Hi,
Thanks for the query.
Adenomyosis is growing of the endometrial tissue at the myometrium of the uterus.
Usually this will not be cured by ablation.
As during ablation tissue will be removed from the endometrial layer. But this can cure menorrhagia to some extent.
The possible causes for your painful urination are :
- Urinary tract infection. It presents with pain and burning sensation during micturition, increased frequency etc.
So once check for urine microscopy and culture and sensitivity.
By this the possibility of UTI can be identified and treated.
-Pressure exerted by the bulky uterus on bladder.
This can present with continuous feeling to urinate, pain during urination etc.
After undergoing hysterectomy, this can be cured.
Meanwhile you can take hormonal pills for one month with your doctor's advice, which can help in decreasing the size of the uterus little bit.
That may relieve your symptoms.
Take care.

Hi,

I understand your question.
The size of the uterus has increased.
However you have not mentioned if an ultrasound of the abdomen, especially the kidney and bladder has been done. The pain may be due to a bladder stone, urine infection or due to the adenomyotic uterus that sometimes irritates the bladder.

Many a times adenomyosis is associated with another condition called endometriosis where the menstrual blood flows in abnormal places like inside the abdomen and causes pain. This will be seen during the surgery only.

Regarding the risk of endometrial cancer,
The risk is very very low in your case because this cancer is more common in women that had never had children and in older age group. You are young and have three children so the risk is very low.

However, for women with similar complaints in my clinic, I make it a point to rule out endometrial cancer by an endometrial biopsy. This is a simple office procedure and is a part of the pre surgical workup.
So discuss with your treating gynecologist about this option so that there will be no need to worry.

Regarding the pain, I suggest you recheck if an ultrasound of abdomen looking for the kidneys and bladder has been done. If it has not been done, get it done along with a urine examination to look for infection.

If the ultrasound is normal, a simple analgesic like diclofenac twice a day with milk with help control the pain. If the urine has infection than you will need antibiotics as it needs to be controlled before any elective surgery or even otherwise.

Hope this was helpful.
Thanks for the query and feel free to ask more.

Have a nice day.
Dr. Madhuri Bagde
consultant gynecologist