The morphological substrate and pathogenetic mechanisms of pelvic pain syndrome in endometriosis

Kogan, E. A.; Парамонова, Н. Б.; Демура, Т. А.; Файзуллина, Н. М.; Ovakimian, A S; Адамян, Л. В.

doi:10.17116/patol201476637-43

Cited by 11 publications

(13 citation statements)

References 8 publications

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“…Regressing (inactive) foci of adenomyosis were characterized by cystic transformation of the glands, and fl attening (metaplasia) of the epithelium. When assessing active and inactive adenomyosis, some authors identify the relationship of cytogenic stroma and glandular epithelium as the main morphological criteria: adenomyosis foci with predominance of cytogenic stroma are classifi ed as active, and those with poorly developed stroma and dystrophic changes in the epithelium, as inactive ones [9]. In our observations, foci of progressive (ac- tive) adenomyosis dominated, with the prevailing cytogenic stroma and secretory glands characteristic for endometrial proliferative phase; regressing (inactive) foci were less common.…”

Section: Resultsmentioning

confidence: 99%

“…These procedures promote the destruction of the morphological barrier between basal layer of endometrium, and myometrium [1]. We have found medical abortions in obstetric history of 95% patients while 38% women were subjected to 5 or more abortions (in half of the cases, up to [8][9][10][11][12][13][14][15]. In addition, in 71% women separate diagnostic curettage of the cervical canal and the walls of the uterus was performed at different times before the surgery.…”

Section: Resultsmentioning

confidence: 99%

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Pathomorphological Analysis of Internal Endometriosis

et al. 2012

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We performed clinical and morphological examination of 59 women with internal endometriosis (adenomyosis). Women were found to develop adenomyosis more frequently in the perimenopausal period (in their 40s) after repeated abortions and diagnostic surgical procedures. In 90% patients, adenomyosis was associated with the formation of multiple leyomyomatous nodules; glandular hyperplasia of the endometrium and fibrocystic transformation or fibrous degeneration of the ovaries were found in 60 and 100% cases. Two morphological variants of adenomyosis were identified: invasion of cytogenic stroma into the underlying myometrium with the formation of endometrial glands and invasion of cytogenic stroma via connective tissue interlayers without formation of endometrial glands and with pronounced neoangiogenesis. Foci of active adenomyosis in the uterus with predominance of cytogenic stroma were most prevalent in the late reproductive period. Endometrioid heterotopias were accompanied by considerable structural and functional reorganization of the myometrium with the formation of multiple leyomyomatous nodules. The presence of active and inactive adenomyosis foci and leyomyomatous nodules in uterus specimens reflects their metachronous development.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Pathomorphological Analysis of Internal Endometriosis

et al. 2012

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“…Периваскулярный тип роста гетеротопий обусловливает дисциркуляторные расстройства и лимфостаз в поврежденных частях кишечной стенки и приводит к развитию гипоксии, усугубляющей микротравму нервных волокон в периваскулярных тканях, а также является кофактором в стимуляции болевого синдрома. Значимую роль в нейропатическом типе болевого синдрома играет компрессия нервных волокон в перифокальной фиброзной ткани и эктопических очагах за счет гипертрофированных и гиперплазированных гладкомышечных волокон [20].…”

Section: механизмы развития нейропатической боли при эндометриозеunclassified

Molecular Mechanisms of Formation of Chronic Pelvic Pain Syndrome in Patients With External Genital Endometriosis: Markers and Targets for Diagnosis and Therapy (Review)

et al. 2018

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This article systematizes the results of studies on the pathogenetic mechanisms of CPPS formation in patients with EGE. Pain is one of the severe clinical manifestations and complications of endometriosis. To ease the pain in patients with EGE is complex but urgent task. Long diagnostic search (mean period 5−8 years) leads to the formation of a persistent Autonomous pain syndrome associated with relapses of pain even after a com-prehensive treatment of patients (surgical and/or long-term hormonal). Patients with endometriosis suffer from mixed pain including neuropathic and nociceptive components which is proved by the example of expression in ectopic foci of specific biomarkers. Therefore, the question of early non-invasive diagnosis of endometriosis is very vital and can be solved by the development of a diagnostic panel consisting of biomarkers expressed by ectopic foci at the initial stage of the disease.

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“…Микроскопически преобладали преимущественно активные, агрессив-ные очаги, представленные цитогенной стромой и железами в 19 случаях с пролиферирующим, а в 15 случаях с гиперплазированным эпителием, имею-щим преимущественно периваскулярный, интрава-скулярный и периневральный характер роста, что подробно описано ранее [17]. Экспрессия PGP 9.5, NGF, NGFRp75 наблюда-ется в нервных волокнах стромы эндометриоидных гетеротопий, а также в нервных волокнах окружаю-щей ткани в группе пациенток как с болевой, так и с безболевой формой (рис.…”

Section: морфологическое и иммуногистохимическое исследованияunclassified

“…Ранее нами был исследован морфологический субстрат болевого синдрома при наружном гени-тальном эндометриозе (НГЭ) с инфильтративным ростом [17]. Установлено, что в генезе боли при эн-дометриозе имеют значение факторы, действующие in situ в зоне локализации очагов эндометриоза, об-условленные развитием воспаления и склероза, ин-фильтративным периваскулярным, интраваскуляр-ным и периневральным ростом эндометриоидных гетеротопий.…”

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