Nerve fibers in uterosacral ligaments of women with deep infiltrating endometriosis

Endometriosis is a disease of high prevalence and enigmatic origin. One aspect not yet clarified is the relationship between endometriosis and nerve tissue.ObjectiveTo evaluate, by immunohistochemistry, the presence of sympathetic and parasympathetic nerve fibers in the uterosacral ligament and adjacent connective tissue in women with deep pelvic endometriosis and women without endometriosis.DesignCross-sectional study (Canadian Task Force II).SettingUniversity Hospital. Obstetrics and Gynecology Department, Santa Casa Medical School, São Paulo, Brazil.MethodologyWe selected 49 patients, 20 of them with deep endometriosis in the uterosacral ligament and 29 patients without endometriosis. Secondary antibodies to NSE (pan-neuronal marker), NPY (that identifies sympathetic nerve fibers), and VIP (that identifies parasympathetic nerve fibers) were used for the immunohistochemistry analyses.ResultsThe immunohistochemical staining by the NSE antibody was positive in 40% of cases of women with endometriosis and in 20.7% of patients without endometriosis (non-significant). The immunohistochemical staining by the NPY antibody was positive in 60% of patients with endometriosis and in 20.7% of the control group (p = 0.005), while staining by the VIP antibody was 60% in patients with endometriosis and 13.8% in patients without endometriosis (p = 0.001).ConclusionImmunoexpression of NPY (sympathetic fibers) and VIP (parasympathetic fibers) is higher in women with deep pelvic endometriosis than in women without endometriosis.