Presentation
Primary infertility.
Patient Data
The uterus is normal in shape without evidence of congenital abnormalities.
The endometrial cavity is enlarged, and a large round filling defect is noted in the inferior part, highly suggestive of leiomyoma (confirmed with transvaginal ultrasonography).
The right fallopian tube is visualized, and normal spillage of contrast is noted at its fimbrial end.
The left fallopian tube is partially distal-blocked, and a small amount of the contrast medium spills into the pelvic space through it.
Case Discussion
Hysterosalpingography is frequently utilized to assess fallopian tubes. Nonetheless, congenital or acquired abnormalities in the uterine, endometrial cavity shape and size, and intracavitary filling defects can also be identified with an appropriate technique. The most prevalent intra-endometrial filling defects, particularly those with round or oval shapes and well-defined margins, include submucosal leiomyoma and endometrial polyps. Hystrosonography or routine abdominal/transvaginal ultrasonography often confirms the diagnosis. In intricate cases with multiple myomas, MRI may be more beneficial for determining the precise size and location of the lesions.
The patient underwent a laparoscopic uterine myomectomy.
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