Guest guest Posted March 26, 2002 Report Share Posted March 26, 2002 Hi All, Well, my doc still hasn't called (hmmmm) but I called up the hospital medical records department and asked for a copy of the report. They said 3 to 5 days, but then I outright begged! and they said " ok, give us an hour and come get it " . So, I ran right out and got it. I don't understand it all, but enough to say that they think it's a septum. Can anyone help me understand it better? I've quoted it below: " Findings: As seen on the HSG of 2/21, there is a duplication of the endometrial cavities down to the internal os. On the MRI, there is a triangular shaped septum between the two endometrial cavities. Portions of it are iso-intense to myometrium. Centrally it is probably somewhat fibrous and lower signal intensity than myometrium. No significant indentation of the external contour of the uterine fundus is seen. The left ovary measures 3 cm in maximal dimension, and the right 4 cm. There is a large amount of free fluid in the cul-de-sac perhaps related to ovulation. Impression: 1) there is a septate uterus with a broad septum between two endometrial cavities without significant notching of the external contour of the myometrium. 2) There is a large amount of free fluid perhpas related to ovulation " I take this to mean I have a big septum, with parts of it looking like normal, uterine wall tissue and the middle part looking like fiberous, poorly vascularized tissue. I have a normal outer shaped uterus, and for some reason, a lot of fluid between my ovaries and my tubes. Not sure if this fluid is a problem or not. I was not ovulating when I had the MRI done; in fact, I was almost done with menstrating. Did I get this right, expert MAers? My HSG report is as follows: " Findings: Contrast fills a normal lower uterine segment. There is then a bifurcation of the endometrial cavity into two separate and equal sized portions. There is flow of contrast into both fallopian tubes, first the right and then the left. There is free spillage into the peritoneal cavity from both tubes. The uterus itself is somewhat tipped toward the left. Impression: Developmental anomaly of the uterus which by HSG is more suggestive of a bicornuate uterus than a septate uterus. There is however, only 1 cervix visualized. Correlation of finding with an US would also be helpful. If further delineation is clinically indicated, MRI would be reccommended. " Thanks, Jill 23 SU Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 26, 2002 Report Share Posted March 26, 2002 Glad to hear the MRI was clear in its diagnosis of SU. Another example of the inconclusiveness of the HSG...it seems like the HSG diagnosis is always BU and often that is incorrect! The fact that the MRI showed: " No significant indentation of the external contour of >the uterine fundus is seen. " (quoted form your post - the MRI report) means your uterus is not BU, it is in fact septate; a significant indentation of the external fundus would indicate BU. I would be satisfied with this dx based on the MRI. The good thing is that during the lap/hyst, if you do decide to have the septum removed, they will confirm the septum vs. BU. As for the rest of the report, I can't shed any light, sorry. What will the next step be? Surgery? I guess you won't know until you meet with your Doctor. Good luck! SU resected, Bicollis, 1 kidney _________________________________________________________________ Get your FREE download of MSN Explorer at http://explorer.msn.com/intl.asp. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 26, 2002 Report Share Posted March 26, 2002 Glad to hear the MRI was clear in its diagnosis of SU. Another example of the inconclusiveness of the HSG...it seems like the HSG diagnosis is always BU and often that is incorrect! The fact that the MRI showed: " No significant indentation of the external contour of >the uterine fundus is seen. " (quoted form your post - the MRI report) means your uterus is not BU, it is in fact septate; a significant indentation of the external fundus would indicate BU. I would be satisfied with this dx based on the MRI. The good thing is that during the lap/hyst, if you do decide to have the septum removed, they will confirm the septum vs. BU. As for the rest of the report, I can't shed any light, sorry. What will the next step be? Surgery? I guess you won't know until you meet with your Doctor. Good luck! SU resected, Bicollis, 1 kidney _________________________________________________________________ Get your FREE download of MSN Explorer at http://explorer.msn.com/intl.asp. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 26, 2002 Report Share Posted March 26, 2002 > " Findings: As seen on the HSG of 2/21, there is a duplication of > the endometrial cavities down to the internal os. Hey sound like mine. A complete septum, down to the cervical canal. > On the MRI, there > is a triangular shaped septum between the two endometrial cavities. > Portions of it are iso-intense to myometrium. Centrally it is > probably somewhat fibrous and lower signal intensity than > myometrium. The physician is just noting that your septum is less dense than regual uterine muscle and is therefore probably fibrous and a real septum. > No significant indentation of the external contour of > the uterine fundus is seen. That is consistent with a septum. No groove down the midline, or just a slight one. > The left ovary measures 3 cm in maximal > dimension, and the right 4 cm. Them thar's big ovaries! Ovaries typically are lager in younger women, and also when there are many tiny cysts (which may or may not be significant) > There is a large amount of free fluid > in the cul-de-sac perhaps related to ovulation. There is always fluid in the cul-de-sac, but if there is a lot of it, it could be liquor folliculi from the popped follicle. Did you ovulate when the MRI was taken? > Impression: 1) > there is a septate uterus with a broad septum between two endometrial > cavities without significant notching of the external contour of the > myometrium. 2) There is a large amount of free fluid perhpas > related to ovulation " > > I take this to mean I have a big septum, with parts of it looking > like normal, uterine wall tissue and the middle part looking like > fiberous, poorly vascularized tissue. I have a normal outer shaped > uterus, and for some reason, a lot of fluid between my ovaries and my > tubes. Not sure if this fluid is a problem or not. I was not > ovulating when I had the MRI done; in fact, I was almost done with > menstrating. Did I get this right, expert MAers? Ah . . . I should read ahead. Yes, looks as though you got it right. I doubt that fluid in the cul-de-sac is bad. In fact, it could be refluxed menstrual blood. It happens all the time, and even more so in significant MAs. Most septa do have areas of muscle tissue in them, as they are formed from primordial tissue that would have given rise to normal myometrium had the ducts not fused. This muscle tissue can be responsible for bad cramps and unorganized contractions during pregnancy. > > My HSG report is as follows: > > " Findings: Contrast fills a normal lower uterine segment. There is > then a bifurcation of the endometrial cavity into two separate and > equal sized portions. There is flow of contrast into both fallopian > tubes, first the right and then the left. There is free spillage > into the peritoneal cavity from both tubes. The uterus itself is > somewhat tipped toward the left. Impression: Developmental anomaly > of the uterus which by HSG is more suggestive of a bicornuate uterus > than a septate uterus. There is however, only 1 cervix visualized. > Correlation of finding with an US would also be helpful. If further > delineation is clinically indicated, MRI would be reccommended. " The HSG report conflicts with the MRI report in that it says your lower uterine segment does not have a septum, just the upper fundus. So which one is right? Beth SU Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 26, 2002 Report Share Posted March 26, 2002 > " Findings: As seen on the HSG of 2/21, there is a duplication of > the endometrial cavities down to the internal os. Hey sound like mine. A complete septum, down to the cervical canal. > On the MRI, there > is a triangular shaped septum between the two endometrial cavities. > Portions of it are iso-intense to myometrium. Centrally it is > probably somewhat fibrous and lower signal intensity than > myometrium. The physician is just noting that your septum is less dense than regual uterine muscle and is therefore probably fibrous and a real septum. > No significant indentation of the external contour of > the uterine fundus is seen. That is consistent with a septum. No groove down the midline, or just a slight one. > The left ovary measures 3 cm in maximal > dimension, and the right 4 cm. Them thar's big ovaries! Ovaries typically are lager in younger women, and also when there are many tiny cysts (which may or may not be significant) > There is a large amount of free fluid > in the cul-de-sac perhaps related to ovulation. There is always fluid in the cul-de-sac, but if there is a lot of it, it could be liquor folliculi from the popped follicle. Did you ovulate when the MRI was taken? > Impression: 1) > there is a septate uterus with a broad septum between two endometrial > cavities without significant notching of the external contour of the > myometrium. 2) There is a large amount of free fluid perhpas > related to ovulation " > > I take this to mean I have a big septum, with parts of it looking > like normal, uterine wall tissue and the middle part looking like > fiberous, poorly vascularized tissue. I have a normal outer shaped > uterus, and for some reason, a lot of fluid between my ovaries and my > tubes. Not sure if this fluid is a problem or not. I was not > ovulating when I had the MRI done; in fact, I was almost done with > menstrating. Did I get this right, expert MAers? Ah . . . I should read ahead. Yes, looks as though you got it right. I doubt that fluid in the cul-de-sac is bad. In fact, it could be refluxed menstrual blood. It happens all the time, and even more so in significant MAs. Most septa do have areas of muscle tissue in them, as they are formed from primordial tissue that would have given rise to normal myometrium had the ducts not fused. This muscle tissue can be responsible for bad cramps and unorganized contractions during pregnancy. > > My HSG report is as follows: > > " Findings: Contrast fills a normal lower uterine segment. There is > then a bifurcation of the endometrial cavity into two separate and > equal sized portions. There is flow of contrast into both fallopian > tubes, first the right and then the left. There is free spillage > into the peritoneal cavity from both tubes. The uterus itself is > somewhat tipped toward the left. Impression: Developmental anomaly > of the uterus which by HSG is more suggestive of a bicornuate uterus > than a septate uterus. There is however, only 1 cervix visualized. > Correlation of finding with an US would also be helpful. If further > delineation is clinically indicated, MRI would be reccommended. " The HSG report conflicts with the MRI report in that it says your lower uterine segment does not have a septum, just the upper fundus. So which one is right? Beth SU Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 26, 2002 Report Share Posted March 26, 2002 Hi Beth, > Hey sounds like mine. A complete septum, down to the cervical canal. > I think the MRI is right. Not sure why the HSG says I have a normal lower section. The doc said (and she looked at the pictures b/c she performed it) that my uterus has very little common area. A very small lower common area, with the bifurcation starting soon after the os. So, I guess maybe the MRI overestimated a little bit the length; it doesn't actually TOUCH the os. My doc said, nonetheless, it's a very long and very broad septum; so long and broad that she " would have bet on it " from the HSG that it would be BU. I'm getting my films and will look at the HSG myself to see what it looks like. I'll look at the MRI films too, but they are impossible for me to decipher. I agree with you about HSG being pretty useless for the SU vs. BU. I'm a biologist (not human biology, though, so THANKS for explaining all those medical terms to me...), so I searched up on PubMed for clinical studies of MA. There's a study done not too long ago that was to evaluate the effectiveness of HSG for determining SU from BU. There were 36 women, all of whom were dx as BU from HSG. Upon lap/hyst , 32 out of 36 really had a septum. The article concludes that HSG is functionally useless for this particular distinction. > Them thar's big ovaries! Ovaries typically are lager in younger > women, and also when there are many tiny cysts (which may or may not > be significant) I do get a lot of pain with ovulation, and it lasts 2 days, and it comes the two days before my temp rise. It is always one sided, and often alternates sides each month, although, sometimes I go two months on the right. Never two months on the left. Hm. My left one is smaller too. And my cramps are always horrid. I take Lodine, a perscription painkiller, for them, and go see an accupuncturist the few days before cd 1 so she can " open up my blood energy " or something like that. It really works to help with the pain. Sometimes the accu. works so well I only need Advil, not Lodine. Maybe I do have cysts that burst. I hope this isn't a problem. I asked my doc about the fluid and she said it was likely no big deal, and anyway, MRI isn't the ideal tool for diagnosing such a thing. I'll talk to the RE about it when I see him. > > There is a large amount of free fluid > > in the cul-de-sac perhaps related to ovulation. > > There is always fluid in the cul-de-sac, but if there is a lot of it, > it could be liquor folliculi from the popped follicle. Did you > ovulate when the MRI was taken? > > I doubt that fluid in the cul-de-sac is bad. In fact, it could be > refluxed menstrual blood. It happens all the time, and even more so > in significant MAs. > > Most septa do have areas of muscle tissue in them, as they are formed > from primordial tissue that would have given rise to normal > myometrium had the ducts not fused. This muscle tissue can be > responsible for bad cramps and unorganized contractions during > pregnancy. > > > > > The HSG report conflicts with the MRI report in that it says your > lower uterine segment does not have a septum, just the upper fundus. > So which one is right? I think it's almost a complete septum but not quite, from what doc says. Will look at the films myself, and will get a better idea when I get a lap/hyst from the RE. I assume he'll order one up, and if it's indeed a SU, he'll remove it at the same time. Thanks for helping me intepret some of this stuff. I'm gonna tell my husand I've got " big nads " . He'll get a kick out of THAT ONE!!! :) I hope it won't turn out a problem. Oh well, I'll ask mr. hot shot harvard RE. Wow, if I can get in the office next week, and then maybe I'll get my lap/hyst in a month or so, then two months recovery (right??) .... I could start trying maybe by July !!! I wanted to start now, but I'm glad I found out about all this. Maybe prevent one or more m/c. Jill 23 SU Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 26, 2002 Report Share Posted March 26, 2002 Hi Beth, > Hey sounds like mine. A complete septum, down to the cervical canal. > I think the MRI is right. Not sure why the HSG says I have a normal lower section. The doc said (and she looked at the pictures b/c she performed it) that my uterus has very little common area. A very small lower common area, with the bifurcation starting soon after the os. So, I guess maybe the MRI overestimated a little bit the length; it doesn't actually TOUCH the os. My doc said, nonetheless, it's a very long and very broad septum; so long and broad that she " would have bet on it " from the HSG that it would be BU. I'm getting my films and will look at the HSG myself to see what it looks like. I'll look at the MRI films too, but they are impossible for me to decipher. I agree with you about HSG being pretty useless for the SU vs. BU. I'm a biologist (not human biology, though, so THANKS for explaining all those medical terms to me...), so I searched up on PubMed for clinical studies of MA. There's a study done not too long ago that was to evaluate the effectiveness of HSG for determining SU from BU. There were 36 women, all of whom were dx as BU from HSG. Upon lap/hyst , 32 out of 36 really had a septum. The article concludes that HSG is functionally useless for this particular distinction. > Them thar's big ovaries! Ovaries typically are lager in younger > women, and also when there are many tiny cysts (which may or may not > be significant) I do get a lot of pain with ovulation, and it lasts 2 days, and it comes the two days before my temp rise. It is always one sided, and often alternates sides each month, although, sometimes I go two months on the right. Never two months on the left. Hm. My left one is smaller too. And my cramps are always horrid. I take Lodine, a perscription painkiller, for them, and go see an accupuncturist the few days before cd 1 so she can " open up my blood energy " or something like that. It really works to help with the pain. Sometimes the accu. works so well I only need Advil, not Lodine. Maybe I do have cysts that burst. I hope this isn't a problem. I asked my doc about the fluid and she said it was likely no big deal, and anyway, MRI isn't the ideal tool for diagnosing such a thing. I'll talk to the RE about it when I see him. > > There is a large amount of free fluid > > in the cul-de-sac perhaps related to ovulation. > > There is always fluid in the cul-de-sac, but if there is a lot of it, > it could be liquor folliculi from the popped follicle. Did you > ovulate when the MRI was taken? > > I doubt that fluid in the cul-de-sac is bad. In fact, it could be > refluxed menstrual blood. It happens all the time, and even more so > in significant MAs. > > Most septa do have areas of muscle tissue in them, as they are formed > from primordial tissue that would have given rise to normal > myometrium had the ducts not fused. This muscle tissue can be > responsible for bad cramps and unorganized contractions during > pregnancy. > > > > > The HSG report conflicts with the MRI report in that it says your > lower uterine segment does not have a septum, just the upper fundus. > So which one is right? I think it's almost a complete septum but not quite, from what doc says. Will look at the films myself, and will get a better idea when I get a lap/hyst from the RE. I assume he'll order one up, and if it's indeed a SU, he'll remove it at the same time. Thanks for helping me intepret some of this stuff. I'm gonna tell my husand I've got " big nads " . He'll get a kick out of THAT ONE!!! :) I hope it won't turn out a problem. Oh well, I'll ask mr. hot shot harvard RE. Wow, if I can get in the office next week, and then maybe I'll get my lap/hyst in a month or so, then two months recovery (right??) .... I could start trying maybe by July !!! I wanted to start now, but I'm glad I found out about all this. Maybe prevent one or more m/c. Jill 23 SU Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 27, 2002 Report Share Posted March 27, 2002 >Thanks for helping me intepret some of this stuff. I'm gonna tell my >husand I've got " big nads " . He'll get a kick out of THAT >ONE!!! :) LOL! That cracks me up! >Wow, if I can get in the office next week, and then maybe I'll get my >lap/hyst in a month or so, then two months recovery (right??) .... I >could start trying maybe by July !!! I wanted to start now, but I'm >glad I found out about all this. Maybe prevent one or more m/c. You're right, you could be back in the game with a remodeled, better-than-ever uterus by summertime! Good Luck! UD Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 27, 2002 Report Share Posted March 27, 2002 >Thanks for helping me intepret some of this stuff. I'm gonna tell my >husand I've got " big nads " . He'll get a kick out of THAT >ONE!!! :) LOL! That cracks me up! >Wow, if I can get in the office next week, and then maybe I'll get my >lap/hyst in a month or so, then two months recovery (right??) .... I >could start trying maybe by July !!! I wanted to start now, but I'm >glad I found out about all this. Maybe prevent one or more m/c. You're right, you could be back in the game with a remodeled, better-than-ever uterus by summertime! Good Luck! UD Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 27, 2002 Report Share Posted March 27, 2002 > os. So, I guess maybe the MRI overestimated a little bit the length; > it doesn't actually TOUCH the os. Ah . . . mine actually did, making a double internal os. On the HSG you can tell this because I have cervical crypts (little dye-filled folds and sacs) that show up more than most women's do. So you can see where the cervix ends. > There were 36 women, all of whom were dx as BU from HSG. Upon > lap/hyst , 32 out of 36 really had a septum. The article concludes > that HSG is functionally useless for this particular distinction. Amen, sister. I was also misdiagnosed as a BU from HSG. > I'm gonna tell my > husand I've got " big nads " . He'll get a kick out of THAT > ONE!!! :) LMAO! You're a macho dudette. :-) Beth SU Quote Link to comment Share on other sites More sharing options...
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