Could you help me understand my TVUS report please?

[faithbaby28]

I have been having excruciating pain in my lower back, lower abdomen and pelvic area for over 10 days straight now and yesterday I started having some spotting that is dark brown. (My period was due last weekend) I am going to see a gyno next wednesday but do you think my pcp could prescribe me pain meds until then because I have been using a heating pad and taking motrin/tylenol and its not helping at all....   :-(   Also, I copied my TVUS below and was wondering if you could help me understand it and whether or not I should be concerned and should I be concerned about the pain I have been experiencing? Thank you very much in advance!


Signs/Symptoms: TENDER LEFT ADRENALINE ON EXAM ENLARGED OVARY


Transvaginal imaging was performed for better evaluation of the adnexa. No
prior studies are provided for comparison.

UTERUS: Anteverted measuring approximately 6.3 x 3.1 x 4.3 cm.

ENDOMETRIUM: The endometrium is heterogeneous and appears prominent along the
fundus measuring 12 mm in diameter.

RIGHT OVARY: 4.3 x 3.5 x 3.2 cm. This contains a complicated cyst with low
level internal echoes and multiple internal septations. The cyst overall
measures approximately 3.6 x 2.4 x 2.7 cm.

LEFT OVARY: 2.8 x 1.9 x 1.7 cm with multiple small follicles.

On Doppler assessment, both ovaries demonstrate vascular flow.

CUL-DE-SAC: No free fluid.

IMPRESSION: COMPLICATED RIGHT OVARIAN CYST MEASURING UP TO 3.6 CM IN SIZE.
FOLLOW UP IS NECESSARY IN A DIFFERENTIAL MENSTRUAL CYCLE IN 6-8 WEEKS TIME. IN
ADDITION, THERE IS PROMINENCE OF THE ENDOMETRIAL STRIPE ALONG THE FUNDUS WITH A
HETEROGENEOUS APPEARANCE AND RE-EVALUATION OF THE ENDOMETRIUM AT THAT TIME IS
ALSO RECOMMENDED.

[faithbaby28]

Thank you very much for your response. I have found a therapist and have my first session with her this week. Between the pain and other symptoms I am experiencing with this cyst and just breaking-up with an abusive boyfriend and just regular life stress's, I realize it is necessary to seek professional advice and take time out for me to deal with everything I am feeling with a professional so I can have some guidance with everything.. Thanks again I really appreciated your insight!

[Annekathryn Goodman, M.D.]

Hi There,

The ultrasound report suggests that you are going to have a period soon. Right before your period, the lining of the uterus increased in thickness. That lining is called the endometrium.  When you have your period, the endometrial lining thins out.

Your ovaries sound young and healthy (that is the vascular (blood) flow.

Your left ovary has some nice little eggs surrounded by nutrient fluid. These are called follicles. The right ovary has a complex cyst that is most likely the maturing cyst called a corpus luteum . This is the cyst that develops after ovulation that supplies the normal hormone, progesterone, in the second half of your menstrual cycle.

The recommendation to repeat the ultrasound in 2 to 3 months is appropriate.  Occasionally there are cysts that are not related to ovulation that are persistent. If that is the case, in the setting of pain, it may be reasonable to look surgically by laparoscopy.

I would strongly discourage yo from seeking narcotic pain medication for this.  From reading your diary, I see that your are in alot of psychic distress.  I love the wonderful responses of support that you have gotten.

I do believe that there are strong mind-body links. It is very common to have terrible pain when you have soul pain.  This does not mean "it is all in your head". The pain is absolutely real. But I would encourage you to follow your gyn doctor's advice.Additionally, you should consider other interventions to get healthy - journal-ling as you are doing, support groups, yoga, athletics, meditation, therapy.

best wishes