Anechogenic mass in the uterus

An anechoic formation in the uterus is a clinical symptom that is detected during ultrasound diagnostics of the uterus and pelvic organs, and this is not a clinical diagnosis. Therefore, you should not worry in case of this diagnosis, but you need to wait for a consultation with a gynecologist and then all doubts will fall into place. It is also not worth "treating" this diagnosis, since it is only a symptom of a certain disease or may even be a physiological condition.

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Causes anechogenic mass in the uterus

First of all, it is necessary to find out the pathogenesis of the development of such an ultrasound symptom as an anechoic formation in the uterus. This is a common sign that is not only detected in the uterine cavity, but can also be detected in the cervical canal, in the ovary, and in the post-uterine space. This term means that this formation does not conduct ultrasound, so on the monitor it looks like a dark homogeneous or heterogeneous spot, which also depends on what is inside. Liquids, blood, and tissue structures conduct ultrasound poorly, so this formation can be anything.

The cause of an anechoic formation in the uterus can be various structures. The simplest and most acceptable physiological option is pregnancy. On the seventh day after fertilization, the fertilized egg, as a result of moving through the tubes, enters the uterine cavity and is implanted in the endometrium with further growth and development. Modern ultrasound transvaginal sensors, which are used in most diagnostic laboratories, allow you to see the fertilized egg no earlier than 3-4 weeks of pregnancy, when it is already of sufficient size with a certain separation ability. In this case, the fertilized egg looks like an anechoic formation in the uterine cavity, which has dimensions of 4-5 millimeters, a homogeneous structure, with a thin shell, oval or round in size. A distinctive feature of such an anechoic formation in the uterus can be considered localization, which allows, taking into account the anamnesis data, to suspect the fertilized egg - this is the corner of the uterus, more often the right, but it can also be the left with a clear attachment to the endometrium. In case of pathological attachment, there may be another localization, but then a clear connection with the "high" endometrium is visible. An anechoic formation in the uterus during pregnancy is a fertilized egg, which confirms the diagnosis and helps to clarify it using anamnesis data.

Another cause of anechoic formation in the uterus may be endometriosis - a disease characterized by the presence of areas of the endometrium outside the uterine cavity or in its cavity itself with constant activity of its function. When localizing foci of endometriosis in the uterine cavity, such areas are visible on ultrasound as anechoic areas of various sizes, they are numerous and located unevenly, against the background of the proliferating endometrium. Their sizes range from 3, 4, 6 millimeters and more, but, as a rule, less than a centimeter. For better diagnostics, it is necessary to conduct repeated studies before and after menstruation, when comparing, you can see distinctive features in the form of an increase or decrease in the size of formations, their blurriness due to the menstrual function of these areas.

An avascular anechoic formation in the uterus is most often a uterine cyst. This is a thin-walled formation that contains fluid inside. The size of a cyst in the uterine cavity can be different - from several millimeters to several centimeters. By appearance, cysts in the uterine cavity can be retention, endometrioid, dermoid, localization can be varied. As for the term "avascular", this means that this formation is not supplied with blood. This can be an important diagnostic feature and allows differentiation from other formations.

A common pathology of the female reproductive system in older women is hormone-dependent benign neoplasms - uterine myoma. By structure, this formation can be diffuse and nodular, namely the nodular form of uterine fibroids on ultrasound examination looks like an anechoic formation in the uterus, but unlike a cyst, it is vascularized. When diagnosing a myomatous node, it can be located subserously, submucously and intramurally, and with repeated diagnostics, the formation grows.

Anechoic avascular formations in the cervix are also cysts, more often, given this localization, they are endometrioid. They are especially dangerous, since this localization can be complicated by cyst rupture with bleeding and severe pain.

An anechoic formation behind the uterus is also an important diagnostic sign, since normally the post-uterine space is free without fluid or any formations. This symptom indicates, in most cases, a disrupted ectopic pregnancy such as a ruptured tube or tubal abortion, or a peritoneal ectopic pregnancy, when the fertilized egg attaches to the peritoneum. This is an important and dangerous symptom that requires immediate treatment tactics.

It has already been said that such a formation can be localized outside the uterine cavity. What does an anechoic formation in the uterine appendages mean? This is the same ultrasound symptom that most often indicates an ovarian cyst or cystoma. It can also be caused by an ovarian or fimbrial pregnancy, which is not so common. Even more dangerous can be a malignant ovarian neoplasm - and all this looks like an anechoic formation on ultrasound, so diagnostics should be carried out carefully.

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Symptoms anechogenic mass in the uterus

Given the huge number of causes, the symptoms of the course of an anechoic formation in the uterus can be varied, so it is necessary to analyze the clinical features of each case.

The first signs of diseases are often not expressed, since the size of the formation is small and for a long time may not pose any threat; moreover, they may be detected by chance.

The symptoms of a fertilized egg as an anechoic formation in the uterine cavity are very simple, since these are all possible and final signs of pregnancy. Firstly, this is a delay in menstruation, which can be accompanied by early gestosis in the form of nausea, vomiting, asthenic signs. A qualitative test for chorionic gonadotropin is positive. During examination, other signs of pregnancy are revealed.

Endometriosis, as a cause of anechoic formation in the uterine cavity, often manifests itself in a very characteristic way. The main symptom is pain in the lower abdomen, which appears a week or two before menstruation and continues after it, while bloody discharge is also observed even before the expected menstruation. When the endometrioid cyst is localized in the cervix, the clinical picture can be revealed by profuse bleeding in the event of its rupture.

A uterine cavity cyst often does not manifest itself with any changes, only in the case of infertility, it can be the cause of this disease due to the violation of the implantation of the egg. When a cyst breaks through with its subsequent suppuration, inflammatory manifestations are possible in the form of pain in the lower abdomen, purulent discharge, increased body temperature, changes in blood tests.

An anechoic formation in the form of a myomatous node does not reveal any clinical symptoms until it gains significant size or until complications appear. In this case, there may be unpleasant sensations during sexual intercourse or dyspareunia. The appearance of complications will be characterized by symptoms of acute abdomen with necrosis of this node, its "birth" or torsion of its stalk.

An anechoic formation behind the uterus, if it is a disturbed uterine pregnancy, will have a vivid clinical picture in the form of acute abdominal pain, pronounced symptoms of blood loss or hemorrhagic shock, as well as a high level of chorionic gonadotropin when it is quantitatively determined. During examination, there will be signs of acute pain in the posterior vaginal fornix with its tension.

Appendage cysts, as an anechoic formation, can have various signs. Basically, the course of cysts is asymptomatic, but everything depends on the localization. Ovarian cysts can disrupt the normal ovariomenstrual cycle with a delay in menstruation. Endometrial ovarian cysts, which are characterized by small blood discharges like the uterine endometrium, cause severe pain in the lower abdomen before and after menstruation when irritating the peritoneum.

These are the main symptoms that can be identified at the stage of primary diagnosis, and to establish an accurate diagnosis, a comprehensive examination of the woman with careful differential diagnosis is necessary.

Complications and consequences

The main complications that may occur with formations in the uterus are bleeding with an endometrioid cyst, which requires immediate medical action, infection of a cervical cyst that has already burst, which requires anti-inflammatory therapy. Complications may also occur in the form of the "birth" of a myomatous node located submucosally or its necrosis, which is accompanied by symptoms of an acute abdomen and requires immediate treatment and timely differential diagnostics.

The consequence of an anechoic formation caused by an ectopic pregnancy may be the formation of adhesions or resection of the tube as a result of surgery.

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Diagnostics anechogenic mass in the uterus

Of course, the symptom of an anechoic formation in the uterus itself is a clinical sign that requires not only careful diagnostics, but also differential diagnostics in order to determine the correct diagnosis, since the symptom itself has many causes. Therefore, this sign on ultrasound is not a diagnosis, but requires additional diagnostics. The features of this formation are taken into account in terms of localization, clarity of structure, and blood supply.

A very important diagnostic criterion is the anamnesis data. With their help, it is possible to establish a possible pregnancy. In case of a delay in menstruation and an anechoic formation in the uterine cavity in the area of its cusp in the form of a fertilized egg, it is possible to establish a diagnosis of pregnancy with an exact indication of the term. It is necessary to conduct diagnostics with an ectopic pregnancy, then the fertilized egg is outside the uterine cavity, and can be in the retrouterine space. For the purpose of additional diagnostics, among other diagnostic methods, an instrumental examination is carried out in the form of a diagnostic puncture of the posterior vaginal fornix, which allows identifying blood in the puncture in case of an interrupted ectopic pregnancy.

Diagnosis of an anechoic formation in the ovary is sometimes particularly difficult, when an appendage cyst and ovarian ectopic pregnancy can be suspected. Then, along with anamnestic data, it is necessary to conduct a laboratory study of urine or blood with a quantitative determination of chorionic gonadotropin. In the case of an ectopic ovarian or fimbrial pregnancy, this indicator will be significantly increased, and in the case of a cyst, it will be within the normal range.

For additional diagnostics of anechoic formation in the uterus in case of complications or if a malignant process is suspected, other instrumental diagnostic methods can be used, which are more accurate - CT.

Differential diagnosis

In the differential diagnosis of a myomatous node and an endometrioid lesion, which are anechoic in nature on ultrasound, it is sometimes necessary to perform a laparoscopic diagnostic operation, which allows identifying foci of endometriosis in the pelvic organs and ovaries.

One should not forget about a simple diagnostic method, such as examining a woman in mirrors. In this case, an anechoic formation can be palpated with differentiation of a cyst, a myomatous node, which is growing dynamically.

It is also necessary to differentiate an anechoic formation in the uterine cavity from other conditions that can cause this symptom secondarily - these are metastatic foci, foreign bodies.

Treatment anechogenic mass in the uterus

Speaking about the treatment of anechoic formation in the uterus, it should be clearly determined that the treatment of this symptom cannot be carried out until the exact cause and clinical diagnosis are established, therefore the treatment tactics are different and depend on the cause of the disease. There is conservative treatment, which can also be medicinal and folk, and surgical. In each case, there are certain indications for one or another type of treatment.

Conservative drug treatment when determining an anechoic formation in the uterus and appendages is indicated in initial cases as a starting therapy.

Treatment of endometrioid cysts in the uterine cavity, which is accompanied by the symptom of an anechoic formation on ultrasound, involves hormone replacement therapy with progesterone drugs or combined hormonal drugs with a predominant content of progesterone. This allows to reduce the number of foci and their sizes in the uterine cavity. The main drugs used for this are:

1. Marvelon is a combined estrogen-progesterone drug, with a predominant content of progesterone. The action of the drug promotes regression of the endometrioid cyst in the uterine cavity by normal regulation of hormonal levels, which is accompanied by a decrease in the size of the anechoic formation with possible complete regression. The drug is available in tablets of 100 mg and is taken one tablet per day at the same time from the 1st to the 21st day of the cycle. This ensures a constant normal concentration of hormones in the blood. Side effects of the drug are dyspeptic phenomena in the form of nausea, vomiting, discomfort in the mammary glands, allergic phenomena, libido disorders, weight gain due to metabolic disorders. Contraindications for use are acute liver dysfunction, acute cholecystitis, malignant processes of any localization.
2. Duphaston is a single-phase hormonal drug that is a synthetic analogue of natural progesterone. The mechanism of action of this drug, like others, is replacement therapy for insufficiency of the second ovarian phase, which leads to the formation of anechoic formations in the uterine cavity and appendages. The drug is available in the form of tablets of 10 mg, used according to an individual scheme with general dosages in the form of taking 10 mg twice a day from the 5th day of the cycle or from the 11th day of the cycle. The features of the intake are decided by the doctor on an individual basis, since a combination of the drug with estrogen drugs is possible.

Contraindications to the use of the drug are acute liver damage, acute heart failure and lactation. Side effects are allergic manifestations, dyspeptic manifestations in the form of nausea, vomiting, discomfort in the mammary glands, libido disorders, uterine bleeding, requiring a change in dosage.

3. Janine is a combined estrogen-progesterone drug that has the same mechanism of action on anechoic formations in the uterus as the previous hormonal drugs. It is available in the form of pills, the number of which is 21. The drug is taken from the first day of the menstrual cycle. Due to the content of estrogens and progesterone, the drug can regulate any hormonal imbalance. Take one pill per day for 21 days, then take a break for 7 days, then resume taking. Side effects can develop in the form of dyspeptic manifestations, skin allergic reactions, changes in the mammary gland in the form of pain, swelling, as well as bloody uterine discharge. Contraindications to the use of the drug are diabetes mellitus, vascular problems in the form of thrombosis in the anamnesis or thrombophlebitis, migraine.
4. Anteovin is a two-phase combined estrogen-progesterone drug that suppresses the processes of the normal menstrual cycle by regulating hormonal levels. This promotes the regression of anechoic formations in the uterine cavity. The drug is available in the form of tablets, 21 pieces per package. Among them, 11 are white and 10 are pink, according to the difference in composition. Take one tablet from the 5th day of the cycle. Side effects can develop in the form of dyspeptic manifestations, discomfort in the chest and a feeling of tension, heaviness in the chest. Contraindications to taking the drug are diabetes mellitus with vascular disorders, arterial hypertension, varicose veins, and smoking is not recommended while taking this drug.

As for myomatous nodes, the entire treatment strategy here comes down to observing such a patient, with regular examinations and ultrasound monitoring. With further growth of such an anechoic formation or with the appearance of complications, surgical treatment is performed.

Surgical treatment of anechoic formation in the uterus is indicated in case of ectopic pregnancy, then emergency surgical intervention is performed in the form of extraction of the ovum. In case of nodular uterine myoma, a planned operation is also performed. Cysts of the uterine cavity and appendages are treated surgically in case of ineffectiveness of conservative treatment.

It is necessary to conduct general strengthening and immunomodulatory treatment in the form of vitamin therapy in parallel with conservative therapy and in the postoperative period. Vitamins of group C, A, E are recommended, and better yet, multivitamin complexes. Among the physiotherapeutic methods of treatment, iontophoresis and electrophoresis with painkillers and anti-inflammatory drugs, and amplipulse therapy are recommended.

Traditional treatment of anechoic formation in the uterus

Often, due to the asymptomatic course of the pathology, which causes the formation of an anechoic image in the uterus during ultrasound, women begin treatment with folk methods. The general principle of such treatment involves plants and folk methods that help normalize the ovariomenstrual function and sanitize the uterine cavity.

The main folk methods of treating anechoic formations in the uterus:

• Potato juice has preferential indications in the treatment of anechoic formation in the uterus if the cause is a myomatous node. Potato juice has a number of positive effects - reparative, anti-inflammatory, immunostimulating, analgesic action. To prepare a medicinal solution, it is necessary to thoroughly wash the potatoes, preferably young ones, then grate or grind in a blender, and rub the resulting mass through a sieve. This juice should be taken on an empty stomach, half a glass once a day for three months. The juice can be stored in the refrigerator for no more than a day. For douching, use potato juice diluted with carrot juice in equal parts.
• Propolis tincture 20%, which can be bought in a regular pharmacy, is taken 20 drops in water daily. Duration of treatment is 3 courses of 20 days, with a ten-day break between them.
• In case of anechoic formation, which is caused by a cyst of the uterine cavity or cervix, walnuts are effective. To prepare a medicinal solution, the shell of the nuts or their membranes should be poured with a glass of alcohol and infused in a dark place for 3 days, then take a tablespoon on an empty stomach, but before that dilute with boiled water in a one to one ratio and take for two weeks.

Herbal infusions that have affinity for the female reproductive system are also widely used in the treatment of anechoic formations of the uterus and appendages.

1. Tincture of motherwort herb is prepared by infusing the leaves of the plant, which are filled with alcohol, for 3 days in a dark place, then taken one teaspoon three times a day for at least a month.
2. Currant leaves and inflorescences or strawberry fruits are steamed in hot water and a glass of this tea is taken in the morning and evening, drunk for three weeks.
3. Prepare a herbal infusion from the leaves of the orthilia secunda, burdock and celandine - take them in equal quantities, pour hot water over them and boil for another 10 minutes, then cool and drink warm, half a glass every other day for a month.
4. Herbal collection of nettle leaves, barberry, cloves has a pronounced effect on endometrioid discharge. Tea is prepared from these leaves and taken during the day no more than 4 times for about three weeks.

Homeopathic remedies that help normalize the ovariomenstrual cycle and endometrial proliferation are also widely used in the treatment of anechoic formations in the uterine cavity.

• Dysmenorm is a complex homeopathic preparation that affects hormonal imbalance, including anechoic formations in the uterus. The drug is available in tablet form and is taken 1 tablet 3 times a day half an hour before meals. Side effects are rare, but nausea and temporary deterioration of the condition may occur. Not recommended for patients with celiac disease.
• Lycopodium is a homeopathic monocomponent preparation that is effective in the pathology of the right half of the uterus, right-sided myomatosis. The preparation is produced in the form of homeopathic granules of 10 g in a jar, also in the form of a tincture of 15 ml. Take between meals, dissolve under the tongue until completely dissolved, 1 granule 4 times a day. Not recommended for pregnant women.
• Gynecoheel is a combined homeopathic preparation, which is produced in the form of drops and is used 10 drops three times a day, before which it must be dissolved in warm water. Side effects are rarely noted in the form of allergic reactions.
• Cyclodinone is a homeopathic drug that normalizes the ovariomenstrual cycle when its second phase is insufficient. The drug is available in tablets or drops. Dosage: 1 tablet in the morning or 40 drops once a day. The course of treatment is at least three months. Contraindications for use are pregnancy and allergic hypersensitivity to the components of the drug.

Prevention

Prevention of the formation of anechoic structures in the uterus and appendages is non-specific: rules of intimate hygiene, hygiene of sexual relations, timely preventive examinations, pregnancy planning with the prevention of abortions and ectopic pregnancies, timely referral to a doctor in case of problems, avoidance of routine use of hormonal contraceptives.

An anechoic formation in the uterus is a very common pathology, the cause of which can be a huge number, so it is necessary to conduct a comprehensive examination to establish an accurate diagnosis. You should not be afraid of such a diagnosis prematurely, because it can be a simple pregnancy, or something more serious that requires a more thorough differential diagnosis. Treatment of this pathology depends on the cause and often the prognosis is favorable.