Objective: The aim of this investigation was to assess whether a correlation exists among microvascular density (MVD), expression of endothelial growth factor, and pelvic pain in patients with ovarian endometriosis.
Methods: Sixty-five patients (mean age 33.3 years, range 20-49 years) were diagnosed as having suspected cystic ovarian endometriosis and were scheduled for surgery. Patients were classified into two groups according to clinical complaints: group A, asymptomatic patients or patients with mild dysmenorrhea, and group B patients with severe dysmenorrhea and/or chronic pelvic pain and/or dispareunia. Immunohistochemical staining for CD34 and vascular endothelial growth factor (VEGF) in histological specimens for MVD and VEGF cellular expression assessment were performed.
Results: Five patients were excluded after surgery because no ovarian endometriosis was found in histological analysis. Thirty women were included in each group. MVD was higher in the symptomatic group. No differences were found in VEGF cellular expression.
Conclusions: We conclude that pain symptoms in ovarian endometriosis are directly correlated with MVD but not with VEGF cellular expression. Based on our results, it appears that in endometriotic cysts, the angiogenic processes are present but not completely mediated by VEGF.