Innervation of endometrium and myometrium in women with painful adenomyosis and uterine fibroids

Objective: To determine whether nerve fibers can be detected in the endometrium and myometrium in women with painful uterine fibroids and adenomyosis. Design: A retrospective immunohistochemical study. Setting: An academic training hospital. Patient(s): Thirty-seven women with uterine fibroids and 29 women with adenomyosis. Intervention(s): Histologic sections of contiguous endometrial and myometrial tissues were stained immunohistochemically using the highly specific polyclonal rabbit antiprotein gene product 9.5 (PGP9.5) and monoclonal mouse antineurofilament protein (NF). Main Outcome Measure(s): Results were determined through immunohistochemical staining using PGP9.5 and NF. Result(s): We detected PGP9.5-immunoactive nerve fibers in the functional layer of the endometrium in women with pain but not in women without pain. PGP9.5-immunoactive nerve fiber density in the basal layer of the endometrium or myometrium significantly increased in women with pain, however, PGP9.5-immunoactive nerve fiber density had no statistical differences between women with adenomyosis and uterine fibroids. We identified NF-immunoactive nerve fibers in the basal layer of the endometrium and myometrium in women with adenomyosis and uterine fibroids, but found no significant differences. Conclusion(s): These results suggest that PGP9.5-immunoactive nerve fibers appearing in the endometrium and myometrium of women with painful adenomyosis and uterine fibroids may play a role in pain generation in these two disorders. (Fertil Steril (R) 2010;94:730-7. (C) 2010 by American Society for Reproductive Medicine.)