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What Does My Transvaginal Sonogram Indicate?
Question: Hello,
I went to obgyn yesterday experiencing lower left pelvic pain. I had transvaginal sonogram and my uterus lining measured 1 mm. I have no bleeding and uterus size is normal. My doctor proceeded to say he wanted to check for endo cancer and that I should get a mri. He said the sonogram showed no fibroids or cysts on my one remaining ovary. Why would he go in this direction?
I went to obgyn yesterday experiencing lower left pelvic pain. I had transvaginal sonogram and my uterus lining measured 1 mm. I have no bleeding and uterus size is normal. My doctor proceeded to say he wanted to check for endo cancer and that I should get a mri. He said the sonogram showed no fibroids or cysts on my one remaining ovary. Why would he go in this direction?
Brief Answer:
Your ultrasound was completely normal for a postmenopausal woman
Detailed Answer:
Hello, and I hope I can help you today.
If you only saw your GYN doctor for pain, and had no vaginal bleeding, and your ultrasound only showed the findings you mentioned, I agree with you that an MRI really would not add any additional information. The only reason I could think of his being concerned about endometrial cancer is if there was some other finding on the ultrasound in addition to what you mentioned. A 1mm endometrial stripe is normal for a post-menopausal woman and really leads away from endometrial cancer.
The other possibility is that your doctor felt that you still didn't have a diagnosis for your pain, so an MRI might find something non-gynecological that could explain your symptoms. It is unlikely you had pelvic pain from trichomonas, because it really only infects the lower genital tract, unlike gonorrhea or chlamydia, which can cause pelvic inflammatory disease.
So in any case, I agree with you that the need for an MRI in your situation is unclear. Of course, to truly give a second opinion I would need to review the ultrasound report and your medical records, but with the information you have given me I agree with your opinion.
I hope I was able to answer your question and that this information was helpful. Please do not hesitate to contact me further if you need any further assistance.
Best wishes, Dr. Brown
Your ultrasound was completely normal for a postmenopausal woman
Detailed Answer:
Hello, and I hope I can help you today.
If you only saw your GYN doctor for pain, and had no vaginal bleeding, and your ultrasound only showed the findings you mentioned, I agree with you that an MRI really would not add any additional information. The only reason I could think of his being concerned about endometrial cancer is if there was some other finding on the ultrasound in addition to what you mentioned. A 1mm endometrial stripe is normal for a post-menopausal woman and really leads away from endometrial cancer.
The other possibility is that your doctor felt that you still didn't have a diagnosis for your pain, so an MRI might find something non-gynecological that could explain your symptoms. It is unlikely you had pelvic pain from trichomonas, because it really only infects the lower genital tract, unlike gonorrhea or chlamydia, which can cause pelvic inflammatory disease.
So in any case, I agree with you that the need for an MRI in your situation is unclear. Of course, to truly give a second opinion I would need to review the ultrasound report and your medical records, but with the information you have given me I agree with your opinion.
I hope I was able to answer your question and that this information was helpful. Please do not hesitate to contact me further if you need any further assistance.
Best wishes, Dr. Brown
Above answer was peer-reviewed by :
Dr. Raju A.T
I would be at rest with the answer but I am having collick-like cramping especially after the endo biopsy. I can't figure out why I am in so much discomfort and seems to be where he pressed on my uterus. Could anti-biotics cause inflamation-I was on cipro briefly but it made me ill. Any other reasons for lower pelvic pain. I had an mri and no diverticulitis showed and no masses showed up anywhere. So to recap:
ultrasound-no masses 1mm thick lining
vagina-no discharge
cbc-unremarkable
urine reflex-unremarkable
cat scan-unremarkable
* I did have at least 3 surgeries to remove ovarian cysts and finally an ovary removed-could we suspect adhesions and could the infection have aggravated the adhesions?
ultrasound-no masses 1mm thick lining
vagina-no discharge
cbc-unremarkable
urine reflex-unremarkable
cat scan-unremarkable
* I did have at least 3 surgeries to remove ovarian cysts and finally an ovary removed-could we suspect adhesions and could the infection have aggravated the adhesions?
Brief Answer:
I think you may have had a complication from the endometrial biopsy
Detailed Answer:
Hello, I am sorry I tried to answer you earlier and the site did not post my response, so I will try again.
You did not mention to me previously that the doctor performed an endometrial biopsy and I am concerned that you may have developed an infection or had a complication from the endometrial biopsy.
I understand now why your OBGYN was concerned about cancer, because if your uterus is very tender on examination one of the causes can be endometritis, or inflammation or infection of the uterine lining. This can happen because of instrumentation of the uterus, like a biopsy, or from endometrial cancer. So that may be why the doctor suggested the MRI. But I agree with you that you most likely have some sort of infection that is causing this pain and I think that a course of antibiotics designed to treat uterine infections, like a combination of doxycycline and a longer course of metronidazole may help your symptoms. I think old adhesions are an unlikely cause of pain all of a sudden of your previous ovarian surgery was years ago. Again, I am somewhat limited in the information I can use to advise you without reviewing all your medical reports, but I think a trial of antibiotic treatment is the next logical step while the results of your endometrial biopsy are pending.
I hope that I was able to provide some additional insight into your diagnosis as I can in this situation. I hope you are able to reach a final diagnosis with your treating physician, but again, I do agree that endometrial cancer is unlikely given your test results so far, and infection is a more likely etiology.
Sincerely, Dr. Brown
I think you may have had a complication from the endometrial biopsy
Detailed Answer:
Hello, I am sorry I tried to answer you earlier and the site did not post my response, so I will try again.
You did not mention to me previously that the doctor performed an endometrial biopsy and I am concerned that you may have developed an infection or had a complication from the endometrial biopsy.
I understand now why your OBGYN was concerned about cancer, because if your uterus is very tender on examination one of the causes can be endometritis, or inflammation or infection of the uterine lining. This can happen because of instrumentation of the uterus, like a biopsy, or from endometrial cancer. So that may be why the doctor suggested the MRI. But I agree with you that you most likely have some sort of infection that is causing this pain and I think that a course of antibiotics designed to treat uterine infections, like a combination of doxycycline and a longer course of metronidazole may help your symptoms. I think old adhesions are an unlikely cause of pain all of a sudden of your previous ovarian surgery was years ago. Again, I am somewhat limited in the information I can use to advise you without reviewing all your medical reports, but I think a trial of antibiotic treatment is the next logical step while the results of your endometrial biopsy are pending.
I hope that I was able to provide some additional insight into your diagnosis as I can in this situation. I hope you are able to reach a final diagnosis with your treating physician, but again, I do agree that endometrial cancer is unlikely given your test results so far, and infection is a more likely etiology.
Sincerely, Dr. Brown
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Above answer was peer-reviewed by :
Dr. Sonia Raina
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