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What does an enlarged uterus with mixed echogenecity imply?

Q: My co-worker has a problem with her stomach. Her stomach is slightly enlarged and the ultrasound results are - Uterus is enlarged in size with mixed echogenecity most likely due to fibroid. Trans-vaginal U/S has been advised. She is 35 years old and got divorced 10 years back and has not had any sexual relation with anybody. Now she wants to marry someone. She complains of a feeling of stomach fullness. What exactly is her problem and possible solution?

A:An enlarged uterus with mixed echogenecity implies either a fibroid, which is a non-cancerous tumour of the uterus, or an adenomyosis where the lining of the uterus grows into the muscular wall of the uterus. If this gives unbearable pain or bleeding during the period or if it is a cause of infertility, only then does it need treatment. Only a detailed evaluation of the ultrasound can help us decide if this is against achieving a pregnancy.

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