standard protocol. Antibodies to Ki-67, PTEN, ER, PR, ("Dako"), CD34 ("Cell Marque", USA), VEGF, EGF, EGFR, COX-2 ("Abcam"), and MMP 1 and 2 ("Abbiotec") were applied. Dako REAL EnVision Detection System kits ("Dako", Denmark) were used as secondary antibodies.
  
  
  RESULTS
  The morphological substrate of pelvic pain syndrome in deep infiltrating endometriosis was established to be factors that acted in situ at the location of endometriotic foci and those caused by the infiltrative perivascular, intravascular, and perineural growth of endometrioid heterotopies.
  
  
  CONCLUSIONS
  Inflammation and fibrosis in the endometriotic foci contribute to the accumulation of algogenes, which gives rise to somatogenic pain syndrome, and chronic nerve fiber injury as a source of nociceptive stimulation leads to neuropathic pain syndrome.
authors.affiliation: FGBU "Nauchnyĭ tsentr akusherstva, ginekologii i perinatologii im. akad. V.I. Kulakova" Minzdrava Rossii, Moskva; GBOU "Pervyĭ Moskovskiĭ gosudarstvennyĭ meditsinskiĭ universitet im. I.M. Sechenova" Minzdrava Rossii, Rossiĭskaia Federatsiia.
authors.forename: E A
authors.initials: EA
authors.lastname: Kogan
authors.affiliation: FGBU "Nauchnyĭ tsentr akusherstva, ginekologii i perinatologii im. akad. V.I. Kulakova" Minzdrava Rossii, Moskva; GBOU "Pervyĭ Moskovskiĭ gosudarstvennyĭ meditsinskiĭ universitet im. I.M. Sechenova" Minzdrava Rossii, Rossiĭskaia Federatsiia.
authors.forename: N B
authors.initials: NB
authors.lastname: Paramonova
authors.affiliation: FGBU "Nauchnyĭ tsentr akusherstva, ginekologii i perinatologii im. akad. V.I. Kulakova" Minzdrava Rossii, Moskva; GBOU "Pervyĭ Moskovskiĭ gosudarstvennyĭ meditsinskiĭ universitet im. I.M. Sechenova" Minzdrava Rossii, Rossiĭskaia Federatsiia.
authors.forename: T A
authors.initials: TA
authors.lastname: Demura
authors.affiliation: FGBU "Nauchnyĭ tsentr akusherstva, ginekologii i perinatologii im. akad. V.I. Kulakova" Minzdrava Rossii, Moskva.
authors.forename: N M
authors.initials: NM
authors.lastname: Faĭzullina
authors.affiliation: FGBU "Nauchnyĭ tsentr akusherstva, ginekologii i perinatologii im. akad. V.I. Kulakova" Minzdrava Rossii, Moskva.
authors.forename: A S
authors.initials: AS
authors.lastname: Ovakimian
authors.affiliation: FGBU "Nauchnyĭ tsentr akusherstva, ginekologii i perinatologii im. akad. V.I. Kulakova" Minzdrava Rossii, Moskva.
authors.forename: L V
authors.initials: LV
authors.lastname: Adamian
mesh_terms: D000328:Adult; D049109:Cell Proliferation; D004715:Endometriosis / Q000150:complications / Q000235:genetics* / Q000473:pathology*; D005260:Female; D005786:Gene Expression Regulation; D006801:Humans; D007249:Inflammation / Q000235:genetics / Q000473:pathology; D008875:Middle Aged; D017699:Pelvic Pain / Q000209:etiology / Q000235:genetics* / Q000473:pathology*; D014176:Protein Biosynthesis