Perivascular nerve fibre proliferation: The consequence of prolonged straining

Four clinical cases are described in which a history of straining to achieve defaecation over many years, was associated with prolonged pelvic pain and the neuro-immunohistochemical observation of perivascular nerve fibre proliferation (PVNFP). Specimens of uterus, vagina, vulva and bladder have all demonstrated this novel histological feature. In three of the four cases, treatment with gonadotrophin releasing hormone agonists was associated with temporary improvement of the pain.