significant free fluid in pouch of douglas

[brontec]

Hello

I have been suffering with terrible pain in my right side lower groin. I described to the Gap that it feels like I am carrying something or a pressure in lower back and at times causes my right thigh to actually go numb. I went to the GP and was referred for an ultrasound for a hernia. No hernia found. I went for a private ultrasound and it was noted that I have significant free fluid in my pouch of Douglas? Apparently 17.58ml.

The sonographer also asked if anyone had ever said anything about adenmyosis to me before as I had eveidence of this on the scan in posterior of my uterus. I have had pain and cramping and heavy bleeding and am now in menopause. I’ve been on HRT for 9 years. The pain in lower right side is getting too much and consistent. Oh, and also I’ve had 4 uti infections and 4 rounds of antibiotics in past 8 months. What should I be asking the GP for. I just want a hysterectomy and to be done with this. My mum passed away with very sudden onset and fast growing endometrial cancer in august 2022. She was diagnosed in July 2022 and died 9 weeks later. What can I ask for to help with this? Should the fluid be drained and can I ask for a laparoscopy to determine adenmyosis and if the fluid is infected.

[Marcia71]

It may well be adenomyosis and also it is possible to be endometriosis so asking for an up to date scan - transvaginal ultrasound or mri would be a good next step to see what is going on inside. A referral to a gynae that has the extra training in endo (called a special interest) would also be sensible as they can then assess and discuss your options. With adenomyosis a hysterectomy is a cure and removes the uterus, but endo could keep growing even without ovaries so it is important to find out about endo and have any removed at the time of hysterectomy to ensure you don't suffer with pain after the operation.

[brontec in reply to Marcia71]

Thanks for this. The gynaecologist from nhs is insisting that hysterectomy is not needed! He is suggesting mirena coil! I don’t want this coil. My mother had one and neglected to get it removed and so I have a real mental blockage towards this….can you help me with what I can say to make my case and stop them from insisting on a coil?

[Marcia71 in reply to brontec]

I would say to GP you have had a scan that is showing adenomyosis that’s makes sense to you for pain and bleeding. And you want to be referred to a gynae to discuss hysterectomy. I’d get gp to refer you to a different gynae and if they won’t say to gynae now you know you have adenomyosis (scan is best way to see it and can only be confirmed after hysterectomy and a biopsy of the uterus once removed ) you want to see gynae with extra training in endo (adeno comes under endo usually). And say you have a right to refuse any hormonal treatment and you don’t want the coil as you don’t think the hormones will help you overall. Both mentally and physically so you don’t want it.

[Endofitall]

MRI will be better to pick up adenomyosis but this will usually be done via Gynae rather than direct by GP.

I think with your age and the pain you’re describing and your family history, a pelvic ultrasound, a blood test for CA125 (ovarian marker) and referral to gynae is more than warranted.

[brontec in reply to Endofitall]

Thank you so much. This is really helpful and just so good to be heard by empathic ears. The GP is fobbing me off and saying today that this might not be any of these things but will refer me and see what gynaecologist says… let’s see. I’ve found a specialist that I want to be referred to via bupa as I have given up with the dismissive attitude…