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What are the findings and required treatment from the transvaginal ultrasound report?

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Practicing since : 2005
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I did a transvaginal US today and the results reads uterus position anteverted appearance inhomogenous and non gravid. Pathology: small heterogenous solid mass 1.2x1.1cm posterior body. Endometrium 9.9mm vacuity line not seen Appearance hyperechoic Morrisons pouch nil Cul de sac trace amount of fluid Cervix NAD Renals NAD right ovary fundus 4.0x2,4cm with prominent follicular periphery Left ovary fundus 4,2cmx2.2cm with small simple cyst, 2.6x1.9x1.9cm vol 4.9cm3 What does all of this mean for me?
Posted Mon, 23 Dec 2013 in Women's Health
Answered by Dr. Rhea Chanda 2 hours later
Brief Answer: possible fibroid with pcos Detailed Answer: Hello According to the report you may have a possible small posterior fibroid . The size is small and doesn't require any intervention at present . However your ovaries are slightly bulky with peripheral follicles suggestive of polycystic ovaries . The simple cyst on the left is small and doesn't require any intervention . The rest of the report is ok . But this report has to be compared to your symptoms and why the reportTVS was done . I see that you have a history of pcos please related your symptoms . Ideally the TVS should be repeated after 6 months to follow the size of the solid mass and the cyst on.
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Follow-up: What are the findings and required treatment from the transvaginal ultrasound report? 1 hour later
Thanks Dr. XXXXXXX Some of my PCOS symptoms are painful periods, passing of clots with heavy bleeding, minimal facial hair, hair on the lower end of finger and toe joints. Hairy arms, legs, thighs and lower back and buttocks. Anovulatory cycles, and I am experiencing the third one this year. Previously this never happened. Darkened pubic area especially the inner thighs as well as the armpits. Weight gain especially in the lower abdomen and difficulty in loosing weight. The TVS was ordered during my last anovulatory cycle because I was bleeding mildly for two weeks straight. I was also given a prescription for Primolut (Norethisterone) 5mg but menses stepped in two days later. I still have the prescription. I was diagnosed with PCOS about four years ago, I have also been trying to get pregnant for that long now with no success. The fibroid was not there a year ago. I had an HSG done last December and everything was clear with no masses found in my uterus, now I have a fibroid. How do I shrink it? Would I need surgery soon? When I bring in my results to my doctor she will order the scan for me again in 6 months time. Also she ordered a pelvic scan which showed this result of my liver: heterogenous solid mass, 2.4x2.3x2.1cm noted in posterior segment R lobe liver. ??fold fatty sparing.
Answered by Dr. Rhea Chanda 16 minutes later
Brief Answer: hormone medication Detailed Answer: Firstly your anovulatory cycles are causing the bleeding abnormality . You have to be put on hormones to regularise your cycles first . After that it will be stopped and you may need ovulation induction drugs to help you conceive . Don't worry about the fibroid now. It's still small and doesn't require any intervention at present. If you wish to conceive then that's the first priority . Meanwhile you need to consult an infertility specialist. This will take time and is a long process . Be patient and hope for the best . The liver mass needs evaluation by a surgeon . Solid mass in the liver is a pathology and needs to be evaluated. Injections and drugs are available for induction drugs. Normally we start with oral drugs and consequently injections . Without ovulation natural conception is not possible . So after your doctor sees the report the mode of management will be decided .
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Follow-up: What are the findings and required treatment from the transvaginal ultrasound report? 22 minutes later
Thanks Doc, what about metformin? I have been put on that before but stopped due to horrible side effecs. I have also done Clomid for three cycles straight at 100mg days 3-7 I ovulated but I don't think it was that strong. I also chart my temperature to confirm Ovulation so that is how I know when my cycles are anovulatory. I live in the Caribbean and the island where I am from there are no fertility specialists my regular obgyn whom I have seen over the last three years basically said there is nothing more she can so for me so I had my regular doctor write me the note to get the Ultra sounds done. I bring the results back to her. I know she can't help me with the fertility issues but she is nice and can order tests for me when I request them. So should I go on birth control for 3-6 months and then use Clomid again? Meanwhile I think I will go back on the Meformin to control my insulin resistance. I am also a vegetarian so I must supplement with Bcomplex to prevent deficiencies what else can I take?
Answered by Dr. Rhea Chanda 20 minutes later
Brief Answer: injections Detailed Answer: Well, its difficult to follow this without proper care. Firstly, metformin can be used. But dont take it if your side effects are severe. It has an effect on blood sugar and needs to be monitored. Start with 500mg daily. See if you can handle it. Next, go on oc pills containing cyproterone for 3 mths. Then do clomid for at least 6 months day 2-6. Follicular monitoring alongside. If it doesnt work, injections are next. You may have to see a specilaist for that. For now, start with this.
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