Ultra sound results

[becky65]

I recently had a complete check up...i.e.: pap smear, cervical screening,  mammogram etc.  I am ashamed to say it was my first one in over 10 years.  I just turned 40.  All my tests have come back normal except I had an Ultra Sound that showed fibroid cists which was causing my severe cramping and bleeding very large clots ( the reason why I could not put off going to the doctor )  I have always had extremely painful periods, ever since my first period and even after having my child.  I am still very normal every 28 days..  My OBGYN said the cysts are benign and the cause of the heavy bleeding.  She put me on the mini pill.  Which seemed to work.  My question is how do they know that the cysts are not tumors and why does it take so long for a result of a pap smear to come back?.  I have an HMO.  My OBGYN said it takes 4-6 weeks.  Will the pap results show the tumor and an Ultra sound can not?

[Annekathryn Goodman, M.D.]

Hi Becky,
A pap smear is a screening test for precancer and cancers of the skin of the cervix. The cervix is the doorway to the uterus and opens into the vagina. Yes it does take an awfully long time to get pap smear reports back. I guess that is because of the volume of pap smears which are performed.

Fibroids are benign muscle growths of the muscular wall of the uterus (not cervix). There is a very characteristic look to fibroids on an ultrasound. A pap smear does not give information about fibroids because fibroids are deep inside  and paps only check the surface lining (skin ) of the vagina ans cervix.

It sounds like you have had a wonderful evaluation and examination by your OBGYN. I am glad that you came back into the system. I hope you will be able to go back and see your OBGYN yearly now.

[ne'chee]

Becky

I've had fibroids for years, and just had some removed. Click on the categories under Topics of Interest (to the left) to learn all about fibroids. I am post-menopausal so my symptoms were different from yours.



http://www.fibroidsecondopinion.com/about_fibroids.htm

[just_plain_fae]

In answer to the second part of your question, they can identify the TYPE of cyst or mass using ultrasound, MRI or CT scan.  Types are things like fibroid, dermoid, etc.  Yours was identified as fibroid.  However, they CAN NOT determine if it is benign or cancerous by any "test" or scan or ultrasound.  The ONLY way to determine this for sure is to biopsy the cyst.  One test doctors used is the CA-125 test, which measures certain markers in your blood.  High CA-125 markers can sometimes indicate cancer, but this test is notorious for false positives.  (Endometriosis and other things can also raise CA-125 levels).  Most doctors do not use this test alone to determine if a cyst is cancerous or not.  

Depending on the size and placement of your fibroid, and the amount of pain or discomfort it causes you, you may consider talking with your doctor about having it biopsied.  The dr would be able to make a very small incision and basically take out a piece and test it.  Its an outpatient procedure with very fast results.  This would give you more information to decide if you want to just keep taking the pill or to have it surgically removed.  The bad thing about fibroids is that they grow with each menstral cycle unless you are on medication or in menopause.  New fibroids can occur even after surgery.  Just some more info for you, as I'm in a similar situation.  I'm 24 with a grapefruit sized fibroid near/on my right ovary.

[grammyaa]

just_plain_fae, am new to forum, this actually first one. Your comments concerning cysts am curious about. Did post a question the 27th or 28th. Am thinking now that doctors do not respond in this section as I had thought. Anyway, I had a hysterectomy in '99 for prominant uterus,endometriosos. He left my left ovary. A year ago began experiencing cramping as though on my monthly. My stomach is bloated very much. Also, at night can not sleep with knees drawn up as it hurts my stomach. If my hand lies on my stomach, it wakes me up hurting. Have alot of indigestion. Did sonogram pelvic abdom, and vaginal.Their finding is almost 2cm sonolucent cyst.The cancer center told me sonolucent is a word describing the permitting passage of ultrasound rays without echos. This is confusing term(sonolucent)because on test results it says" no flow is seen within the cyst although arterial flow is seen in the adjacent ovary. No free fluid was identified".  To me, the cyst sounded solid, but the word sonolucent indicates fluid.   In your comments, I gather that a sonogram cannot make a distiction between cysts. So now am wondering if it is cancer. Have to go back in two months for another sonogram. Tried talking with nurse at clinic where receive help at reduced rate. Doctor who ordered test travels to clinic once a month, and did not phone me, her nurse did.Would appreciate your insight. Thanks!

[akg]

hey jpf
listen, I think your questions are great. But it is hard to give too firm an opinion. It would be highly unusual for a 2 cm cyst to cause pain. You usually do not get symptoms from them until they are much bigger (5cm and more) That makes me wonder if something else is going on. You need to find a doctor or nurse practitioner who can see you and help evaluate the issue. Find a place that does not have a traveling doc. My experience is that face to face is a much more effective way to communicate. Phone calls are for quick questions about results and for prescription refills. So make an appointment and go in to be seen. Bring a list of your questions. Be sure you have all the reports of previous testing. It is good to also get a copy of your operative note and the pathology report to bring with you. Good Luck and best wishes.

[grammyaa]

Hugs for responding! I will try again as you suggested.Thanks!

[Linda J]

Hi there, it has been my experience that even smaller cysts 2-3cm. can cause quite a bit of pain. I had one that size on my left ovary. It turned out to be a benign serous cystadenoma that was twisting,  and my fallopian tube was swollen like a balloon. It also caused back, hip, leg and rectal pain as well as gas and bloating. Don't underestimate what these nasty things can do.

Good luck!

Linda J

[just_plain_fae]

Well, I must admit that once I found out what type of cyst mine was, that I stopped researching - too depressing in general.  So I don't know that I can shed much light on your question, but I agree with Linda J that even small cysts can be painful.  Do bring a list of questions with you to the gyn.  If he doesn't offer answers, tell him you appreciate the efforts he has made, but is there someone else who might be able to explain things more fully or in a different way?  You may even be better off seeing a gyn/oncologist, though you may have to be referred to one from your gyn.  Best of luck!