Differences in primary compared with secondary vestibulodynia by immunohistochemistry.

Abstract:

OBJECTIVE:To assess whether primary and secondary vestibulodynia represent different pathologic pathways. METHODS:This was an analysis of archived vestibulectomy specimens from 88 premenopausal women with vestibulodynia (2002-2008). Patient records were reviewed to classify the type of vestibulodynia, duration of symptoms, and hormone status. Histologic sections were stained for hematoxylin and eosin to grade inflammation, S100 to highlight nerves, CD117 for mast cells, estrogen receptor α, and progesterone receptor. Differences between primary and secondary vestibulodynia were tested by t tests, chi-square analysis, and linear and logistic regression. RESULTS:Primary vestibulodynia showed significant neural hypertrophy and hyperplasia (P=.02, adjusted odds ratio [OR] 3.01, 95% confidence interval [CI] 1.2-7.6) and increased progesterone receptor nuclear immunostaining (P=.004, adjusted OR 3.94, CI 1.6-9.9) compared with secondary vestibulodynia. Estrogen receptor α expression was also greater in primary vestibulodynia when symptom diagnosis was less than 5 years (P=.004, adjusted OR 5.53 CI 1.71-17.91). CONCLUSION:Primary and secondary vestibulodynia have significantly different histologic features, suggesting that they may have separate mechanistic pathways. Clinically, this may mean the discovery of distinct conditions.

journal_name

Obstet Gynecol

authors

Leclair CM,Goetsch MF,Korcheva VB,Anderson R,Peters D,Morgan TK

doi

10.1097/AOG.0b013e31821c33dc

subject

Has Abstract

pub_date

2011-06-01 00:00:00

pages

1307-1313

issue

6

eissn

0029-7844

issn

1873-233X

pii

00006250-201106000-00008

journal_volume

117

pub_type

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