Comparison of pain intensity, smooth muscle cells density, and alpha-smooth muscle actin expression in ovarial and peritoneal endometriosis

Sutrisno Sutrisno, Mukhamad Nooryanto, Shella Widya Gani
In: Majalah Obstetri & Ginekologi · 2021 · vol. 29(3) , pp. 108 · doi:10.20473/mog.v29i32021.108-117 · W3215966660
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⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

Endometriosis patients exhibit higher pain intensity, smooth muscle cell density, and alpha-SMA expression than healthy individuals, with peritoneal endometriosis showing greater levels than ovarian endometriosis.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-09 · read from full text ⓘ

This cross-sectional analytic observational study compared women with ovarian endometriosis or peritoneal endometriosis undergoing laparoscopy/laparotomy (n=16; 8 per group) and healthy individuals, using smooth muscle cell density quantification on tissue sections, α-smooth muscle actin (α-SMA) immunohistochemistry, and self-reported pain intensity (EHP-30) recorded the day after surgery. Pain intensity, smooth muscle cell density, and α-SMA expression were higher in endometriosis patients than in healthy individuals, and within endometriotic patients these measures were higher in peritoneal endometriosis than ovarian endometriosis. The study reported significant correlations among α-SMA expression, smooth muscle density, and pain intensity, and analyzed group differences with independent t-tests and correlations with Pearson tests, though the small sample size was a major limitation. This paper is centrally about endometriosis — specifically comparing smooth muscle cell density, α-SMA expression, and pain intensity between ovarian and peritoneal endometriosis.

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Abstract

HIGHLIGHT1. Pain intensity, smooth muscle cells density, and alpha-SMA expression can be used to analyze the role of smooth muscle in endometriosis.2. Compared to healthy individuals, those with endometriosis have higher pain intensity, smooth muscle cells density, and alpha-SMA expression. 3. Among endometriotic patients, those with peritoneal endometriosis have higher pain intensity, smooth muscle cells density, and alpha-SMA expression than those with ovarial endometriosis.3. The expression of alpha-SMA, smooth muscle density, and pain intensity were found to correlate significantly in endometriosis. ABSTRACTObjectives: to identify the role of smooth muscle through the analysis of smooth muscle cells density, expression of a-SMA, and the pain intensity.Materials and Methods: Study design is a cross sectional analytic observational. Study sample consists of women with ovarial endometrios and women with peritoneal endometriosis that undergo laparoscopy and laparotomy in RSUD Saiful Anwar Malang and RSIA Melati Malang from January until December 2019. There are 16 samples: 8 samples of ovarial endometriosis and 8 samples of peritoneal endometriosis. Smooth muscle cell density was analyzed by comparing the number of smooth muscle cells with the total area of endometriosis tissue in one microscopical field. a-SMA expression obtained by immunohistochemistry. Degree of pain obatined by filling the part 1 point 1-11 of EHP-30 queistionnaire the day after the procedure. Data was analyzed by Independent T-test and Pearson correlation.Results: Pain intensity, smooth muscle cells density, and a-SMA expression is higher in the endometriosis patient compared to healthy individual. Pain intensity, smooth muscle cells density, and a-SMA expression is lower in the ovarial endometriosis compared to peritoneal endometriosis.Conclusion: There are a significant correlation between the expression of a-SMA, smooth muscle density, and pain intensity in endometriosis.
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Abstract

Objectives: to identify the role of smooth muscle through the analysis of smooth muscle cells density, expression of a-SMA, and pain intensity.

Materials and methods

The study design was cross-sectional analytic observational. Study sample consisted of women with ovarian endometrios and women with peritoneal endometriosis who underwent laparoscopy and laparotomy in Dr. Saiful Anwar Hospital and RSIA Melati Hospital, both in Malang, Indonesia, from January until December 2019. There were 16 samples: 8 samples of ovarian endometriosis and 8 samples of peritoneal endometriosis. Smooth muscle cell density was analyzed by comparing the number of smooth muscle cells with the total area of endometriosis tissue in one microscopical field. a-SMA expression was obtained by immunohistochemistry. The degree of pain was determined by filling the part 1 point 1-11 of EHP-30 queistionnaire the day after the procedure. Data were analyzed with Independent T-test and Pearson's correlation test.

Results

Pain intensity, smooth muscle cells density, and a-SMA expression was higher in endometriosis patients compared to healthy individuals. Pain intensity, smooth muscle cells density, and a-SMA expression was lower in the ovarian endometriosis compared to peritoneal endometriosis.

Conclusion

There was a significant correlation between the expression of a-SMA, smooth muscle density, and pain intensity in endometriosis. Czyzyk A, Podfigurna A, Szeliga A, Meczekalski B. Update on endometriosis pathogenesis. Minerva Ginecol. 2017;69(5):447-461. doi: 10.23736/S0026 -4784.17.04048-5. Epub 2017 Mar 7. PMID: 28271702. Surrey ES, Soliman AM, Johnson SJ, et al. Risk of Developing Comorbidities Among Women with Endometriosis: A Retrospective Matched Cohort Study. J Womens Health (Larchmt). 2018;27(9): 1114-1123. doi: 10.1089/jwh.2017.6432. Epub 2018 Aug 2. PMID: 30070938. Ozkan S, Murk W, Arici A. Endometriosis and infertility: epidemiology and evidence-based treatments. Ann N Y Acad Sci. 2008;1127:92-100. doi: 10.1196/annals.1434.007. PMID: 18443335. Eisenberg VH, Zolti M, Soriano D. Is there an association between autoimmunity and endome-triosis? Autoimmun Rev. 2012;11(11):806-14. doi: 10.1016/j.autrev.2012.01.005. Epub 2012 Feb 4. PMID: 22330229. 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Outcome instruments

EHP-30

Condition tags

endometriosis

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