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Enlarged uterus! Very concerned about results
History of menorraghia . 46yrs,s periods every 23 days usually lasts for 2 heavy days & 5 days light spotting. I had an ablation done in 08 but right back to heavy menses in 09. uterus always been retroverted.OB/GYN tried to do an endomentrial biopsy today but was unsuccessfull & now wants to schedule a D&C . I am very concerned about a recent ultrasound report that reads as follows:
Findings(Transabdonimal) study has a prior study for comparison dated 12/7/09. At that time, the endom. measured 7 mm. There is a small posterior leiomyoma that measured 1.2 cm. Currently, the uterus in a normal anteverted anteflexed,orientation, but has enlarged since the prior study, currently measuring 13.9. x 7.8 x 5.6 cm compared to a prior measurement of 8.8x 6.9x5.9 cm. The endometrium measures 12 mm, which is mildly thickened and is considerably thicker than the previous measurement of 7 mm. The right ovary 2.1 x 2.2.x1.9 cm There is a cyst in the left adnexa measuring 1.7 x 1.2x1.3 cm. There is no free fluid within the cul-de-sac.
Conclusion: The uterus has gotten considerably larger than on the prior study & endometrium is thicker than on the prior study.Findings TRANSVAGINAL: high resolution transvaginal techniques, pelvis was evaluated. uterus measures 13.9.x7.8x5.6 cm The endom. is well seen & measures 12 mm. There is a small simple cyst in left adnexa measuring 17 mm. The right ovary is grossly normal measuring 2.1x2.2x1.9cm. no evidence for a leiomyoma.CONCLUSION:1. diffuse & heterogeneous enlargement of uterus with mild thickening of the endom., but don't see a discrete leiomyoma. Also had abnormal Pap test with endometrial cells (!?) however the pap test was done on the last day of my period where i still had slight spotting so could that have effected the Pap Test?
Could this be of concern for cancer? Can a D&C be done under twilight anesthesia? And last not least is D&C the next necessary step or can an MRI give a good conclusion before doing the invasive D&C.
Findings(Transabdonimal) study has a prior study for comparison dated 12/7/09. At that time, the endom. measured 7 mm. There is a small posterior leiomyoma that measured 1.2 cm. Currently, the uterus in a normal anteverted anteflexed,orientation, but has enlarged since the prior study, currently measuring 13.9. x 7.8 x 5.6 cm compared to a prior measurement of 8.8x 6.9x5.9 cm. The endometrium measures 12 mm, which is mildly thickened and is considerably thicker than the previous measurement of 7 mm. The right ovary 2.1 x 2.2.x1.9 cm There is a cyst in the left adnexa measuring 1.7 x 1.2x1.3 cm. There is no free fluid within the cul-de-sac.
Conclusion: The uterus has gotten considerably larger than on the prior study & endometrium is thicker than on the prior study.Findings TRANSVAGINAL: high resolution transvaginal techniques, pelvis was evaluated. uterus measures 13.9.x7.8x5.6 cm The endom. is well seen & measures 12 mm. There is a small simple cyst in left adnexa measuring 17 mm. The right ovary is grossly normal measuring 2.1x2.2x1.9cm. no evidence for a leiomyoma.CONCLUSION:1. diffuse & heterogeneous enlargement of uterus with mild thickening of the endom., but don't see a discrete leiomyoma. Also had abnormal Pap test with endometrial cells (!?) however the pap test was done on the last day of my period where i still had slight spotting so could that have effected the Pap Test?
Could this be of concern for cancer? Can a D&C be done under twilight anesthesia? And last not least is D&C the next necessary step or can an MRI give a good conclusion before doing the invasive D&C.
A related discussion, Adenomyosis with D&C pathology results was started.
Thanks so much have a few more question. So if a D&C is done and cells are none cancerous what is next? Is a hysterectomy needed for adenomyosis? And how is adenomyosis detected witha D& C also?
He also said something about a scope. Maybe he is taking some device to look in there.? What is the best way to know if it is Adenomyoisis? Would an MRI do any good?
THanks in advance
He also said something about a scope. Maybe he is taking some device to look in there.? What is the best way to know if it is Adenomyoisis? Would an MRI do any good?
THanks in advance
MEDICAL PROFESSIONAL
Hi!
I'll try to anwer in order!
This is how I would counsel a patient of my own:
The enlargement of the uterus is most likely caused by adenomyosis which is a form of endometriosis, and is benign. Yes, doing the pap on the last day of your period could have affected the results. I would not be too concerned especially since you are not menopausal. There is a very small possibility of cancer. A d&c can be done under many different types of anesthesia, depending upon patient wishes and the anesthesiologist's recommendations. I believe that d&c is what is needed next. An MRI can't give a sample to the pathologist, and that is what is needed to rule out cancer.
Hope this helps!
Dr B
I'll try to anwer in order!
This is how I would counsel a patient of my own:
The enlargement of the uterus is most likely caused by adenomyosis which is a form of endometriosis, and is benign. Yes, doing the pap on the last day of your period could have affected the results. I would not be too concerned especially since you are not menopausal. There is a very small possibility of cancer. A d&c can be done under many different types of anesthesia, depending upon patient wishes and the anesthesiologist's recommendations. I believe that d&c is what is needed next. An MRI can't give a sample to the pathologist, and that is what is needed to rule out cancer.
Hope this helps!
Dr B
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