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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest Treatment For Severe Pelvic Pain And Frequent Urination

I am a 43 white female with no pregnancies and I have recently had severe pelvic pain, frequent urge to urinate, pelvic area feeling full or bloated and experiencing unexplained weight gain. My obgyn ordered a pelvic ultra sound and then followed with an MRI. This was the result. Are these measurements listed below normal? What can be done about cyst? Is this just a result of endometriosis. Which I have been told there is no cure. I am not on birth control. I tried it 15 years ago and the results were not helpful. MRI RESULTS: Uterus measures 59 x 38 x 40 mm. There is focal thickening of the junctional zone posteriorly suggesting focal adenomyosis. Endometrium is not thickened. The left ovary shows a simple 35 x 43 mm cyst with of enhancement. Draped along the posterior lateral aspect there is a crescent-shaped 19 mm thick collection which has high T1 signal with marked signal dropout on T2 weighted sequences consistent with an endometrioma. The right ovary measures 31 x 28 mm and shows several subcentimeter cysts including one with a fluid fluid level and an additional 19 x 17 mm cystic appearing lesion with intermediate signal. On T1 weighted sequences there are several small subcentimeter tiny foci of bright signal along the posterior wall of the uterus. These findings also support endometriosis . There is no free fluid or adenopathy.
Wed, 11 Oct 2017
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OBGYN 's  Response
Hello,
by reading your post and MRI report, your pelvic pain, frequent urination is because of endometriosis and adenomyosis.
Cyst in female above 40 years of age should be looked for either by sonography after 3 months or biopsy.
Some blood tests will help in taking decision ,
ESR, CA 125, Beta HCG, S. oestradiol, AFP.

In my opinion you should go for Diagnostic laparoscopy and if needed ablation of endometritic patches. OR

you should be given OC pills or dienogest or leuprid Depot. after three months again assess your complains and take a decision accordingly.
I hope this should help you.
Regards,
Dr Tejashree Bhor
Gynaecologist, Pune.
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Suggest Treatment For Severe Pelvic Pain And Frequent Urination

Hello, by reading your post and MRI report, your pelvic pain, frequent urination is because of endometriosis and adenomyosis. Cyst in female above 40 years of age should be looked for either by sonography after 3 months or biopsy. Some blood tests will help in taking decision , ESR, CA 125, Beta HCG, S. oestradiol, AFP. In my opinion you should go for Diagnostic laparoscopy and if needed ablation of endometritic patches. OR you should be given OC pills or dienogest or leuprid Depot. after three months again assess your complains and take a decision accordingly. I hope this should help you. Regards, Dr Tejashree Bhor Gynaecologist, Pune.