Pelvic Adhesions and Pelvic Pain 
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 Pelvic Adhesions and Pelvic Pain

J Pathol 2000 Nov;192(3):396-403

Growth of nerve fibres into murine peritoneal adhesions.

Sulaiman H, Gabella G, Davis C, Mutsaers SE, Boulos P, Laurent GJ,
Herrick SE
Department of Medicine, University College London, London, UK.

[Record supplied by publisher]

Adhesions in the peritoneal cavity have been implicated in the cause of
intestinal obstruction and infertility, but their role in the aetiology
of chronic pelvic pain is unclear. Nerves have been demonstrated in
human pelvic adhesions, but the presence of pain-conducting fibres has
not been established. The purpose of this study was to use an animal
model to examine the growth of nerves during adhesion formation at
various times following injury and to characterize the types of fibres
present. Adhesions were generated in mice by injuring the surface of the
caecum and adjacent abdominal wall, with apposition. At 1-8 weeks
post-surgery, adhesions were processed and nerve fibres characterized
histologically, immunohistochemically, and ultrastructurally. Peritoneal
adhesions had consistently formed by 1 week after surgery and from 2
weeks onwards, all adhesions contained some nerve fibres which were
synaptophysin, calcitonin gene-related peptide, and substance
P-immunoreactive, and were seen to originate from the caecum. By 4 weeks
post-surgery, nerve fibres were found to originate from both the caecum
and the abdominal wall, and as demonstrated by acetylcholinesterase
histochemistry, many traversed the entire adhesion. Ultrastructural
analysis showed both myelinated and non-myelinated nerve fibres within
the adhesion. This study provides the first direct evidence for the
growth of sensory nerve fibres within abdominal visceral adhesions in a
murine model and suggests that there may be nerve fibres involved in the
conduction of pain stimuli. Copyright 2000 John Wiley & Sons, Ltd.

PMID: 11054724

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Wed, 07 May 2003 03:00:00 GMT
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