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Discussion in 'All Categories' started by Rukhsana - Nov 28th, 2015 5:05 pm.
Dear Sir

My Clinical Information: Pain in lower abdomen for 1 ½ year. No pregnancy.
History: 39 years old Mrs. Sultana Jannat, married for 8 years with regular cycles, No children, Weight- 65.5 kg, Height- 155 cm, B/P- 100/70. P-0 +1, ectopic pregnancy managed by Laparotomy (7/5/2015) followed by right sided salpingectomy. History of Laparoscopy (13/6/2014) bilateral patent tubes/endometriosis and three cycles of COS+IUI.
Family History: History of 2 elder sisters fibroid. Uterus of one of them removed due to fibroid.
Investigations Reports (Attached for your kind perusal):
Transvaginal sonogram (07 Nov, 2015): The uterus is normal in size (4.2 3cm in AP dimesion and anteverted in position). A well defined rounded hypoechoic area is seen measuring about 32mm x 30 mm in posterior wall of fundus causing indentation & displacement of the endometrium anteriorly in that region. Otherwise rest of the endometrial echo is uniform & thickness is about 6.3 mm. Cervix is Normal in size & echotexture. A thin wall clear cystic area measuring about 75.2 mm x 37.8 mm x 35.3 mm, vol- 52.5 cc is noted in right adnexal region. Otherwise right & left ovary show few small follicles. Cul-de sac: Free of collection.
MRI Report of Pelvis (29 Oct, 2015): Uterus is normal in size 8.8 x 4.7cm in size. 35 x 27 mm uterine myoma in the posterior fundus. The mass is causing anterior displacement of endo-metrium. Mild collection is noted in uterine cavity. Left overy is unremarkable. Right overy is not visualized (operated). The pelvic inlet appears normal, with normal configuration of the iliac wings and iliopsoas muscles. No abnormalities are found in imagined bowel structures an there are no signs of wall thickening or mass lesions.
USG of Pelvis (TA) on 22 Aug, 2015: The uterus is anteverted in position. Normal in size (L-8.9 cm, W- 5.0 cm, AP-4.2 cm). The myometrium is homogeneous texture with presence of a subendometrial myoma of size 31 x 23 mm seen along central region of the uterus. Endometrium is 5.9 mm in thickness and has high echo. The right ovary is 8.5 cm and left ovary is 2.6 cm (range 1.8-5.7 cm). The right ovary is moderately enlarged in size and the left ovary is normal in size. No mass or cysts seen in the tubo ovarian areas.
Management Plan:
Under the above circumstances we solicit your kind advice & suggestions.
Plz. Plz. reply.
Please your kind advice will be highly appreciated. Waiting for your early reply.
With kind regards
re: Myoma by Dr R K Mishra - Dec 2nd, 2015 10:25 pm
Dr R K Mishra
Dr R K Mishra
Dear Madam

generally small size myoma is not a cause of infertility. If the myoma's are asymptomatic it is not necessary to remove it. You should consult a infertility specialist to diagnose the cause of infertility and probably you can try IVF.
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