32 yrs F,P2 A0,with a history of disturbed mens cycle,polymenorrhoea and prolonged bleeding,cycle...8-10/15-20days since 6 months.her usg report shows...a TO mass of mixed echo gene city right lateral to uterus.USG print given below. Ca125-15.4, TSH-2.1 HB,CBC normal..what should be her management.

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D/d of to masses are endometriosis, tubercular, pid nd ovarian tumours. This case can be pid give a course of antibiotics , get her hormone profile done thyroid nd prolactin. If pertaining only to ovaries or a case of endometriosis can be kept on oral contraceptives.

think of diagnostic scopy and treat To Mass by excision with contralateral salphingectomy with hysteroscopy to rule out endometrial pathology if normal u can try medical ablation thermal ablation also alternative

Abdominal hysterotomy.

32yrs p2 with irregular men's u s t o mass she can be pid endometriosis or tub first detailed. any ho dys menorrea fever low grade loss of wt inv thyroid profile e s r montoux give her course of antibiotic no response do hystero with lapro in premenstrual phase do curettage t o mass can be removed under laparoscopy other side salpingectomy can be done

Total hysterectomy

Polymenorrhoea must be due to pelvic inflammatory disease. Put her on combination antibiotics and then remove tubo ovarian mass either laparoscopically or by open method.

Pratap Madam and Vasundhara Madam please give your opinions..

Excision of the t o mass, start oral pills for few months if there is no improvement then go for endometrial ablation.

thanx all of you..

I think we should proceed with laparoscopy followed by diagnostic hysteroscopy and D&C. Endometrial polyp and other Endometrial pathology should be ruled out by doing hysterscopy and D&C.

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