title: Ovarian endometrioma vascularization in women with pelvic pain.
abstract: OBJECTIVE
  To assess whether a correlation exists between angiogenesis in ovarian endometrioma with the presence of pelvic pain.
  
  
  METHODS
  Prospective study.
  
  
  METHODS
  Tertiary-care university hospital.
  
  
  METHODS
  Sixty-five patients (mean age, 33.3 years; range, 20-49 years) were diagnosed as having suspected cystic ovarian endometriosis, and were scheduled for surgery. Patients were classified into two groups according to clinical complaints: group A, asymptomatic patients or patients presenting mild dysmenorrhea; and group B, severe dysmenorrhea and/or chronic pelvic pain and/or dyspareunia.
  
  
  METHODS
  Transvaginal power-Doppler ultrasonography and immunohistochemical staining for CD-34 in histological specimens.
  
  
  METHODS
  The amount of blood flow, lowest pulsatility and resistance indexes, and microvessel density (MVD).
  
  
  RESULTS
  Five patients were excluded after surgery because no ovarian endometriosis was found in histological analysis. Thirty women were included in each group. Ovarian endometriomas were more frequently vascularized in group B (87%) than in group A (60%). The lowest pulsatility and resistance indexes were significantly lower, and MVD was significantly higher, in group B compared with group A. There was a correlation between the degree of vascularization detected by power-Doppler ultrasound and MVD.
  
  
  CONCLUSIONS
  We conclude that vascularization of ovarian endometriomas evaluated by transvaginal color Doppler and MVD is higher in patients who present with pelvic pain than in asymptomatic patients. This could be an indicator of the activity of endometriosis.
authors.affiliation: Department of Obstetrics and Gynecology, Clínica Universitaria de Navarra, School of Medicine, University of Navarra, Pamplona, Spain. jlalcazar@unav.es <jlalcazar@unav.es>
authors.forename: Juan Luis
authors.initials: JL
authors.lastname: Alcázar
authors.forename: Manuel
authors.initials: M
authors.lastname: García-Manero
mesh_terms: D001783:Blood Flow Velocity / Q000502:physiology*; D004715:Endometriosis / Q000000981:diagnostic imaging* / Q000473:pathology / Q000503:physiopathology* / Q000601:surgery; D004717:Endometrium / Q000098:blood supply* / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D010535:Laparoscopy; D010049:Ovarian Diseases / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology* / Q000601:surgery; D017699:Pelvic Pain / Q000209:etiology*; D011446:Prospective Studies; D018608:Ultrasonography, Doppler