1
|
Vancaillie T, Tan Y, Chow J, Kite L, Howard L. Pain after vaginal prolapse repair surgery with mesh is a post-surgical neuropathy which needs to be treated - and can possibly be prevented in some cases. Aust N Z J Obstet Gynaecol 2018; 58:696-700. [PMID: 29577243 PMCID: PMC6585787 DOI: 10.1111/ajo.12804] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2017] [Accepted: 02/22/2018] [Indexed: 11/29/2022]
Abstract
Post-surgical neuropathy leading to chronic pain is a recognised complication. It also can occur after surgery for pelvic organ prolapse repair involving mesh. Post-surgical neuropathy needs to be identified and properly treated to minimise the occurrence of chronic pain. A treatment algorithm is put forward for discussion .
Collapse
Affiliation(s)
- Thierry Vancaillie
- Department of Women's and Children, University of New South Wales, Sydney, New South Wales, Australia.,Royal Hospital for Women, Sydney, New South Wales, Australia.,Women's Health & Research Institute of Australia, Sydney, New South Wales, Australia
| | - Yasmin Tan
- Women's Health & Research Institute of Australia, Sydney, New South Wales, Australia.,Vulval Health Clinic, Royal Hospital for Women, Sydney, New South Wales, Australia
| | - Jason Chow
- Women's Health & Research Institute of Australia, Sydney, New South Wales, Australia.,Chronic pelvic pain clinic, Royal Hospital for Women, Sydney, New South Wales, Australia
| | - Lauren Kite
- Women's Health & Research Institute of Australia, Sydney, New South Wales, Australia.,Chronic pelvic pain clinic, Royal Hospital for Women, Sydney, New South Wales, Australia
| | - Liz Howard
- Women's Health & Research Institute of Australia, Sydney, New South Wales, Australia.,Osteopath, Pain Management, Education and Support, Women's Health & Research Institute of Australia, Sydney, New South Wales, Australia
| |
Collapse
|
2
|
An Investigation of the Relationship between Pelvic Pain and Density of Nerve Fibers in Peritoneal Lesions of Endometriosis. JOURNAL OF ENDOMETRIOSIS AND PELVIC PAIN DISORDERS 2014. [DOI: 10.5301/je.5000185] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Purpose Endometriosis is a gynecological disease often characterized by severe pelvic pain, including perimenstrual and intermenstrual pain and dyspareunia. Sensory nerve fibers within peritoneal lesions have previously been shown to contribute to generation of pain in endometriosis; however, their association with different types of pelvic pain is currently uncertain. Methods Peritoneal endometriotic lesions (n = 30) were sectioned and stained immunohistochemically with protein gene product 9.5 (PGP 9.5; pan-neuronal marker), neuropeptide Y (NPY; sympathetic), vasoactive intestinal polypeptide (VIP; parasympathetic), substance P (SP; sensory) and nerve growth factor (NGF) to identify nerve fibers and neurotrophin levels. Densities were assessed within stroma of the lesions and in the adjacent peritoneum. Pelvic pain scores were obtained using a visual analogue scale (VAS), and correlation analysis was performed. Results Increased density of nerve fibers was observed within the stroma of lesions. NGF expression was significantly increased in glandular epithelium, compared with stromal regions (p = 0.026) and correlated inversely with menstrual pain scores (p = 0.05). Sympathetic nerve fiber density (NPY) in stroma showed a significant positive correlation with intensity of menstrual pain (p = 0.04). Parasympathetic nerve fiber density (VIP) also showed a strong trend toward a positive correlation with menstrual pain intensity (p = 0.056). Conclusions There is increased neurogenesis in the stromal region. Innervation of lesions correlates to intensity of menstrual pain. NGF in glandular epithelium may promote growth of nerve fibers into the core of lesions; however, the inverse correlation between NGF expression in glandular epithelium and menstrual pain indicates that mechanisms of pain generation in endometriosis are complex.
Collapse
|
4
|
Stacy J, Frawley H, Powell G, Goucke R, Pavy T. Persistent pelvic pain: Rising to the challenge. Aust N Z J Obstet Gynaecol 2012; 52:502-7. [DOI: 10.1111/j.1479-828x.2012.01473.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2012] [Accepted: 07/08/2012] [Indexed: 12/30/2022]
Affiliation(s)
- Jackie Stacy
- Department of Obstetrics and Gynaecology; University of Notre Dame; Sydney; Australia
| | - Helena Frawley
- Melbourne School of Health Sciences; University of Melbourne; Parkville; Vic.; Australia
| | - Gail Powell
- MSS Caulfield Hospital Pain Management and Research Centre; Caulfield; Vic.; Australia
| | - Roger Goucke
- WA Pain Management Centre; Sir Charles Gairdner Hospital; Nedlands; WA; Australia
| | - Timothy Pavy
- Pelvic Pain Clinic; King Edward Memorial Hospital For Women; Subiaco; WA; Australia
| |
Collapse
|
5
|
|