“You’re textbook bicornuate.” This was the diagnosis according to the results of my HSG yesterday.After about 30 minutes of forced small-talk with the nurse while my sweaty self sat half-dressed on the radiology table, OB finally appeared to start the procedure. I had pre-medicated with the ibuprofen as suggested by the doc and was bracing for the cramping I heard was so common with this test. What I didn’t expect was intravaginal PINCHING.
Call me naïve, but I seriously didn’t realize there were different lengths of speculums. Apparently, if it’s too short, during attempted placement, it pinches you internally. It is a GREAT sensation…if you love excruciating pain. After trying to place the speculum that was apparently too short, the doctor asked: “How tall are you?” “I’m 5’9,” I responded. “Oh yup, yup…I always say we need the longer speculum if you’re over 5’8”.” Thanks for checking my stats AFTER the fact, lady! The nurse had to run back up to the 6th floor to get another vagina-vice and the doctor attempted chit-chat while she was gone. Said the doctor down at my feet: “Wow. Looks like you got a tan over the holiday weekend.” And “are your hips OK resting like that? Yes? You must be very flexible.” Can you say UNCOMFORTABLE?!
The actual procedure wasn’t too bad. Just a few moments of cramping and it was all over. They showed me the digital x-rays of my uterus right away. It looked very similar to many of the HSG photos I’ve looked at in research papers and online. She pointed to the notch that intruded about half-way into my uterine cavity. I questioned how we knew for certain that it is bicornuate and not septate, and she said if it were septate, the notch would be long and thin. (Sounded like a bunch of hooey to me.) The horns of my uterus were almost identical in size and my tubes were free and clear of any obstructions. After she pointed out the clear tubes on the screen, the nurse asked: “So she’s OK to start trying to get pregnant again?” The doctor said “Yup!” as she waved and walked out the door. What I’m left with is a diagnosis that appears to be about as clear as mud.
I’m seriously beginning to doubt the expertise of my high-risk OB and THANKING God that I took the initiative to get a referral to an RE. I want to know for certain that this is NOT a septum that will affect my ability to carry a baby. I have so many mixed feelings. I left the hospital with hope, but now more than anything, I feel confused. Has anyone had an incorrect MA diagnosis based upon ultrasound and HSG results? Should I press the RE for a saline sonogram?
I hate being in limbo-land. And I really hate getting my chacha pinched!
9 comments:
No, it is NOT that simple. I can't believe your OB would just call it bicornuate and leave it at that, when plenty of research suggests that HSGs are quite poor at accurately diagnosing MAs. Septums come in all shapes and sizes and can be quite broad. To say that it's not septate because it's not long and skinny, well--you're right--that's just hooey!
This just confirms my hatred of HSGs. My complete septum was grossly misdiagnosed as unicornuate by the HSG, but luckily my OB sent me for a pelvic ultrasound. And the ultrasound people said it was "bicornuate in appearance." Only REs really know what's going on, apparently. And don't be satisfied until you've had at least an MRI or lap/hyst unless your RE is trustworthy like mine and can diagnose via saline u/s.
Good job getting the RE referral already, and good luck!
i completely 100% agree with susan k. my HSG showed a bicornuate uterus. my RE said she didn't trust that, she wanted to do surgery (laporscopy/hysteroscopy), we agreed, and sure enough, she found two huge polyps in my uterus that she removed - and after their removal my uterus shape was normal.
do NOT take those HSG results for face value. you could have a septum or polyp that, if not removed, will either prevent you from getting pregnant or could cause m/c.
good luck!
OWWWWIE!!! The pinching is awful. The worst part for me what when the dye first started going in, it just felt awful.
I am glad you are seeing an RE, too. I will say that my OB AND the X-ray tech at the hospital totally missed my true uterine issues on my HSG film and he caught it several months later. ObGyn's are just not specialists in these types of things and shouldn't try to do so!!
Hopeing that your RE will provide you with further insight and the path to your baby. ;)
*hugs*
First of all, a big OUCH on the speculum issue. I'm 5'10 so I feel your pain - I'm so sorry that it was uncomfortable. Hmmm, I'm glad that they were able to tell you it was bicornuate, but I'm not really experienced with septums. I would definitely see if they could do an MRI if they are willing or something else to confirm as well. Are you involved with the MA group on yahoo? THose ladies are great and would be able to tell you another option besides an MRI possibly that could help with the diagnostic portion. I check on there every now and again - they seem very knowledgable. I'm sure something other than an MRI may be able to help diagnose as well. I had an MRI after my HSG at the urging of my RE - but that was also to see if a rudimentary horn existed with my UU. I hope you get some answers and yes - the RE should be good at dealing with MAs more so than an OB. Is your OB that is high risk a peri? Or is he an OB that also sees non high risk patients?
Either way...sending you lots of hugs in the meantime and I'm glad at least they got the HSG portion done this week.
I was misdiagnosed bicornuate via ultrasound. Told to try again. Miscarried again. I skipped the HSG all together. I can't urge you enough to push for either an MRI or straight to the lap/hyst. I was able to get a good diagnosis by MRI, but radiologists are just as bad at knowing the difference so make sure you ask for a disk of the MRI and keep it with you for a second opinion if necessary. I actually was able to look through the images and post them on the MA forum. The girls "called" it SU - and it was!
Fact is, Septums are much more common and have pretty scary statistics attached to them. I think you are smart to question your doc.
Good luck...
So sorry you are going through this. HSGs are notoriously bad for diagnosing Mullerian anomalies and as others have mentioned, a septum is not necessarily narrow. The gold standard for diagnosis is a combination laparascopy/hysteroscopy that enables simultaneous visualization of the interior and exterior of the uterus.
Not sure if you've already located us, but I belong to a fabulous Yahoo group dedicated to issues related to MA's...the link is on this page:
http://mulleriananomalies.blogspot.com/2007/11/welcome.html
There are more of us there than I can count who were told after an initial HSG that we were bicornuate, only to find out with the lap/hyst that in fact we had a septum that could be fairly easily (in most cases) resected.
Good luck navigating through the MA diagnosis and definitely press on to get a more definitive answer about whether it's BU vs. SU.
Best,
Kathy
Hi,
I want to chime in that I had a septum that was 4 cm wide and 3 cm long. Septums are not necessarily long and thin. Also, I want to second the observation that radiologists can screw up the MRI reads. I was diagnosed with a borderline septum via the MRI. You really want to push for a MRI at the minimum. Gook luck!
My septum was short and broad, so the long and thin thing, a bunch of crap. I am glad you are going to an RE - make sure the RE has some experience with uterine anomalies.
Good luck, at least you are one step closer to figuring out for sure :) Like the others, I suggest a lap/hyst and/or MRI.
Here from L&F...
Hmmmm, my septum was short and wide as well, so based on that I would consider getting your RE to have a look at the films... they are experienced in diagnosing off films from HSG, normal gynae's just are not experienced enough.
Good luck for the RE appointment!
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