Three-dimensional power doppler vascularization in women with ovarian endometriomas and relationship with associated painful symptoms

Objectives—The objective of the study was to evaluate the correlation between endometrioma-associated pain and lesion vascularization as measured with 3- dimensional power Doppler transvaginal sonography. Methods—Endometriomas were examined, and 4 indices were obtained: mean grayness, flow index, vascularization index, and vascularization-flow index. Dysmenorrhea, chronic pelvic pain, and dyspareunia were analyzed in terms of severity, presence/absence, and duration. Results—Twenty-nine women were selected. The univariable association of painful symptoms in terms of presence/absence and duration was low with the exception of mean grayness with the presence of chronic pelvic pain (b5–0.106; P5.047; 95% confidence interval, 0.810 to 0.998). The R2 value increased to 0.226 for dysmenorrhea (b5–0.475; P5.029) when analyzing the association between the vascularization index and the severity of painful symptoms. The visual analog scale scores for chronic pelvic pain and dyspareunia were higher (R250.300; b5–0.547 and –0.548, respectively; P5.028 and.053). Conclusions—We observed an inverse association between the severity of pain and endometrioma vascularization. Further larger studies are required to confirm our findings.