Pathogenesis of pain in endometriosis


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Abstract

The review analyzes foreign and Russian articles on theoretical issues of the pathogenesis of pain in endometriosis. The current concepts are that inflammation, neuroangiogenesis, and neurogenic inflammation, which underlie peripheral and central sensitization, as well as the advancing interorgan sensitization, are involved in the pathogenesis of pain in endometriosis. The review considers the molecular mechanisms underlying the above pathological phenomena causing deterioration in quality of life in patients with endometriosis in some cases even after surgical excision of heterotopias. By now, it has not been possible to identify endometriosis-specific pain; the disease can take both its asymptomatic course and its course with the only pain symptom of varying intensity, as well as with their combinations. The study of the pathogenesis of endometriosis is still relevant; there are many questions to be answered in order to improve quality of life in patients and to relieve the pain syndrome that is present in almost half of the cases of endometriosis. Conclusion: The pathogenesis of pain in endometriosis includes the following components: a biochemical signal that is converted through activation of nociceptors into a nerve signal that is modulated at the spinal level and sent to the brain neurons with pain f ixation. The nature of the pain syndrome largely depends on the prevalence of endometrioid heterotopias, the duration of the disease and the individual characteristics of the patients. The nature of pain syndrome largely depends on the prevalence of endometrioid heterotopias, the duration of the disease, and the individual characteristics of the patients.

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About the authors

Yulia S. Timofeeva

Novosibirsk State Medical University, Ministry of Health of Russia

Email: dr.j.timofeeva@yandex.ru
PhD, Assistant at the Obstetrics and Gynecology Department

Igor' O. Marinkin

Novosibirsk State Medical University, Ministry of Health of Russia

Dr. Med. Sci., Professor, Head of the Obstetrics and Gynecology Department, Rector

Vitaliy M. Kuleshov

Novosibirsk State Medical University, Ministry of Health of Russia

Email: kuleshov_vm@mail.ru
Dr. Med. Sci., Professor, Professor at the Obstetrics and Gynecology Department

Svetlana V. Aidagulova

Novosibirsk State Medical University, Ministry of Health of Russia

Email: asvetvlad@yandex.ru
Dr. Biol. Sci., Professor, Head of the Laboratory of Cellular Biology and Fundamental Basis of Reproduction, Central scientific laboratory

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