Pelvic pain. Patient with uterine window at old C-section scar possibly involving the bladder on pelvic ultrasound. PELVIS:UTERUS, ADNEXA: The uterus is anteverted and anteflexed. It is normal in size. The visualized endometrium and junctional zones are normal in thickness. There is a small defect in the lower uterine segment, compatible with a c-section defect/scar. Immediately adjacent to the defect is a 1.7 x 1.0 cm well-defined non-enhancing focus with intrinsic high T1- and low T2-weighted signal intensity with a possible fluid-fluid level. There may be a thin communication to this collection at the level of the c-section defect/scar, best seen on series 1402 image 81. The focus may represent a post-procedural hemorrhagic/proteinaceous collection or endometrioma. This abuts the left posterior dome of the bladder and the fat plane is poorly visualized. Otherwise, the fat plane between the uterus and bladder is preserved. The bladder wall contour is unremarkable.There is a well defined 2.6 x 2.6 cm left mural/submucosal uterine mass which is very low signal intensity on T1- and T2-weighted images demonstrating postcontrast enhancement compatible with a fibroid.Right corpus luteal cyst is noted. Otherwise, several bilateral adnexal follicles. The ovaries are normal in size.Small nabothian cysts.BLADDER: See discussion above. Partially collapsed bladder with normal wall thickness.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
1.1.7 cm post-procedural hemorrhagic/proteinaceous collection or endometrioma adjacent to lower uterine segment c-section scar with a suspected thin communication to the endometrial cavity. 2.The fat plane between the collection/lesion with the adjacent posterior left urinary bladder is poorly defined, however there is no specific evidence of bladder communication. If clinically warranted a fluoroscopic study, such as a cystogram or HSG, to evaluate for a communication between the collection and uterus or collection and bladder may be considered.3.2.6 x 2.6 cm left mural/submucosal uterine mass, likely a fibroid.