Vascularization of ovarian endometriomas tends to be greater in women with associated pelvic pain than women without pelvic pain, a study shows, and ""this could be an indication of the activity of endometriosis,"" the researchers suggest. Vascularization of ovarian endometriomas tends to be greater in women with associated pelvic pain than women without pelvic pain, a study shows, and "this could be an indication of the activity of endometriosis," the researchers suggest.

Drs. Juan Luis Alcazar and Manuel Garcia-Manero from the University of Navarra, Pamplona, Spain used transvaginal power-Doppler ultrasonography and immunohistochemical analysis of microvessel density to look for a correlation between angiogenesis in ovarian endometrioma and pelvic pain.

Study subjects included 60 women with suspected cystic ovarian endometriosis scheduled for surgery.

They authors report in the June issue of Fertility and Sterility that ovarian endometriomas were more frequently vascularized in women with severe dysmenorrhea and/or chronic pelvic pain and/or dyspareunia than in women who were asymptomatic or had only mild dysmenorrhea (87 vs 60 per cent).

Microvessel density was also significantly higher in women with pelvic pain and correlated with the degree of vascularization detected on power-Doppler.

Dr. Alcazar and Dr. Garcia-Manero write that "a possible application of our findings in clinical practice might be the use of power-Doppler to select patients for new therapies, such as antiangiogenic drugs in endometriosis, or to assess the response to conventional therapy.