الفهرس 
Title : Ultrasound estimation of uterine volume and vascularity in uterine adenomyosis and its relation to pain and bleeding as the primary clinical presentation.
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Abstract
Adenomyosis is a prevelant gynecological disorder, adenomyosis can be asymptomatic. Yet heavy menstrual bleeding, dysmenorrheal and intermenstrual bleeding the most common. Dyspareunia is another possible problem.
Imaging investigations, particularly pelvic ultrasonography, are increasingly revealing signs indicative of adenomyosis and the three dimensional ultrasound has largely improved our diagnosis and assessment of adenomyosis.
Our aim in this study was to use the ultrasound estimation of uterine volume and vascularity in patients with uterine adenomyosis and correlate them to the pain and bleeding as a primary clinical presentation.
The study is an observational cross sectional one in which the Morphological Uterus Sonographic Assessment (MUSA) approach, was used to define patients with adenomyosis who sought medical care at KasrAlaini hospitals in the periodbetween January 2021 and January 2022.
Three dimensional volumetric acquisitions were obtained for the uterus using the virtual organ computer‐aided analysis (VOCAL), Second, using power Doppler the degree of vascularization was documented.
Assessment of the clinical presentation of them was done using validated objective measures to quantify pain (Visual Analogue Scale) and menstrual loss (menstrual pictogram).
We found that the increase in uterine volume (evaluated by the assessment tool of this study) was associated with an increase in the assessed uterine vascularity when done using a subjective scoring of the power Doppler flow. Also the increase of volume was associated as well with more severe pelvic pain in the patients, more dyspareunia, pelvic heaviness, frequent micturition episodes and menstrual blood loss.