MODERATE FLUID IN ENDOMETRIAL CAVITY

Hi,
I need some help. First some back ground. I’m 44 years old, no pregnancies. I have been suffering from chronic lower back pain since July 2010 and Hip pain Sept 2010. Additionally I was having right side pain/ache. The following was ordered:  Pelvic ultra sound – can’t find my right ovary. Second ultra sound, still can’t find my ovary. MRI of lumbar was ordered – FINDINGS: Anterior herniation of L5/S1 no nerve impingement.  Pelvic MRI – Moderate fluid in endometrial cavity, trace fluid in pelvic cul-de-sac, FINDINGS: Uterine adenomyosis, STILL CANT FIND MY OVARY, 2.1 cm dominant thin-walled cyst in left ovary.  Hip (both) MRI ordered. I have had terrible heartburn since end of July – out of the blue. I wake up with it. I’ve tried three different OTC medications w/o relief. Back/hip pain is continuous, periods are heavier and spotty and I cramp harder than ever before.
My doctor could care less – he read the pelvic mri over the phone – regarding the ovary – he’s said he cannot determine if its their or not – he said it may have ‘withered’ away.  Is this even possible?  My ovary may have been damaged in a surgery to remove a cyst in 2005 – I just want him to tell me if this is the case.  And he’s not going to perform surgery to make the final determination. He blew off the rest of the report and doesn’t listen to me when I bring up the other stuff.  
What do I need to be concerned about? I’m worried about the ‘moderate liquid’ the test was 2 ½ weeks after my period, so I don’t think that its menstrual fluid. It’s all just so sudden and all in the relatively same area (back, hip, pelvic area).  I need to be armed with the right questions to ask my primary care Dr.  What should I ask, what should I demand. I am very concerned that this might be serious, perhaps early stages of some cancer. I appreciate your time and answer.

[Elaine Brown, MD]

Hi!
If you were my patient, I would reassure you that if the ovary can't be found, it is almost certainly because it is too small.  I think you solved the mystery yourself when you mentioned the ovarian cystectomy -- there probably is just not too much functional ovarian tissue left.  I recently read that it is possible to find ovarian tissue by giving Clomid -- it causes cysts. Honestly, I don't think the cysts would be worth the trouble.
As for the pain, I think it is explained by the herniated disc noted on the MRI.
Finally, the fluid, an ultrasound could be done rignt after your period.  IF there is still fluid present, then, and ultrasound-guided endometrial biopsy should solve the problem.
Hope this helps!
Dr B