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Had heavy bleeding during periods. USG showed intrauterine mass lesion. Is it risky?

Mar 2016
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one of my known person, who is 36 years age, started a bit heavy bleeding during period. usg is
done and the report says that an intrauterine mass lesion is seen 11 x 10 x 7 cm, regular outline
and bulky. cervix is normal. uterus is atneverted endometrial echo is not seen separately. left
ovary not visualised. Impression-intrauterine mass lesion. may be degenerating
fibroid/endometrial mass. is it risky.
Posted Sun, 19 May 2013 in Women's Health
Answered by Dr. S Patra 56 minutes later

Thanks for writing to us.

Intrauterine fibroid is always risky though it is mostly benign tumor. It can cause heavy bleeding during cycles or inter menstrual spotting, infertility, abdominal discomfort, painful coitus, urinary frequency etc. During pregnancy it can cause miscarriage, preterm labor etc.

In this scenario, she must get examined by her gynecologist. Pelvic examination and other relevant investigations are mandatory before any intervention steps.

There are several treatment modalities to treat her condition like medical therapy to alleviate her symptoms with shrinking of the tumor.

Surgical treatment likes myomectomy (removal of the tumor), uterine artery embolization, radio frequency ablation etc are also measurable steps in case of failed medical therapy. Hysterectomy (complete removal of the uterus) is the last option.

Hope, this information is quite helpful to you. If you have any further questions I will be happy to help.

For any future query, you can directly ask me by viewing this page WWW.WWWW.WW
Wish her good health.

Dr Soumen
Above answer was peer-reviewed by
Follow-up: Had heavy bleeding during periods. USG showed intrauterine mass lesion. Is it risky? 3 days later
usg says the mass is formed outside of the uterus is this the reason why the ovary is not visualzed? the size of the mass is enough big so what is the way out? is there any medicine to reduce the size or operation is the only way out. if operation is required then what will be the procedure and is this risky? will it come back again? is there any risk of cancer? please say in detail as there is a huge amount of tension.
Answered by Dr. S Patra 1 hour later

Thanks for your follow up queries. I will give answer one by one.

1) First of all, size of extra uterine fibroid or mass is quite big enough and it is the reason not to visualize the ovary.

2) Most of the uterine tumors are benign. In rare case, there may be early cancerous changes. Though, histopathological examination of the tissue is needed to confirm the same.

3) There are several treatment modalities to treat uterine tumor. These are as follows:
A) MEDICAL THERAPY: 1) GnRH Agonist (like Goserelin) 2) Anti Progesterone (like Mifepristone) 3) Aromatase Inhibitors are very much effective in reducing size of the fibroid along with symptoms. These group of drugs should be continued for 3-6 months duration for effective results. Tranexamic acid is quite useful to control bleeding in combination with any above group of drugs. There may be some tolerable side effects.

In addition, medical treatment is always necessary to reduce size & vascularity of the tumor before going to surgical treatment.

B) In case of failed medical therapy, you have to opt for non-medical treatment or surgery. These are as follows:
1) Uterine artery embolisation- New treatment protocol. Size reduces 40-60% within 4 months along with 90% improvement in heavy bleeding.
2) Laparoscopic myolysis- fibroid shrinkage within 12 months up to 70%.
3) Laparoscopic or abdominal myomectomy (excision of the tumor only) - more convenient and good patient compliance. But it has always some surgical risks and significant recurrence rate.
4) Total hysterectomy (complete removal of uterus and ovaries)- ideal for family completed women and not desirous for baby. High patient satisfaction & definite treatment. Surgical risk is there. HRT (gynecologist regarding above treatment option after clinical examination & relevant investigations to make a proper decision on intervention step.

4) There is high recurrence rate in case of incomplete medical therapy and after myomectomy operation (25-40% within 10 years).

Hope it helps you. If you do not have any clarifications, you can close the discussion and rate the answer.

Good luck.

Dr Soumen
Above answer was peer-reviewed by
Follow-up: Had heavy bleeding during periods. USG showed intrauterine mass lesion. Is it risky? 25 hours later
for the last 2, 3 days she is having a discharge like gelly/water type, white or pale yellow in colour in low quantity. though it is a bit heavy for one or two times. it is happening for the first time in between her periods , she has not faced like this before. what is the cause could you please say. any how is it related to cancer. she is not married. please help.
Answered by Dr. S Patra 3 hours later

Thanks for posting your query.

Presenting feature is mostly suggestive of lukorrhoea in medical term. It is white or yellow colored liquid type clear discharge with no bad smell & itching. It is not related to cancer. So, don't be worried.

It is quite physiological and occurs due to estrogen hormone imbalance. With rising of estrogen, there is abundant secretory activity of the endocervical gland.

Physiological excess occurs during puberty, around ovulation time and before commencing of period, during sexual excitement (more secretion from bartholin gland). These are quite normal phenomena.

Beside this cervical and vaginal cause can more precipitate the above condition. These includes cervical ectopy, cervicitis, mucous polyp, ectropion, increased pelvic congestion in pelvic inflammatory disease (PID), using contraceptive pill, ill health etc.

Pelvic examination and some relevant investigations may be needed if this type of discharge continues in the next cycle with excessive amount. Otherwise, she has nothing to worry.

Hope, I have cleared your doubts. Take care of her.

Dr Soumen
Above answer was peer-reviewed by
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