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Thread: Hoping for some explanations please

  1. #1
    Join Date
    Sep 2006
    Posts
    182

    Default Hoping for some explanations please

    I can not, for the life of me, get my GYN to call me back about my ultrasound report, so I got a copy of it for myself. I've googled galore and still dont know what to make of it. Hope you can help.

    Report:
    "Tansvanginal scanning demonstrated the uterus to measure 3.7 cm AP daimeter, 4.2 cm tranverse diameter, and 7.0 cm in length. The endometrial stripe is homogeneous in the upper body of the uterus, measuring 4.4 mm double layer thickness. However, somewhat web-like endometrium is again demonstrated in the lower body of the uterus, measuring up to 9.0mm double layer thickness.

    The right ovary contains a 1.8cm hemorrhagic cycst. The right ovary measures 3.4 X 1.8 X 3.2 cm. The left ovary measures 2.1 X 2.4 X2.9 cm. No free pelvic fluid is identified.

    Comparison with 7/21/2008, demonstrates similare appearing endometrium, indicating adhesions or synechiae. The hemorragic cyst in the right ovary is new.

    Impression- A new 1.8 cm hemorragic cyst in the right ovary. the endometrium remains weblike in appearance after 4-1/2 months. This is consistestn wtih endometrial adheasions or synechiae."

    2 years ago I had a cyro-ablation as I continued to bleed for over a year after having my daughter prematurly. I had 1 menstral like incident 4 1/2 months ago, and then another now, which is why I had another ultrasound done. My GYN has scheduled me for a D&C, another cyro-ablation, and a hysterocopy (spelling? sorry) on the 31st of this month. But Since I can not get him to return my calls to go over the surgery and my questions I am going to cancel it. I will likely see my PCP about this and see where he wants to take it.

    So with what you know, what are your thoughts? I know my question is so vague, Im sorry. Anything that you see sound potentially life threatening without this surgery? And the cyst.. I can certainly tell it's there. Off and on pain, not bad enough for OTC pain meds yet, but close.

    Any thoughts would be so appriciated. Thanks again!
    Tonya
    Diagnosed with PCOS in 1995, 17 years old.

  2. #2
    Join Date
    Oct 2008
    Posts
    6

    Default

    Hi Tonya

    I had a hysteroscopy on the 16th of this month as they could see things simular to what you are saying, i have scaring/adesions/ who knows what in an area of the uterus that they needed to investigate, even with a hysteroscopy nothing could be found but they do think is is some kind of scaring from when i lost my twins (5 years ago!! but it never showed up on any other scan until now!)

    Sounds like you have a normal cyst due to PCO which sounds like it could do with draining if it is painful and or has been there for sometime.

    Not sure what the web like apperance in the endometrium is but could it be endometriosis? Sorry i dont really know much about it to be able to give you more on that.

    Its annoying that your GYN wont call you back, can you not keep your surgery date and see him before you go in? Again sorry if it is different across the pond, we get to see our surgeon before we go in (they would never in a million years return a call lol)

    Hoping things go well for you hun

    Symone
    xx

  3. #3
    Join Date
    Sep 2006
    Posts
    182

    Default Hi Symone (((hugs))) others pg ment

    Thanks so much. I went ahead and cancelled my surgery. I do not see the point in getting another cyro-ablation done, if the 1st one didnt work. I have no idea about the web like appearance either... same with the adheasoins. I wonder if it could be from the first cyro ablation I had. I hate PCOS. I saw your post the support board. Yay, Im glad to hear that you are back and looking at TTC again. Good Luck, My friend.
    Love,
    Tonya

  4. #4
    Join Date
    Nov 2008
    Posts
    79

    Default

    Tonya
    I think the weblike apperance sounds like you have scar tissue, have you had a hsg done
    I don't like cryo-abelation as it is not kind to the uterus
    I wonder if you have ashermans syndrome from scr tissue i think you need a second opinion before another surgery
    May i suggest you check out the yahoo ashermans group there a lots of girls out there with similar cases, se website below

    http://health.groups.yahoo.com/group/Ashermans/messages

  5. #5
    Join Date
    Oct 2008
    Posts
    103

    Default

    If the cryo-ablation was for an abnormal Pap smear, then it should have very little to do with your menses or the ultrasound appearance. If you had an endometrial or uterine ablation, then that could lead to scar tissue within the uterus.

    If you have PCOS and are not ovulating, then you will not have any periods unless some hormonal treatment is used (such as birth control pills or Provera tablets.) The concern about an abnormal appearing uterin lining in someone who is not menstruating is that it can represent abnormal changes which occur with a lack of menstruation. These changes can include pre-cancerous (hyperplasia) or even cancerous changes. For women with PCOS who do not mentruate normally, and who are not given some type of hormone to allow regular sloughing of the lining, a risk of endometrial cancer exists. An endometrial biopsy or a D&C can test that lining, to see if there are any of these changes. A hysteroscopy can identify scar tissue, but I would pursue some continued evaluation of this abnormal lining.

    Since the thickness of the lining is in the lower part of the uterus only, the changes may also represent a simple polyp within that part of the cavity. Hysteroscopy can identify that as well. The 1.8 cm hemorrhagic cyst is a normal finding and will most likely resolve. But it usually only occurs after ovulation, and if you have not had a menses with that ovulation, then the presence of scar tissue within the cavity is more likely.

  6. #6
    Join Date
    Sep 2006
    Posts
    182

    Default Thank you so much Dr. Williams

    I appriciate you taking the time to help us here. My cyro- ablation was done because after having my daughter prematurely, I didnt stop menstrating for just over 1 1/2 years. Medication didnt stop it, so my GYN offered a complete hysterectomy or cyro ablation. I chose the cyro ablation. I understood by my GYN that it would eleviate all chances of uturine cancer because I would not menstrate anymore. But since then I have had 2 cycles (very much like I use to... months without and then a very painful long cycle). He wants to put me on Provera each month to induce a cycle. I did the ablation so that I wouldnt have cycles anymore, as they are so painful.

    Thanks again.

  7. #7
    Join Date
    Oct 2008
    Posts
    103

    Default Endometrial ablation

    So you did have an endometrial ablation, and the purpose of this is to destroy as much of the endometrial tissue as possible to control the amount of bleeding the tissue produces each month. It does not always destroy all the endometrial tissue; in fact, it usually does not. Women may have much lighter periods after an ablation, which is still a very good outcome for women with heavy menses. There very well may be endometrial tissue within the uterus that has adopted this irregular appearance, and it should be addressed.

    But if areas within the uterus were not completely destroyed, then those areas still function, producing bleeding at times and menses. Also, those areas are at risk for precancerous as well as cancerous changes, especially if you are not ovulating normally. Provera will help to allow these areas to completely pass, just as would happen in a normal menstrual cycle. I expect you will probably have some bleeding after the use of the Provera, but it sounds as if you may still need some hormonal control of your cycle.

  8. #8
    Join Date
    Sep 2006
    Posts
    182

    Default Thank you, again.

    I will go pick up my prescription for provera ands start it next month. thanks again Dr. Williams.
    Very Sincerely,
    Tonya

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