Increased ipsilateral uterine artery vascular resistance in women with ovarian endometrioma.
OBJECTIVE
The aim of this study was to elucidate whether the presence of an ovarian endometrioma is associated with impaired vascular flow. We investigated changes in vascular flow on the ipsilateral and contralateral side of the endometrioma, before and after surgery.


METHODS
This prospective case-control study included 144 women (ovarian endometrioma [n = 40], endometriosis without ovarian endometrioma [n = 33], non-endometriotic ovarian cyst [n = 17], and normal pelvis [n = 54]). The uterine artery (UtA) vascular resistance indices (pulsatility index [PI] and resistance index [RI]) were measured using transvaginal Doppler sonography, and UtA diameters were measured using magnetic resonance imaging.


RESULTS
The UtA PI and RI were significantly higher on the ipsilateral side of the endometrioma than on the contralateral unaffected side in the endometrioma group (P < 0.01), as well as in the non-endometriotic ovarian cyst group (P < 0.05), and normal pelvis group (P < 0.01). The UtA PI and RI on the ipsilateral side of the endometrioma were significantly lower after cystectomy than before cystectomy (P < 0.01). The UtA diameters were significantly larger (P < 0.01) on the ipsilateral side of the endometrioma than on the contralateral side.


CONCLUSIONS
The UtA-vascular resistance might be higher on the ipsilateral side of the endometrioma than on the contralateral unaffected side, indicating a risk of subclinical atherosclerosis in women with endometriosis.
Department of Obstetrics and Gynecology, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan.
Miyoko
M
Waratani
Department of Obstetrics and Gynecology, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan.
Taisuke
T
Mori
Department of Obstetrics and Gynecology, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan.
Fumitake
F
Ito
Department of Obstetrics and Gynecology, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan.
Yukiko
Y
Tanaka
Department of Obstetrics and Gynecology, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan.
Akemi
A
Koshiba
Department of Radiology, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan.
Akiko
A
Takahata
Department of Obstetrics and Gynecology, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan.
Jo
J
Kitawaki
D000328:Adult; D016022:Case-Control Studies; D004715:Endometriosis / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008875:Middle Aged; D010048:Ovarian Cysts / Q000000981:diagnostic imaging*; D010049:Ovarian Diseases / Q000000981:diagnostic imaging*; D010388:Pelvis / Q000098:blood supply* / Q000000981:diagnostic imaging; D011446:Prospective Studies; D055988:Uterine Artery / Q000000981:diagnostic imaging*; D014655:Vascular Resistance / Q000502:physiology*; D055815:Young Adult
ovarian endometrioma; uterine artery; vascular diameter; vascular resistance