Volume 36, Issue 11 pp. 2271-2278
Original Research

Three-Dimensional Power Doppler Vascularization in Women With Ovarian Endometriomas and Relationship With Associated Painful Symptoms

Francesca Rizzello MD, PhD

Corresponding Author

Francesca Rizzello MD, PhD

Department of Clinical and Experimental Biomedical Sciences, University of Florence, Florence, Italy

Address correspondence to Francesca Rizzello, MD, PhD, Department of Clinical and Experimental Biomedical Sciences, University of Florence, Largo Brambilla 3, 50134 Florence, Italy. E-mail: [email protected]Search for more papers by this author
Tommaso Capezzuoli MD

Tommaso Capezzuoli MD

Department of Clinical and Experimental Biomedical Sciences, University of Florence, Florence, Italy

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Ippolita D'Amato Scherbatoff MD

Ippolita D'Amato Scherbatoff MD

Department of Clinical and Experimental Biomedical Sciences, University of Florence, Florence, Italy

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Mauro Cozzolino MD

Mauro Cozzolino MD

Department of Clinical and Experimental Biomedical Sciences, University of Florence, Florence, Italy

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Loredana Gandini BSc

Loredana Gandini BSc

Department of Clinical and Experimental Biomedical Sciences, University of Florence, Florence, Italy

Department of Experimental Medicine, Section of Medical Physiopathology, University of Rome La Sapienza, Rome, Italy

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Maria Elisabetta Coccia MD, PhD

Maria Elisabetta Coccia MD, PhD

Department of Clinical and Experimental Biomedical Sciences, University of Florence, Florence, Italy

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First published: 27 May 2017

Abstract

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 (β = –0.106; P = .047; 95% confidence interval, 0.810 to 0.998). The R2 value increased to 0.226 for dysmenorrhea (β = –0.475; P = .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 (R2 = 0.300; β = –0.547 and –0.548, respectively; P = .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.

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