caa a22 4500 445309652 CHVBK 20180317142625.0 cr unu---uuuuu 170323e20111201xx s 000 0 eng 10.1007/s00404-011-2063-y doi (NATIONALLICENCE)springer-10.1007/s00404-011-2063-y Quinn Martin Womens Hospital, University of Zhejiang, Hangzhou, China aut Endometriosis: the consequence of uterine denervation-reinnervation [Elektronische Daten] [Martin Quinn] Difficult intrapartum episodes and persistent straining during defecation cause injuries to uterine nerves and uterosacral ligaments. Injuries to uterine nerves (denervation) result in loss of fundocervical polarity, uterotubal dysmotility and retrograde menstruation. Ectopic endometrium, delivered by retrograde menstruation, adheres to injuries to uterosacral ligaments and peritoneal surfaces. Difficult vaginal deliveries result in laparoscopic appearances of asymmetry of uterosacral ligaments with, or without, ectopic endometrium. Straining during defaecation causes the "classic” appearances of nulliparous endometriosis including hypertrophy of the uterosacral ligaments often with large volumes of ectopic endometrium. Laparoscopic appearances depend on the site, nature, extent, and timing of tissue injury, as well as the presence of available endometrium. Tissue repair, including reinnervation in the uterine isthmus, cervix, vagina and uterosacral ligaments, contributes to chronic pelvic pain, dysmenorrhea, dyspareunia and subfertility some time after the primary injuries. Springer-Verlag, 2011 Endometriosis nationallicence Chronic pelvic pain nationallicence Denervation nationallicence Reinnervation nationallicence Archives of Gynecology and Obstetrics Springer-Verlag 284/6(2011-12-01), 1423-1429 0932-0067 284:6<1423 2011 284 404 https://doi.org/10.1007/s00404-011-2063-y text/html Onlinezugriff via DOI 1 review-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s00404-011-2063-y text/html Onlinezugriff via DOI NATIONALLICENCE 100 1- Quinn Martin Womens Hospital, University of Zhejiang, Hangzhou, China aut NATIONALLICENCE 773 0- Archives of Gynecology and Obstetrics Springer-Verlag 284/6(2011-12-01), 1423-1429 0932-0067 284:6<1423 2011 284 404 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer