Doppler Assessment of Uterine and Intraovarian Blood Flow in Patients with Genital Endometriosis

В. Д. Воробій
In: Zaporozhye Medical Journal · 2017 · vol. 0(4) · doi:10.14739/2310-1210.2017.4.105039 · W2730598092
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⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

Doppler assessment revealed increased uterine artery resistance in advanced external and internal endometriosis, and intraovarian resistance in endometrioid cysts, with critical circulation changes in severe internal endometriosis.

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This study evaluated uterine and intraovarian hemodynamic changes using Doppler ultrasound in 65 women with external genital endometriosis, 38 women with internal genital endometriosis, and 30 controls without genital endometriosis, measuring pulsatility index, resistance index, and systolic/diastolic ratio in uterine arteries in both menstrual cycle phases. Compared with controls, women with endometriosis showed uterine arterial disturbances that varied by localization and stage, including moderately increased peripheral vascular resistance in external endometriosis stage III and rapidly increasing peripheral resistance with internal endometriosis from stages II–III. Critical circulation changes such as a dicrotic notch were detected in 31.58% of women with stage III internal endometriosis, and negative diastolic blood flow occurred in 36.84% of women with stage III internal disease. Intraovarian velocity differences were generally not significant except in those with endometriod (endometrioma) cysts, where intraovarian resistance index exceeded 0.55; the paper does not explicitly state limitations beyond this descriptive stratification, and its control comparisons may be constrained by the absence of additional methodological detail. This paper is centrally about endometriosis — it uses Doppler assessment of uterine and intraovarian blood flow to characterize hemodynamic changes across internal and external genital endometriosis stages.

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Abstract

The spread of endometriosis among women of reproductive age is 5–10 %. Forming of endometrioid foci commonly begins from development of new blood vessels. So, changes of hemodynamics in vessels that can be determined by Doppler are important for complete diagnosis of endometriosis.Aim of research was to evaluate the uterine and intraovarian hemodynamic changes in women with internal and external genital endometriosis.Materials and methods. The research included 65 women with diagnosis of external genital endometriosis who formed the Ist group. 38 women with internal genital endometriosis were included into the IInd group. Control group involved 30 women without genital endometriosis. Doppler study was set in both phases of menstrual cycle with determination of uterine and intraovarian pulsatility index, resistance index and systolic/diastolic ratio in uterine arteries.Results. In patients with endometriosis we found hemodynamic disturbances in uterine arteries of varying degrees which depended on localization of the pathological process and its stages. In women of I group with I and II stages of external endometriosis indices of peripheral vascular resistance did not differ significantly from parameters of the control group. There was moderate increase of vascular resistance indices higher over healthy women (P < 0.05) in this group in patients with III stage. Increase of peripheral vascular resistance was detected, which grew rapidly according to severity of disease by II-III stages of internal endometriosis. Critical changes of circulation in form of dicrotic notch were detected in 31.58 % of patients with III stage of internal endometriosis. In half of all cases dicrotic notches were symmetrical in both uterine arteries. In addition, in 36.84 % of patients with III degree of internal endometriosis negative blood flow in diastole phase was determined.Significant important difference of pulsatility index and resistance index in intraovarian velocity between healthy women and patients with internal and external endometriosis was not determined, except persons with endometriod cysts, who had resistant index of intraovarian circulation in both phases of the menstrual cycle over 0.55.Conclusions. Blood velocity in uterine arteries during menstrual cycle in patients with genital endometriosis demonstrated highly resistant blood flow in women with external (III stage) and internal (II–III stages) endometriosis and intraovarian velocity (in persons with endometriod cysts). Decompensated changes in blood velocity in uterine arteries were observed only in patients with III stage of internal endometriosis.
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Materials

and methods. The research included 65 women with diagnosis of external genital endometriosis who formed the Ist group. 38 women with internal genital endometriosis were included into the IInd group. Control group involved 30 women without genital endometriosis. Doppler study was set in both phases of menstrual cycle with determination of uterine and intraovarian pulsatility index, resistance index and systolic/diastolic ratio in uterine arteries. Results. In patients with endometriosis we found hemodynamic disturbances in uterine arteries of varying degrees which depended on localization of the pathological process and its stages. In women of I group with I and II stages of external endometriosis indices of peripheral vascular resistance did not differ significantly from parameters of the control group. There was moderate increase of vascular resistance indices higher over healthy women (P < 0.05) in this group in patients with III stage. Increase of peripheral vascular resistance was detected, which grew rapidly according to severity of disease by II-III stages of internal endometriosis. Critical changes of circulation in form of dicrotic notch were detected in 31.58 % of patients with III stage of internal endometriosis. In half of all cases dicrotic notches were symmetrical in both uterine arteries. In addition, in 36.84 % of patients with III degree of internal endometriosis negative blood flow in diastole phase was determined. Significant important difference of pulsatility index and resistance index in intraovarian velocity between healthy women and patients with internal and external endometriosis was not determined, except persons with endometriod cysts, who had resistant index of intraovarian circulation in both phases of the menstrual cycle over 0.55. Conclusions. Blood velocity in uterine arteries during menstrual cycle in patients with genital endometriosis demonstrated highly resistant blood flow in women with external (III stage) and internal (II–III stages) endometriosis and intraovarian velocity (in persons with endometriod cysts). Decompensated changes in blood velocity in uterine arteries were observed only in patients with III stage of internal endometriosis.

References

- (2016). Nakaz Ministerstva va okhorony zdorovia Ukrainy « Taktyka vedennia patsiientok z henitalnym endometriozom» vid 06.04.2016 r. №319 [Order of the Ministry of Health of Ukraine Management of patients with endometriosis from April, 4. 2016. №319]. Retrieved from http://moz.gov.ua/ua/portal/dn_20160406_0319.html. [In Ukrainian]. - Exacoustos, C., Manganaro, L., & Zupi, E. (2014). Imaging for the evaluation of endometriosis and adenomyosis. Best Pract Res Clin Obstet Gynaecol, 28(5), 655–681. doi: 10.1016/j.bpobgyn.2014.04.010. - Cranney, R., Condous, G., & Reid, S. (2017). An update on the diagnosis, surgical management, and fertility outcomes for women with endometrioma. Acta Obstet Gynecol Scand, 96(6), 633–643. doi: 10.1111/aogs.13114. - Hart, R. J. (2016). Physiological Aspects of Female Fertility: Role of the Environment, Modern Lifestyle, and Genetics. Physiol Rev, 96(3), 873–909. doi: 10.1152/physrev.00023.2015. - Lövkvist, L., Boström, P., Edlund, M., & Olovsson, M. (2016). Age-Related Differences in Quality of Life in Swedish Women with Endometriosis. J Womens Health (Larchmt), 25(6), 646–653. doi: 10.1089/jwh.2015.5403. - El-Mazny, A., Kamel, A., Ramadan, W., Gad-Allah, S., Abdelaziz, S., & Hussein, A. M. (2016). Effect of ovarian endometrioma on uterine and ovarian blood flow in infertile women. Int J Womens Health, 28(8), 677–682. doi: 10.2147/IJWH.S124229. - Adamyan, L. V., Andreeva, E. N., Apolikhina, I. A., Bezhenar', V. F., Gevorkyan, M. A., & Gus, A. I. (2013). E´ndometrioz: diagnostika, lechenie i reabilitaciya: federalʹnye klinicheskie rekomendacii po vedeniyu bolʹnykh [Endometriosis: diagnosis, treatment and rehabilitation. Federal clinical recommendations of patient’s management]. Moscow. [In Russian]. Downloads How to Cite Issue Section License Authors who publish with this journal agree to the following terms: Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.

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