Brief Answer: Various possibilities for your problem Detailed Answer: Hi XXXX.Welcome to HCM. There can be various possibilities according to your history. 1.Rt. ectopic pregnancy is one possibility considering history of chronic PID and tubal surgery also.There is fluid in PID along with pain rt. shoulder which means something( blood or fluid ) irritating the diaphragm and causing pain in rt. shoulder, rt. lower abdomen above hip and irregular menstrual cycles. Your Dr. may advise you culdocentesis, where the fluid in Cul de sac is aspirated and checked. If no reason found then in my opinion, there may be need to undergo laparoscopy and see inside the abdominal cavity. 2. Appendicectomy had already been done.There can be some problem related to gut as well but CT Scan is showing normal report. 3. 2.3 x 2.0 cm. simple ovarian cyst and min. hydrosalpinx has nothing to do with this pain and I don't expect this to rupture and cause free fluid in pelvis and cause shoulder tip pain 4. Ca 125 can be done but I think will be inconclusive as anything that irritates peritoneum can raise this level. This is my opinion, however your examining Dr. will be your best judge. Anything else, I will be happy to help. Thanks.

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Brief Answer: You should take the prescribed medicine Detailed Answer: Hi XXXX. Thanks for writing again. The prescribed medicine is for pelvic infection and you should take that . This can also clear the minimal fluid in pelvis. Your CT report is indicating nothing conclusive. So, need to follow your Dr. as per her advise. I could not get what biopsy (which part) dr. advised you, so I can't say anything about that. This medicine is related to the disease. She didn't suggest culdocentesis, does not matter, that was one possibility. The cost depends upon dr. taking the sample herself or the sonologist doing it under ultrasound guidance.This was simply to know if it is blood then possibility of ectopic, if purulent culture can be done and if fluid simply treat for infection. Once you take the medicine, according to me, keep a regular follow up and if all settles repeat a TVS (internal scan) to see the things getting normal. Thanks.

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Brief Answer: Possible causes of pelvic infection Detailed Answer: HiXXXX. I have seen your CT report .The reason for pelvic infection can be any organisms ascending from the genital tract and affecting all structures,starting from uterine lining(endometrium), tubes, ovaries and peritoneum.It is hard to pin point a single thing, but in about 50-60% cases, the reason is sexually transmitted infection caused by Neisseria gonorrhoeae and Chlamydia . The route may be any( via blood,lymphatic,break in local defence,previous histiry of PID, as in your case,post partum infection and so on. The thing is how to get hold of it and treat it and try to prevent recurrence. The only definitive criteria is to get blood tests done for STIs, gram stainig and histopathological evidence of endometritis, which can only be done by endometrial biopsy , as advised to you and also PCR of endometrial curettings to rule out genital tuberculosis. Don't worry, taking this biopsy is a very simple procedure and nothing felt afterwards. Other tests I have already explained you. ESR,CRP CBC,RBS ,Urine routine ex. can be done.CT scan has already been done and any pathology in other abdominal organs ruled out, including gut. Cyst in ovary of this size and follicular cyst is not at all causing this problem.It is not that cyst in rt. ovary earlier is now on left.It is normal process going on. Any follicle size increasing in size is called ca cyst. There is no endometroma,as seen in your CT report. Another test is then laparoscopy. Thanks.I hope I have answered your queries and if satisfied you can close the discussion.

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Brief Answer: Answering various queries Detailed Answer: Hi. Welcome back. Here i am for your various queries. 1.Using public toilet can transmit HPV, and you may get local infection by contact of similar seat .You can use plenty of water and vaginal wash once in the morning while taking bath to keep vaginal pH maintained.A word of caution at this stage. While using jet, don't allow anal contamination to touch or enter vagina.This may lead to recurrent UTI and source of infection.Keep a good hygeine. Get pap smear done every year. 2. In washing machines you should assure that no detergent remains inside .It should be thoroughly cleaned and at the same time it should be dried in sun or ironing done to kill germs. 3.Male partner should be tested for HIV,HPV,Gonorrhoea,chlamydial infection,syphilis,and genital herpes. 4.There is serological test for syphilis--VDRL,and blood test for HIV and other tests are done from urethral secretions for gonorrhoea, chlamydia .He needs to get smear and culture sensitivity of urethral secretions.However, the status of sexual partner is the single most important clue to the diagnosis of chlamydia infection.I f woman has stable relation with asymptomatic man, then symptoms are unlikely to be due to chlamydia. 5. There are chances of getting ectopic pregnancy in future due to PID and also due to tubal surgery ,may be about 1in 200. 6. Yes, biopsy can be done after 2 weeks .It is not an emergency.

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