ABSTRACT
UNLABELLED: Endometriosis is a disease of high prevalence and enigmatic origin. One aspect not yet clarified is the relationship between endometriosis and nerve tissue. OBJECTIVE: To 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. DESIGN: Cross-sectional study (Canadian Task Force II). SETTING: University Hospital. Obstetrics and Gynecology Department, Santa Casa Medical School, São Paulo, Brazil. METHODOLOGY: We 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. RESULTS: The 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). CONCLUSION: Immunoexpression of NPY (sympathetic fibers) and VIP (parasympathetic fibers) is higher in women with deep pelvic endometriosis than in women without endometriosis.
Subject(s)
Endometriosis/etiology , Ligaments/innervation , Nerve Fibers/chemistry , Adult , Cross-Sectional Studies , Endometriosis/pathology , Female , Humans , Immunohistochemistry , Neuropeptide Y/analysis , Phosphopyruvate Hydratase/analysis , Sacrum/innervation , Uterus/innervation , Vasoactive Intestinal Peptide/analysisABSTRACT
Estudamos 31 pacientes masculinos com história de infertilidade conjugal. Realizamos espermograma, teste de hiposmolaridade (H.O.S.) e recuperaçäo espermática através da técnica de "swim-up". Naqueles pacientes com H.O.S. > 60% os valores de concentraçäo espermática/ml, motilidade total e progressiva tanto no sêmen fresco como no "swim-up: foram superiores e estatisticamente diferentes quando comparados com aqueles de H.O.S. < 60%. Quando comparamos os parâmetros do espermograma, analisados indívidualmente, e o H.O.S., näo obtivemos correlaçäo significativa para nenhum dos dois grupos estudados (H.O.S. > e < 60%). Estes resultados demonstram que o H.O.S. é um bom método de acompanhamento e de avaliaçäo da fertilidade do espermatozóide, e que realizado conjuntamente com o espermograma consegue separar com precisäo sêmen de melhor ou pior qualidade, mesmo após o seu beneficiamento ("swim-up") processo utilizado nos programas de fertilizaçäo assistida, onde a avaliaçäo do potencial de fertilidade do espermatozóide é extremamente importante
