Detection of nerve fibers in the eutopic endometrium of women with endometriosis, uterine fibroids and adenomyosis

Garima Yadav, Meenakshi Rao, Meenakshi Gothwal, Pratibha Singh, Priyanka Kathuria, Prem Prakash Sharma
Obstetrics & gynecology science · 2021 · vol. 64(5) , pp. 454–461 · doi:10.5468/ogs.21114 · PMID:34154045 · PMC8458614 · W3177364559
article OA: gold CC0 ⤵ 9 in-corpus citations
📄 Open PDF View on OpenAlex View on PubMed View at publisher
⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

Nerve fibers were detected in the functional layer of eutopic endometrium in women with endometriosis, correlating with pain scores and offering diagnostic potential, while less frequently found in adenomyosis or fibroids.

One-sentence paraphrase of the abstract; not a substitute for reading it. No clinical advice. How this works

⚙ AI-generated deep summary by claude@2026-06, 2026-06-07 ⓘ

This prospective study assessed whether protein gene product 9.5 (PGP 9.5)–positive nerve fibers are present in eutopic endometrium and whether their density relates to pain in women with histopathologically confirmed endometriosis (n=56), adenomyosis (n=73), or uterine fibroids (n=61), using immunohistochemistry on endometrial samples collected by biopsy, curettage, aspiration, or hysterectomy specimens, and correlating nerve fiber density with Visual Analog Scale pain scores. Nerve fibers were detected in 68% of endometriosis patients in deep endometrium sections, were not detected in aspirated endometrium of endometriosis patients, and were present in smaller proportions of adenomyosis (13.7%) and fibroids (3.3) groups; nerve fiber density correlated with pain score specifically among women with endometriosis. The paper explicitly notes that absence of nerve fibers does not always exclude disease, and methods varied by sampling route, which could affect detection. This paper is centrally about endometriosis — it evaluates PGP 9.5–positive nerve fibers in eutopic endometrium as a diagnostic correlate of endometriosis-associated pain.

Read from the paper's body, not the abstract. Not a substitute for reading the paper. No clinical advice. How this works

Abstract

OBJECTIVE: The primary objective of this study was to establish the presence of nerve fibers in the eutopic endometrium of women with endometriosis and to determine whether these nerve fibers are exclusive to endometriosis or are also found in other pelvic pathologies associated with dysmenorrhea. METHODS: Endometrial tissue was obtained by aspiration (Pipelle), endometrial curettage, or following hysterectomy in women with endometriosis confirmed through histopathological examination, leiomyomas, and adenomyosis. The eutopic endometrium was subjected to immunohistochemical staining to detect PGP 9.5, which is a highly specific pan-neuronal marker. The nerve fiber density was correlated with the patient's pain score, as indicated by the Visual Analog Scale. A control group was formed by staining the endometrium of women presenting with dysmenorrhea but without the above-mentioned disorders. RESULTS: Nerve fibers were observed in sections of the endo-myometrium (in the deep endometrium) in 68% of patients with endometriosis who underwent hysterectomy or a deep endometrial biopsy. Nerve fibers were not observed in the aspirated endometrium of women with endometriosis. Only 13.7% of women with adenomyosis and 3.3% of women with fibroids had nerve fibers in their endometrium. Nerve fiber density was correlated with pain score in women with endometriosis. CONCLUSION: Nerve fibers were found in the functional layer of eutopic endometrium in women with endometriosis; hence, we concluded that the presence of nerve fibers in the eutopic endometrium could diagnose endometriosis with a fairly good specificity of 92.7%. However, the absence of nerve fibers does not always exclude the disease.

My notes (saved in your browser only)

Condition tags

endometriosisadenomyosisdysmenorrhea

Citation neighborhood

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

References (12)

Cited by (9)

Source provenance

europepmc
last seen: 2026-06-11T06:19:48.454388+00:00
openalex
last seen: 2026-06-10T17:14:06.276822+00:00
pubmed
last seen: 2026-05-13T22:24:31.988741+00:00
License: CC0 · commercial use OK