Abnormal Uterine Ultrasound Results

What Does an Abnormal Uterine Ultrasound Result Actually Mean?

An abnormal uterine ultrasound result can mean many things, depending on what it reveals. In general, it means the ultrasound picture of your uterus doesn’t look like what your doctor expected. An ultrasound scan uses sound waves to draw a rough image. Shapes and shadows appear on the film or the computer screen, but the image can’t show what’s causing those abnormal shapes or shadows.

A radiologist or doctor reads your abnormal report for signs of thickened or uneven tissues, usually measured in millimeters. Your doctor may not know what the results really mean because ultrasound images are consistently low-resolution. An ultrasound compared to a hysteroscopy is a rough pencil drawing compared to a detailed photograph. That difference is not only due to the technology used, as an ultrasound looks at your uterus from the outside, while a hysteroscopy provides real-time images from within.

An unusual ultrasound result signals an abnormality worth double-checking, but it’s not a diagnosis or a treatment. To reach a diagnosis, you need a hysteroscopy specialist to get a better look. At Hysteroscopy Center of New York, Felix Cohen, MD, FACOG, uses an advanced, minimally invasive hysteroscopy procedure to view your uterine cavity more directly.

Why Did My Ultrasound Result Lead to a Follow-Up Hysteroscopy?

A follow-up hysteroscopy takes the question your scan raised and gives you an answer about what’s really going on. Dr. Cohen uses the procedure to see exactly what’s inside your uterus. Being referred by your primary care doctor or general gynecologist doesn’t mean your health or fertility is in danger. It means your doctor wants to be sure.

“When I look inside your uterus with the camera, I see the exact thing your ultrasound scan revealed,” says Dr. Cohen. “Suddenly, we’re dealing with a fact, not a worry. Once I diagnose it, we can create a treatment plan. In fact, sometimes, I can even treat it right there and then.”

How Does Dr. Cohen Perform My Follow-Up Hysteroscopy?

A NYC board-certified gynecologist at Hysteroscopy Center New York inserts a thin, lighted scope, the hysteroscope, through your vagina, past your cervix and into your uterus. There are no incisions and no stitches. A small amount of sterile saline flows through the scope to expand your uterus a little so the view is clear. Then the doctor can find the spot that showed up on the ultrasound.

Your procedure takes 10 to 30 minutes. You stay awake for this office procedure. Since it’s an outpatient procedure, you most likely head home later the same day. You must schedule your appointment for the days right after your period, when the inside of your uterus is easiest to see.

Dr. Cohen adds: “You can watch the screen with me if you’d like. I’ll talk you through what I find as I go. The process feels like a normal gynecological exam.”

Which Abnormal Ultrasound Findings Point to a Follow-Up Hysteroscopy?

A thick uterine lining is a common reason for a follow-up hysteroscopy. The American College of Obstetricians and Gynecologists treats a lining of four millimeters or less as an indication that there’s a greater than 99 percent chance no cancer is present. A thicker reading requires a second look.

Several abnormal uterine ultrasound findings lead your doctor to recommend a follow-up test. Common findings that may trigger this next step include:

• A thick or uneven uterine lining that needs a closer look than an ultrasound can provide
• Endometrial polypsWhich are small growths that can cause bleeding between periods
• FibroidsThat press into your uterine wall, changing the thickness or shape of your uterine wall
• Intrauterine adhesionsOr scar tissue left from an old procedure or infection
• Retained products of conceptionWhich is leftover tissue after a pregnancy or miscarriage
• Uterine septumA congenital wall of tissue splitting your uterus fully or partially
• Embedded or lost IUDThat’s drifted out of place

Why Can’t My Ultrasound Provide an Answer by Itself?

An abnormal uterine ultrasound provides only a good starting point. It misses color, texture and fine detail. A direct office hysteroscopy fills in what the scan didn’t show, including:

• Whether your abnormal ultrasound spot is a polyp, a fibroid or simple thickening
• The true color and surface of your uterine lining, up close
• A tiny problem hiding behind a normal-looking measurement
• The exact place to take a sample, if one is needed

Hysteroscopy is a powerful diagnostic tool. Research suggests a hysteroscopy spots up to 19 percent more detail inside your uterus than an ultrasound scan catches. For postmenopausal bleeding, ACOG now advises pairing an ultrasound with a tissue sample.

What Happens if My Abnormal Ultrasound Shows That I Need Treatment?

An abnormal uterine ultrasound finding often leads to a follow-up hysteroscopy. If the second test reveals a need for treatment, it can be accomplished right away. Dr. Cohen uses the see-and-treat approach for issues, using small tools that go through the same scope he’s already using. Some of the problems that can be treated in that same session include:

• Removing a growth your ultrasound picked up
• A hysteroscopic myomectomy to shave down a fibroid that pushed into an open space
• Endometrial ablation, to address heavy bleeding that nothing else has stopped, if you’re done having children
• Taking a small tissue sample for lab testing

“A hysteroscopy works as both a diagnostic tool and, if needed, an operative tool for certain conditions,” says Dr. Cohen. “If I can safely address the issue immediately, there’s no need for a second procedure.”

How Soon Should I Schedule a Hysteroscopy After an Abnormal Scan?

Your doctor or general gynecologist recommends scheduling your follow-up hysteroscopy as soon as it’s convenient for you. An abnormal scan requires a definitive test, although you must wait a few days after your period. Dr. Cohen keeps wait times short with three office locations in New York City. Reasons to book sooner rather than later include:

• Getting quick answers so you stop worrying about the abnormal scan
• Abnormal uterine bleedingStopping abnormal uterine bleeding that keeps coming back
• Uterine abnormalities that may be affecting your fertilityClearing uterine abnormalities that may be affecting your fertility
• Out-of-town patientsTreating out-of-town patients who want a diagnosis and treatment in one trip

Most findings reveal nothing serious. But serious health issues respond to treatment better when you catch them early. Women fly in from Canada or other states just to see Dr. Cohen to get a follow-up hysteroscope. When you want an expert in the procedure, visit Hysteroscopy Center of New York.

Frequently Asked Questions (FAQs) about Abnormal Uterine Ultrasound Results