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Have pinched nerve at the L-4 and increased thickness of endometrium. Any solution?

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My GP sent me for an x-ray to diagnose pain in my right leg from hip to foot. He determined there was a pinched nerve at the L-4. I am set up to see a neurosurgeon. But there was something in the x-ray that caused him to send me for an MRI. They saw excess matter in the uterus, which the person who read the MRI stated was unusual for a female of my age (59). My GP said it warranted further investigation so I had an abdominal and a trans-vaginal sonogram. I was given a copy of the report but I don't understand what it says and now I have an appointment with a gynecologiost. I would like to know before my appointment, what I may expect to hear. The "discussion": portion stated that the pelvic ultrasound transabdominal and transvaginal shows a uterus measureing 8.6 x 5.5 x 6.9 cm. No myometrial lesions are seen. In the expected endopmetrial region, there is heterogernous echogenicity with shadowing measuring up to 2.3 cm. in thickness. This could represent an endometrial polyp, submucosal fibroid, or endometril hyperplasia/dysplasia. The right ovary measures 2.4x1.4x1.9 c, and the left ovary meaures 1.9x1.8x2.7 cm. No ovarian abnormality is seen. Ultrasound color Doppler and spectral waveform shows arterial waveform in both ovaries. No free fluid is present.
Could you please explain thiis to me? My GP did not take the time to do so and would not come to the phone to speak with me. Thank you, XXXXXXX
Wed, 26 Dec 2012 in Vaginal and Uterus Health
Answered by Dr. Asra Ishtiaq Ahmed 1 hour later
Hello there.

Thanks for writing.

Yes the finding of increased thickness of endometrium is a bit worrisome until investigated completely.

The endometrium refers to uterus lining which is shed during menses.
The myometrium refers to uterus muscle.

In your case your ultrasound shows heterogenous which means varying, echogenesity which refers to density of the matter seen which is around 2.3cm (23mm). In other words, it is likely that your endometrium (uterus lining) is increased and which is definitely suspicious for your age.

Considering your post menopausal, it further makes evaluation of this finding necessary as after menopause the uterine lining is very thinned out and is usually less than 4 mm.

The increased thickness of endometrium at your age could range from anything like a benign endometrial polyp to a hyperplastic endometrial tissue which can be either benign or malignant (cancerous). These can be differentiated only after a biopsy report which studies the nature and composition of the growth.

Do not panic. It is always better to get your problems investigated before them manifesting.

Endometrial lesions usually manifest with problems like post menopausal bleeding, unexpected vaginal bleeding or spotting.

You need to visit your gynecologist for an XXXXXXX examination with Pap smear tests.
Also any endometrial lesion is best evaluated by a minor surgical procedure called endometrial biopsy.
Hysteroscopic endometrial biopsy is an alternative and better procedure wherein first the uterine cavity and lining are visualized with the help of a scope (camera probe) inserted through vagina followed later by biopsy of the abnormal area and uterus lining.

I hope I have given you clarity.

Kindly revert back if any doubts remain.

Take care.
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