What Does The Absence Of Adnexal Mass And Free Fluid In Douglas Pouch Indicate?

Bulky anteverted uterus 94 x 56 x 49mm with a 5.9mm thick endometrium. At least hypoechoic nodular foci in the uterine wall, larger 19mm in the left fundal region and in the posterior wall 13 and 11mm respectively seen. The ovaries could not be identified. No adnexal mass or free fluid in the pouch of Douglas. Intramural myomas.