transvaginal ultrasound/sonogram

[sally51]

This is my second question in this forum.  Can anyone tell me who exactly reads transvaginal sonograms and ultrasounds?  So far I have had one of each and a ct scan of the abdomen and pelvis which showed a 5.0 x2.4 x 2.5 cyst on the right ovary.  The TVS showed 3 areas of blood flow to that area.  My CA125 was only 17 but I have jewish ancestry and a family history of ovarian cancer in my aunt and breast cancer in my mother and other female relatives.  I am 53 years old/post-menopause.  The reason for my question is this:  I saw a gyn-onc last week who advised me to have another TVS mid-February to check the size of the cyst.  I also have had bypass surgery and a history of       insulin dependent diabetes so I believe they are being slow to recommend surgery for this.  The gyn-onc wants the results of the future TVS to be faxed to her and I guess her decision will depend on what she sees in the results.
I'm having a lack of faith in my local gyn since he doesn't seem to be explaining all of this in a very clear way and I'm concerned about the fact that the TVS will be done locally and the specialist is in another city.  Can someone who's been through this help.

[MickeyVicki]

Someone posting on this forum had a similar experience; it was possibly Pfunk - but I am not sure.  I recall her posts being  about things showing up on scans, but then not being found during laparascopic procedures.  Or, do I have that backwards?  Anyway, the poor woman was having difficulties getting her conditions properly diagnosed and treated.

[Writegal319]

Do any of you know anything about 'blocked views" during ultrasounds. I have had two internal and two external ultrasounds with similar inconclusive results.

I've been told I have such large fibrods that it is impossible to see my ovaries and that there is "something" on my left ovary but they can't figure out what it "is" since they are not getting a clear view. This last tech could not see anything at all on my entire right side.

I am starting with a brand new Dr this week--and going to demand an MRI or catscan.

Anyone else with the same experience?

[sally51]

Thank you for your answer.  I am fairly near a teaching hospital but I will take advantage of the program you're referring to.  When it comes to this subject, I'm not sure you can get too many right answers!

[1kimmyb]

In Lexington KY at the University is a great program with alot of fine people who will take the time to answer your questions.  I have had many years of tvu done, most of them there (I dontated both my time and body to science for this "research".) Most of the people who do the tests, although not allowed to tell you because they are just tech's, know what they are looking for.  The tests then read by someone else, and forwarded on to our DR, who seem to have a hard time explaining things to us normal people.  I recently had an issue with cysts in my breasts (my mother had breast cancer twice) and the "surgeon" just blew it off not really explaining things to me and I was scared to death.  I called Lexington and spoke to a DR there.  He explained how the tests are read. I felt alot better. Try their web site www.uky.edu   Go to Medical Center or Research and click on clinical trials.  Maybe you can enroll yourself in one.  If you are not close to Lexington Kentucky, maybe you can try a Medical University close to you to become involved in.  Good luck and God Bless.

[sally51]

I'm sure the doctors are hoping it's something benign.  For one reason, so they don't have to do high risk surgery.  But I just think that's where it's headed anyway.  The CT Scan results showed "multiple rounded enhancing areas in the mesentery" which sounds ominous to me but the gyn onc is actually questioning if an infection I have in one toe is causing enlarged lymph nodes in the mesentery.  Have you ever heard of ovarian cancer spreading into the mesentery?

[MickeyVicki]

You are correct - no one will know exactly what the mass is until the doctor goes inside for a look.  Yes, the cysts can grow fast.  My endometrioma went from a size just smaller than a tennis ball to the size of a grapefruit in about three weeks.  And, yes, even with my benign endometrioma, if it had ruptured then the contents (blood) would have spilled into my abdomen possibly causing a severe infection, so it had to be removed even if it was not cancerous.  Of course, there are types of functional cysts that do dissolve naturally, so perhaps the doctors hope that you have one of those.

[sally51]

My cardiologist considers me to be moderate high-risk for surgery so I know that's why everyone seems to be erring on the side of caution but will just 3 weeks show anything on the TVS?  And if no one can really make the diagnosis without going in and identifying what's in there, is it just a matter of whether I put my life on the line on the operating table or by doing nothing and possibly letting something bad go wild?  I'm starting to think that even with all the tests they've been running, surgery is really the only choice here.   Either that or living without knowing until it's really too late.  What does everyone think?

[MickeyVicki]

My tvu was done by a technician, and the recorded images were studied by a radiologist trained in this specialty.   Whomever it was made an exact determination of my cyst from those images.  Of course, we did not know for certain until my doctor performed the surgery, but he or she was right.  I know where my tvu was done;  I have no idea where the radiologst was located.  The report was one page long, and had as complete a description of the cyst as I have ever seen.  That report, and any images too, could be mailed/faxed/emailed anywhere.   For example, to simply her medical care, my mother visits a diagnostic center for comprehensive bloodwork, then the test results are sent to all her doctors (I think she must have 6 or 7 of them due to all her health problems.)

I obviously do not know the specifics of your conditions, but do consider that the gyn/onc sees many cysts and tumors and builds experience in making determinations as to the likelihood of cancer.  If the gyn/onc suspects cancer then you will urged into immediate surgery.  I've had nurses tell  me of women taken to surgery all of two days after a suspicious mass was discovered.

[confused in arizona]

Hi There,
I hope you get repsonse back it seems as though no one really responed back to me.  But I too have a solid component on my left ovary (I don't have my right) and it's about 3cm and my ovary is also enlarged a little.  I've had three opinions and all just want to watch it and have more TVU to watch it each month.  I did take a CA-125 blood test and mine too was low like 13 or something like that.  I had a regular ultasound on my pelvis four years ago and it was not there.  So I am too confused on what to do.  I can't decide whether to just tell them forget the watch and wait approach or just remove it and then I'd have to go into menapause which that is what they are trying to avoid because I'm only 34 (I'm not having kids, so that's not an issue).  I too am a little baffled because my FM and GI doctor want it out, but all three of the GYNO's that I saw said most likely that it is benign.  But my question is how in the heck do they REALLY know that it is benign unless we go in and remove it.  I was told by different doctors that it could become cancerous and some say no it can not.

So I feel for you, cause I'm just as confused as you are.  I hope you get responce back.  Mine are solid and not cystic so I was told that cystic tend to disappear at times and solid does not!

Keep me posted!