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Got My Ultrasound Report. What Does It Indicate?

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Posted on Fri, 19 Apr 2013
Question: I would like an opinion on the results of the ultrasound and suggestion for follow up.
doctor
Answered by Dr. Timothy Raichle (9 hours later)
Hello, I would be happy to help you with your question. I am sorry about the delayed response. You have given ample information to give you an excellent answer.

So to review:
1. You have a history of endometriosis originally diagnosed at age 27
2. You had a child at age 29
3. You have fibroids on ultrasound dated to 2006
4. You recently complained of pelvic pain / discomfort in LLQ
5. On exam your uterus was felt to be enlarged

The diagnosis if endometriosis obviously did not affect fertility and is a relative non-issue. The ultrasound report actually shows a uterus that is of normal size in all dimensions. The 'endometrial stripe' is the part of the uterus that grows and sheds each month and is normal. The fibroids noted are small, and do not impinge upon the uterine lining - i.e. they do not affect that part of the uterus that normally carries a pregnancy.

With regard to the right adnexal cyst: the adnexa refers to the ovary and tube on the right side. The uniloculur cyst (i.e. it is a simple cystic structure) most likely represents a 'paratubal cyst'. These are common, benign structures that are of little clinical significance. In fact, it does not even correlate with the location of your pain.

So to summarize, with regard to the findings on ultrasound:
1. The fibroids are small, common, and benign. They do not become cancer. The size and location of your fibroids are unlikely to represent a problem with regard to future fertility. They are, though, associated with heavy painful periods.
2. The right adnexal cyst is also unlikely to be an issue. It might be associated with the ovary, but more likely, it is associated with the right tube. It is of low clinical significance, and is not on the same side as the pain you are experiencing.

So in terms of followup:
1. I agree with the followup ultrasound in 3 months
2. If the pain persists AND the cyst in the right adnexa persists, then you could entertain a 'laparoscopy' to assess whether this cyst is the source of your pain and go ahead with its removal
3. If the pain is gone, regardless of the cyst, then observation and continued followup (another 3 months) would be warranted.

I hope that this helps!! Please ask if you have additional questions.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Timothy Raichle (7 hours later)
I see my 2nd reply but not my first so I will try and recreate it now:

I had major surgery in 1982 for the endo, left with two very small ovaries. It was a large 8 cm mass. Then went on danizol for 6 months. I conceived my daughter in 1984.

3 days after my recent ultrasound and exam, I noticed a discharge light beige in color. Very slight amount that seems to come and go. It has been about 2 weeks since the US. Almost feels like it might have stirred something up. I have not been sexually active so I am not sure if this plays a role in this or not.

Thank you so much for your thorough answer!

I have had no periods for about 10 years now.
doctor
Answered by Dr. Timothy Raichle (4 hours later)
Thank you for the followup - I am sorry that part of your question was lost.

If you had a vaginal ultrasound, it is not uncommon for it to cause the cervix to bleed a small amount. This often manifests as a light brownish discharge. It is also possible that the ultrasound and gel has upset the normal bacterial environment in the vagina and you have a mild infection (such as BV, which is a common infection).

It is reassuring that you were able to conceive after such a severe course and treatment for endometriosis. I am going to assume that this answer and my prior answer covers everything. If I have forgotten anything, please let me know.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Timothy Raichle (4 minutes later)
Thank you, I can't tell you how helpful this as been to me!
doctor
Answered by Dr. Timothy Raichle (11 hours later)
It has been my pleasure to try and help you! If you ever want to direct a question to me directly please just state "this is for Dr. Raichle..." And I will get back to you as soon as possible!! Good luck.
Note: Revert back with your gynae reports to get a clear medical analysis by our expert Gynecologic Oncologist. Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Timothy Raichle

OBGYN

Practicing since :1999

Answered : 1687 Questions

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Got My Ultrasound Report. What Does It Indicate?

Hello, I would be happy to help you with your question. I am sorry about the delayed response. You have given ample information to give you an excellent answer.

So to review:
1. You have a history of endometriosis originally diagnosed at age 27
2. You had a child at age 29
3. You have fibroids on ultrasound dated to 2006
4. You recently complained of pelvic pain / discomfort in LLQ
5. On exam your uterus was felt to be enlarged

The diagnosis if endometriosis obviously did not affect fertility and is a relative non-issue. The ultrasound report actually shows a uterus that is of normal size in all dimensions. The 'endometrial stripe' is the part of the uterus that grows and sheds each month and is normal. The fibroids noted are small, and do not impinge upon the uterine lining - i.e. they do not affect that part of the uterus that normally carries a pregnancy.

With regard to the right adnexal cyst: the adnexa refers to the ovary and tube on the right side. The uniloculur cyst (i.e. it is a simple cystic structure) most likely represents a 'paratubal cyst'. These are common, benign structures that are of little clinical significance. In fact, it does not even correlate with the location of your pain.

So to summarize, with regard to the findings on ultrasound:
1. The fibroids are small, common, and benign. They do not become cancer. The size and location of your fibroids are unlikely to represent a problem with regard to future fertility. They are, though, associated with heavy painful periods.
2. The right adnexal cyst is also unlikely to be an issue. It might be associated with the ovary, but more likely, it is associated with the right tube. It is of low clinical significance, and is not on the same side as the pain you are experiencing.

So in terms of followup:
1. I agree with the followup ultrasound in 3 months
2. If the pain persists AND the cyst in the right adnexa persists, then you could entertain a 'laparoscopy' to assess whether this cyst is the source of your pain and go ahead with its removal
3. If the pain is gone, regardless of the cyst, then observation and continued followup (another 3 months) would be warranted.

I hope that this helps!! Please ask if you have additional questions.