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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Advised To Insert Mirena Due To Bleeding, Removed And Still Bleeding. Pelvic Ultrasound Done, Findings?

I am 34 years old. Due to bleeding, doctor has advised me to insert Mirena, after 4 year & 6 months, when doctor out the Mirena, heavy bleeding is there. In my TVS pelvic ultrasound following findings are there :
Uterus is bulky in size retroverted. Uterus meassure 8.7x4.7x4.0 cms. Myometrial echoes are nohomegenous. There is a posterior wall myometrial mass of 8 mm. Endometrial echoes are normal. Endometrial thickness is 7 mm. There is no fluid collection in uterine cavity.
cervix is bulky
Both adnexae are clear
Both ovaries are normal in size.
There is no retroperitioneal or mesenteric lymphadenopathy.
There is minimal free fluid cul de sac.

OPINION :
1. NONHOMOGENOUS MYOMETRIUM ? ADENOMYOSIS WITH SMALL POSTERIOR WALL FIBROID UTERUS.
2. PELVIC INFLAMMATORY DISEASE.

Please advice me, what is the problem & what should I Do?
What are the findings in my ultrasound in general words ?
Please help.
posted on Sun, 31 Mar 2013
Twitter Fri, 7 Jun 2013 Answered on
Twitter Fri, 7 Jun 2013 Last reviewed on
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Radiologist,  's  Response
Hi,
1. Myometrium is the wall of uterus. Generally it is expected to be uniform or homogeneous but in your case it is mentioned as heterogeneous or non uniform. There is also mention of an 8 mm mass in posterior wall of uterus. In simple words there is gland tissue in the uterus wall which is normally devoid of such tissue with the doubtful presence of a small (really small 8 mm) lump beside it.
2. Minimal free fluid in cul de sac - pelvi inflammatory disease: There is some fluid in the space behind your uterus. While this copuld also be normal (upto 5ml), if patient is clinically symptomatic for pelvic infetion and quantity is more, a diagnosis in favour of local infeaction around the uterus is made.
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Advised To Insert Mirena Due To Bleeding, Removed And Still Bleeding. Pelvic Ultrasound Done, Findings?

Hi, 1. Myometrium is the wall of uterus. Generally it is expected to be uniform or homogeneous but in your case it is mentioned as heterogeneous or non uniform. There is also mention of an 8 mm mass in posterior wall of uterus. In simple words there is gland tissue in the uterus wall which is normally devoid of such tissue with the doubtful presence of a small (really small 8 mm) lump beside it. 2. Minimal free fluid in cul de sac - pelvi inflammatory disease: There is some fluid in the space behind your uterus. While this copuld also be normal (upto 5ml), if patient is clinically symptomatic for pelvic infetion and quantity is more, a diagnosis in favour of local infeaction around the uterus is made.