PD20-02 CHARACTERIZATION OF CERVIX INNERVATION: RELEVANCE TO LOOP ELECTROSURGICAL EXCISION PROCEDURES
Bibliographic record
Abstract
You have accessJournal of UrologySexual Function/Dysfunction: Female (PD20)1 Apr 2019PD20-02 CHARACTERIZATION OF CERVIX INNERVATION: RELEVANCE TO LOOP ELECTROSURGICAL EXCISION PROCEDURES Madeline Monaghan, Olivia Giovannetti, Johanna Hannan*, Barry Komisaruk, Sue Goldstein, Irwin Goldstein, and Michael Adams Madeline MonaghanMadeline Monaghan More articles by this author , Olivia GiovannettiOlivia Giovannetti More articles by this author , Johanna Hannan*Johanna Hannan* More articles by this author , Barry KomisarukBarry Komisaruk More articles by this author , Sue GoldsteinSue Goldstein More articles by this author , Irwin GoldsteinIrwin Goldstein More articles by this author , and Michael AdamsMichael Adams More articles by this author View All Author Informationhttps://doi.org/10.1097/01.JU.0000555734.67736.e3AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVES: The cervix has a well-recognized role in reproduction and pregnancy, but its function in female sexual response has yet to be fully clarified. Using functional MRI, Komisaruk et al (2011) showed that pressure stimulating the cervix activated the paracentral lobule in the genital sensory cortex, providing evidence that cervical sensory activity is perceptible. The triple afferent innervation of the cervix via the pelvic, hypogastric, and vagus nerves supports its multifaceted physiologic role. Inna et al (2010) reported significant negative deficits in overall sexual and orgasmic satisfaction after Loop Electrosurgical Excision Procedures (LEEP) for cervical dysplasia. The present study characterized the innervation of cervical tissue from hysterectomy specimens. METHODS: Seven tissue samples from Kingston General Hospital (Ontario), selected from an archive tissue bank from total hysterectomy procedures, were acquired and examined histologically. Tissue blocks from both the anterior and posterior walls of the cervix were used for analysis. The tissue included the cervical external os, around which the loop wire cuts during the LEEP procedure. RESULTS: A general nerve stain, protein gene product 9.5 (PGP9.5), showed overall innervation of the tissue. Further immunohistochemical analyses showed staining for subpopulations of nerves. The tissue stained positive for: cholinergic innervation [anti-choline acetyltransferase (ChAT) antibody]; adrenergic innervation [anti-tyrosine hydroxylase (TH) antibody]; and sensory innervation [anti-Nav1.8 (Nav1.8) antibody, Fig.1]. Comparison with PGP9.5 provided evidence of further innervation that may not be specific to ChAT, TH, or Nav1.8. Qualitative analysis of serial sections demonstrated many highly innervated vascular and glandular structures, as well as nerve fibers that appear to be travelling through the tissue. CONCLUSIONS: The cervix is a richly vascularized and innervated organ. Evidence of sensory innervation through Nav1.8 positive staining in and near the epithelium suggests that the LEEP procedure transects through these neural structures. Future studies will collect excised cervical tissue obtained from LEEP and morphologically reconstruct the LEEP excised tissue to understand the tissue’s structure and physiology. A greater knowledge of the tissue removed during LEEP will allow for modification of the surgical procedures to reduce the risk of post-LEEP sexual dysfunction. Source of Funding: None Kingston, Canada; Greenville, NC; Newark, NJ; San Diego, CA; Kingston, Canada© 2019 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 201Issue Supplement 4April 2019Page: e377-e377 Advertisement Copyright & Permissions© 2019 by American Urological Association Education and Research, Inc.MetricsAuthor Information Madeline Monaghan More articles by this author Olivia Giovannetti More articles by this author Johanna Hannan* More articles by this author Barry Komisaruk More articles by this author Sue Goldstein More articles by this author Irwin Goldstein More articles by this author Michael Adams More articles by this author Expand All Advertisement PDF downloadLoading ...
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.015 | 0.004 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".