1. < Gynecologic Cancers

Endometrial Ultrasound findings and next step suggestions

Posted by beebe @beebe, 6 days ago

Ten years post menopause I noticed mild vaginal bleeding and contacted my primary care physician. She ordered a pelvic and transvaginal ultrasound ( I drank 5 cups of water in 1/2 hour, waited 1/2 hour, and then had the ultrasound; no peeing allowed before the ultrasound). The results are listed below:

OVARIES: Right was normal could not see left ovary due to gas? Should I insist the left ovary be checked out with further testing.
ENDOMETRIUM: markedly thickened and measures 2.3 cm. Careful follow-up is recommended.
ENDOMETRIAL STRIPE: markedly thickened. This finding is consistent with endometrial hyperplasia or neoplasia. Careful follow-up is recommended.

What does the pathologist mean by "careful follow-up". Should I expect to be referred for a Hysteroscopic examination after I see the gynecologist in January (yes, that is the soonest I could get in and she is a Nurse Practitioner so may not do the Hysteroscope procedure).

What are the medical procedural steps I should request/expect to get a reliable diagnosis?
I have been using a vaginal estriol cream for atrophy/extreme dryness. Should I discontinue use of it while I wait for a diagnosis? My Doctor thinks it is fine to continue with it. I am thinking of cutting the dose in half just to be cautious or may find a substitute and discontinue it altogether. Research shows it does not contribute to endometrial cancer but I wonder.
Any thoughts on how I should proceed would be greatly appreciated.

Interested in more discussions like this? Go to the Gynecologic Cancers Support Group.

beebe | @beebe | 13 hours ago
In reply to @naturegirl5 "@beebe I'd wait about 5 office days. So, I would call the hospital on Wednesday, November..." + (show)
@naturegirl5

@beebe I'd wait about 5 office days. So, I would call the hospital on Wednesday, November 20. That should give them plenty of time to process your referral.

Jump to this post

Helen, thank you for the feedback. I will follow your recommendation and wait until next Wednesday. In the meantime meditate to distract my busy mind:)

REPLY
lilacs777 | @lilacs777 | 10 hours ago
In reply to @beebe "Went to my follow-up pelvic scan appointment with the gynecologist nurse practitioner yesterday afternoon. We discussed..." + (show)
@beebe

Went to my follow-up pelvic scan appointment with the gynecologist nurse practitioner yesterday afternoon. We discussed my ultrasound and then she said "Lets take a sample!". I replied "what do you mean?" "She replied, We'll see if we can stretch you enough to get a good view and sample". Sounds like fun, right? "
I, then told asked her if a hysteroscopy wouldn't be more accurate, she agreed and referred me to there hysteroscopy clinic. I asked to be referred to the gyno oncologist for the procedure but that is not allowed without a dx.
So unless I want to try to find a gyno oncologist outside of my healthcare system I will have a hospital preformed hysteroscopy.
She did comment that there is a shortage of IV solution so she did not know if the appointments were backed up due to that issue. Can't they do the procedure with some type of local anthestics that don't require IV drugs?

Jump to this post

interesting.... I just had a procedure w/IV and no one had mentioned anything about any relevant drug shortages. They can do an 'in office' type hysteroscopy with minimal / local anesthetic which is of course better than blind sampling, but they can't use the larger scope they would use if you were sedated. The larger scope, from my understanding, gives them a better ability to see and look around in the lining, but its much too painful for it to be done when you're awake.

REPLY
1 reply
beebe | @beebe | 9 hours ago
In reply to @lilacs777 "interesting.... I just had a procedure w/IV and no one had mentioned anything about any relevant..." + (show)
@lilacs777

interesting.... I just had a procedure w/IV and no one had mentioned anything about any relevant drug shortages. They can do an 'in office' type hysteroscopy with minimal / local anesthetic which is of course better than blind sampling, but they can't use the larger scope they would use if you were sedated. The larger scope, from my understanding, gives them a better ability to see and look around in the lining, but its much too painful for it to be done when you're awake.

Jump to this post

An IV manufacturing plant was damaged in Hurricane Helene causing a shortage of the solution but I just recently read that hospitals are changing how they use the solution, using smaller bags and injecting directly some medications instead of administering via IV. The gynecologist who saw me was a Nurse Practitioner with 1 year experience under her belt and she may not be trained to preform the "in office" type hysteroscopy so instead referred me for the hospital procedure. Thinking about the appointment she seemed in a hurry even though I was the last patient of the day and did not give me the opportunity to ask all of the questions I otherwise would have.
Thanks for your input, I will ask the RN when I get the scheduling call which type I am getting.

REPLY
View MoreView Less
Please sign in or register to post a reply.