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What Does This Ultrasound Report Indicate?

Posted on Thu, 17 Nov 2016

Question: I had a d&c Sept 20 and large cysts formed within 5 days and caused ovarian torsion and I had emergency surgery to remove my left ovary. It's a month later and ultrasound showed hypervascular myometrium in my uterus as well some possible "contents". The doctor said this was not leftover from d&c since I've had no bleeding. But I did get a bad uti a week ago that caused me to go back on antibiotics and I have a white discharge from my urethra hole above my vagina. Should I get a second opinion or is a hypervascular uterus with possible "contents" really nothing to worry about?

Answered by Dr. Deepti Verma (13 minutes later)

Brief Answer:
Second opinion recommended

Detailed Answer:
Hi dear,
I have gone through your question and understand your concerns.
Hypervascular myometrium with possible contents can be present in retained products of conception or gestational trophoblastic disease.
In both these conditions, bleeding may not occur.
However, the exact diagnosis should be made by proper examination and investigations, including MRI, and treatment should be done accordingly.
I will suggest you to get a second opinion.
Hope you found the answer helpful.
Regards
Dr Deepti Verma
OBGYN

Above answer was peer-reviewed by : Dr. Veerisetty Shyamkumar

Follow up: Dr. Deepti Verma (2 days later)

I have two questions: 1) Could the hypervascular myometrium of my enlarged uterus be due to not having had a period to shed the lining since July? I was pregnant, miscarriage d&c, ovarian torsion and removal surgery, then put on birth control a week ago. I should have a period in about two weeks hopefully when on the placebo bc pills week.

2) I have a rash that's newly developed of red bumps around the three incision sites on my abdomen and in between are a few bumps where there was no incision. This has started a month since my last surgery. My ob/gyn today said she didn't know what it was and took no swab to test in the lab. I had two infections since the surgery and finished antibiotics Friday. Could it be another new bacterial infection on the outside now?

Answered by Dr. Deepti Verma (19 hours later)

Brief Answer:
Unlikely due to delayed periods

Detailed Answer:
Hi dear,
1. Hypervascular myometrium is unlikely due to not having periods after D & C.
However, a repeat ultrasound should be done after the periods to confirm.
2. Rash around the infection site is mostly due to the bacterial infection. Antibiotics should be taken according to the report of the swab.
Hope you found the answer helpful.
Regards
Dr Deepti Verma

Above answer was peer-reviewed by : Dr. Nagamani Ng

Follow up: Dr. Deepti Verma (1 hour later)

Thank you very much Dr. XXXXXXX I am having a lot of stabbing and cramping pain in my uterus area. But, my ob/gyn yesterday said she thinks it's because I will have my first period since surgeries. Could there be a more life-threatening or other reason for the pain? Should I go to an ER or Urgent Care? I have an appointment for a second opinion doctor on Thursday but am a little scared to wait if it could be something else. My CT scan and ultrasound showed the hyper vascular myometrium and enlarged uterus but the ER doctor then told me I could go home but she wasn't sure what it was. I didn't have the stabbing pain in my uterus then though. It started a few days ago. Should I just wait for a period to hopefully come??

Answered by Dr. Deepti Verma (23 hours later)

Brief Answer:
Can wait

Detailed Answer:
Hi dear, you can wait till the doctor's appointment.
There is no urgency if you are not having any heavy bleeding or severe pain.
Regards
Dr Deepti Verma

Above answer was peer-reviewed by : Dr. Nagamani Ng

Follow up: Dr. Deepti Verma (23 hours later)

The o!/gyn second opinion doctor said that my hcg was 11,000 still at 5 weeks later. She recommends a second d&c but I'm extremely concerned because she confirmed my uterus is extremely highly vascular all over. I read Doing a d&c on a highly vascular uterus with retained products of conception can lead to life-threatening massive hemorrhaging. But a methotrexate injection can help reduce hypevasvularity instead. Thoughts?

Answered by Dr. Deepti Verma (12 hours later)

Brief Answer:
Gestational trophoblastic disease likely

Detailed Answer:
Hi dear, increased vascularity of the endometrium and increased beta hCG levels are indicative of gestational trophoblastic disease.
D & C is not advisable in this scenario due to the risk of excessive bleeding.
You should be given methotrexate after complete work-up, and serial beta hCG values should be done to assess the response to treatment.
Regards
Dr Deepti Verma

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Above answer was peer-reviewed by : Dr. Raju A.T