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Adenomyosis, uterine and abdominal pain, severe bloating, bladder infections, irritated bladder. Serious?

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Internal Medicine Specialist
Practicing since : 1998
Answered : 1579 Questions
My doctor says I have adenomyosis, though it's never been confirmed with an ultrasound or any other test. I have lots of uterine and abdominal pain along with SEVERE bloating that persists for weeks at a time. I've also been having lots of bladder infections (2 within the last month alone), which are becoming more frequent and more painful. Can these bladder infections be a result of the adenomyosis, or are they more likely two separate problems? My urine stays cloudy and my bladder feels irritated constantly.
Posted Fri, 13 Apr 2012 in Vaginal and Uterus Health
Answered by Dr. Jasvinder Singh 42 minutes later

Thanks for posting your query.

From the symptoms that you have described, two important possibilities need to be ruled out.

1) Since you are having recurrent bladder infections, abdominal pain and bloating and urine is cloudy, definitely this needs evaluation other than adenomyosis. Adenomyosis will not cause repeat bladder infections and cloudy urine and could be due to other reasons. Most common cause is stones in kidney which is blocking urine pathway. It can also be due to retention of urine anywhere in its flow due to obstruction. The obstruction can be due to abnormality of structures since birth, stones or diseases like tumors. So you should get done an ultrasound, CT scan and also urine examination and kidney function tests.

2) The second possibility for abdominal pain and bloating apart from adenomysosi can be severe abdominal pain, discomfort, bloating and alteration of bowel habits like alternate constipation and loose stools. Please get this possibility evaluated from your doctor.

The typical signs of adenomyosis are prolonged, heavy bleeding during your periods or severe cramping. To confirm the diagnosis which has still not been done in your case, ultrasound and MRI scan and biopsy of endometrial tissue need to be done.You should also get a Pap smear done.

So you should consult your doctor and get these investigations done. All these are separate issues and hence should be investigated.

Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health.

Above answer was peer-reviewed by
Follow-up: Adenomyosis, uterine and abdominal pain, severe bloating, bladder infections, irritated bladder. Serious? 9 hours later
Thank you for getting back to me.

I would, however, like to mention that my pap smears have all been normal. Also, when my OBGYN performs any physical exams, my uterus is always very tender and quite painful to the touch. I do not have prolonged or heavy bleeding or severe cramping even though I am on no form of birth control. There are two specific times throughout the month though where the ovulation and my menstrual cycle (the bloating is persistant regardless of my cycle but is worse during these times as well). My doctor has suggested I have a hystorectomy, but at this time I have no health insurance.

In regards to the urinary problems, I also wanted to mention that I do urinate frequently as well. And, if for any reason, I tend to put off going to the bathroom - even for a little bit or without even realizing that I need to go - my bladder/abdomen feel very sore, my urine is cloudy, and often times this can trigger the onset of a bladder infection. I must confess that I do not drink enough fluids throughout the course of the day - water or soda, etc. I realize that this is not a healthy habit and I have lately been trying to do better by consuming more water.

My bowels seem to be normal, regular bowel movements, and I do not suffer from constipation.

I wanted to provide you with this information, having not mentioned all of it previously, in case any of it was pertinent to your opinion.

Are the possible tumors you referred to previously considered extremely serious, such as cancerous tumors? I'm also curious if the new information I've provided you with changes any of your prior opinions, especially with the two sets of problems being non-related.

Thank you for your time and advice.
Answered by Dr. Jasvinder Singh 15 hours later
Thanks for writing back.

The tumors which can cause persistent urinary infection are benign tumors and at your age, it is very less likely for malignant tumors to be present. so do not worry about that.

The two problems that you have are non related and for the uterine causes, adenomyosis and pelvic inflammatory disease are important to be ruled out.

Another cause which needs to be ruled out is adhesion formation inside the abdominal cavity which can occur in women who have undergone cesarean sections.

For the urinary symptoms, you need a detailed evaluation to rule out recurrent infections, kidney causes and Interstitial cystitis. Interstitial cystitis is a painful condition due to inflammation of the tissues of the bladder wall and occurs more commonly in women. Urine examination, culture, cystoscopy and urodynamic studies may need to be done.

Both these are separate issues and you have to consult a gynecologist as well as urologist.

Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries.

Wishing you good health.


Above answer was peer-reviewed by
Follow-up: Adenomyosis, uterine and abdominal pain, severe bloating, bladder infections, irritated bladder. Serious? 1 hour later
Thank you for providing me with such great information, as well as giving me direction on how to proceed. I've been doing my own internet research because I simply was not satisfied with the diagnosis I had been given - there were too many unknowns and I didn't feel that my diagnosis (adenomyosis) was completely accurate given the lack of testing. That being said, I do have one final question for you. You mentioned "adhesion formation inside the abdominal cavity" which are common in women who have had c-sections. Can you please explain to me what these adhesions are and what types there may be? I've researched uterine fibroids and found that I have many of the symptoms associated with them. But are fibroids and adhesions the same thing?
Answered by Dr. Jasvinder Singh 1 hour later

Thanks for writing back.

Adhesions can form on any surface in the pelvic region and abdomen after surgery and basically are XXXXXXX scars formed during healing process after surgery or strand like fibrous tissue that form an abnormal bond between two parts of the body after surgery. This may cause abdominal pain, tenderness in the pelvic region around the uterus, fallopian tubes etc or pain during intercourse. Sometimes adhesion formation in females may cause Asherman's syndrome {formation of adhesions (scar tissue) inside the uterus} and this may cause constant uterine pain which is most severe near the periods. Direct visualization of the uterus via Hysteroscopy is the most reliable method for diagnosis. Other methods are sonohysterography (SHG) and hysterosalpingogram (HSG).

Fibroids and adhesions are not the same thing. Fibroids are noncancerous growths of the uterus and may cause heavy or prolonged menstrual bleeding, pelvic pressure or pain and difficulty emptying the bladder. These can be easily visualized by ultrasound, CT scan, hysteroscopy or hysterosalpingography.

Hope this answers your query.

Wishing you good health.

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