Angiogenesis In Ovarian Ndometriomas And Pain: A Priliminary Study

BACKGROUND AND OBJECTIVEEndometriosis is a benign disorder, affecting women of reproductive age. Pelvic pain is the most common symptom and the incidence of dysmenorrheal and chronic pelvic pain has reached 20-90%. Recently, pelvic pain correlated with endometriosis has become a hot spot. But the pathophysiology of the association between endometriosis and pelvic pain is poorly understood. Recent studies have found that angiogenesis play an important role in the pathogenesis of endometriosis. The aim of the study was to explore whether a correlation exists between angiogenesis in ovarian endometriomas and pelvic pain.METHODSWe used a visual analogue scal(eVAS)to establish the degree of pain. Then the patients were divided into two groups according to the degree of pain. Group A, patients with no or mild pain; and group B, patients with moderate or severe pain. we detected the blood flow signals of endometriomas, the lowest pulsatility and resistance indexes by transvaginal Doppler ultrasonography in 52 patients. Microvessel density (MVD) and expression of VEGF were assessed immunohistochemically.RESULTSModerately or highly vascularized endometriomas were more frequent in group B (P <0.05). The lowest PI and RI were significantly lower in group B (P<0.05).The mean MVD was significantly higher in group B (P <0.05).There was no significantly difference in expression of VEGF between two groups (P>0.05). MVD was related with VAS score and the degree of vascularization detected by transvaginal power-Doppler(rs=0.399 and 0.539 , P<0.05).CONCLUSIONWe conclude that vascularization of ovarian endometriomas evaluated by transvaginal power Doppler and MVD is higher in patients who present with severe pelvic pain than in asymptomatic patients or patients presenting mild pain. There is a correlation between the degree of vascularization in ovarian endometriomas and pelvic pain.