A study of nerve fibers and histopathology of postsurgical, postinfectious, and endometriosis-related adhesions

OBJECTIVE: To evaluate the presence of nerve fibers and histopathology of endometriosis-related adhesions, postsurgical adhesions, and postinfectious adhesions in women with and without pelvic pain. METHODS: We evaluated the presence of nerve fibers and histopathology of endometriosis-related adhesions, postsurgical adhesions, and postinfectious adhesions in 50 women. The nerve fibers were identified by immunocytochemistry staining with an antibody to neurofilament. RESULTS: Nerve fibers were found in the intraabdominal adhesions in 39 of the total 50 patients with such adhesions (78%). There was no significant difference in the proportion and the mean nerve score in adhesions due to previous intra-abdominal infection, endometriosis, and previous uninfected intra-abdominal surgery. The degree of lymphocytes and edema in endometriosis-related adhesions was significantly higher than in postsurgical adhesions and postinfectious adhesions (P < .05). No difference was found in the amount of nerve fibers and the mean nerve score in adhesions from women with pelvic pain and from those without pelvic pain. CONCLUSION: Nerve fibers are found commonly in intraabdominal adhesions, and their presence are not related to the underlying pathology or pelvic pain. Endometriosis-related adhesions contain more inflammatory cells and tissue edema than postsurgical or postinfectious adhesions.