Markers of Nociception in Chronic Pelvic Pain
Research type
Research Study
Full title
Urogenital pain mechanisms: changes in peripheral signalling processes in sensory afferents of pelvic floor muscles, endometrium and urothelium; in patients with mesh-induced chronic pelvic pain . An observational study using immmunohistochemistry to look at Substance P, C-GRP and P2X3, TRPV1 receptors in patients with urogynaecological mesh-induced, chronic pelvic pain and pelvic floor dysfunction.
IRAS ID
195882
Contact name
Sohier Elneil
Contact email
Sponsor organisation
University College London Hospital (UCLH)
Duration of Study in the UK
1 years, 1 months, 3 days
Research summary
Chronic pelvic pain, secondary to pelvic floor dysfunction is a poorly managed but common condition with a significant global impact on women.
Up to 30% of women undergoing pelvic reconstructive surgery with transvaginal mesh to treat pelvic organ prolapse, develop chronic pelvic pain following mesh placement.
Possible causes include post-surgical infection, scarring, pudendal nerve damage and generalised muscle spasm. Most women undergo subsequent operations to remove the mesh and correct the pelvic organ prolapse, but in a significant proportion of cases the pelvic pain does not resolve.
The aim of this observational study is to analyse which pain-inducing substances (Substance P, C-GRP) are released in tissues adjacent to the implanted mesh, and what type of peripheral receptors become present and activated (Purinergic and Vallinoid), in patients with mesh-related chronic pelvic pain.
Identifying these specific receptors and pain mediators could provide valuable information about the underlying mechanisms that cause chronic pelvic pain and help clinicians develop more effective, targeted treatments in this specific group of patients.This observational study will analyse tissue samples from 15 patents with different problems in the pelvis: pain, pelvic organ prolapse, bowel and bladder dysfunction, using antibody-mediated florescent staining via microscopic analysis.
Participants planning to undergo pelvic surgery for medical reasons, will be recruited by their lead clinician from a gynaecology clinic. The tissue used for analysis in the study will be removed during their planned surgical treatment and will not have any impact on the conduct of the surgery or its outcomes. Participants will be asked to fill in a set of questionnaires about pelvic pain and function, before their surgery.
Samples will be embedded in paraffin blocks, processed and analysed using immunohistochemistry techniques.
REC name
London - Dulwich Research Ethics Committee
REC reference
16/LO/1232
Date of REC Opinion
2 Sep 2016
REC opinion
Further Information Favourable Opinion