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Abdominal pain even after surgery, abdominal lump. Could it be adhesions that grew in placed of the removed ones?

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Infertility Specialist
Practicing since : 2000
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I was having severe pains in my lower left quadrant of my abdomen. When it is painful, I can feel a lump sticking out. After going to multiple doctors and having a cat scan, and multiple diagnoses one surgeon figured it may be either adhesions or an inflamed ovary.

This surgeon has always been somewhat questionable. He has had issues with other patients. I went to him first with this problem, and he stabbed my abdomen with a metal syringe and moved it around inside. I did not know what he was doing, and he did not explain it. It was extremely painful, and he used no anesthesia. However my GP recommends him, so I went with him in the end.

I underwent a laparoscopic surgery to see what is going on. The surgeon found adhesions on both of my ovaries, even connecting to my intestines.
The surgeon supposedly removed all of it, and close it up.
After surgery, I was having severe pains, my blood pressure was very low, and I had no color. A day later and after a blood plasma transfusion and 2 blood transfusions, the surgeon took me back in to surgery to find that I was bleeding internally from the wound, with a puddle of blood inside of me. He cleaned it up, and closed it. After recovery from this extremely painful 2 week ordeal, I assumed that the lump and pain would be gone.

Now I am having the same pains as I was prior to the surgery. I can still feel that lump. And sometimes it hurts even worse than it did before. A sharp stabbing pain. It feels almost like a knife in me.

What do you think it is? Could it be adhesions that grew in place of the removed ones? Could it be inflammation of my ovaries? I had the surgery 3 months ago, and still haven't had a period. Granted I did change from Yaz to Lo Loestrin Fe a week prior to the surgery, so it may be my body getting used to it.

I just want an opinion and some advice.

Thank you!
Posted Tue, 8 May 2012 in Women's Health
Answered by Dr. Mahesh Koregol 1 hour later

Thanks for posting your query.

I am very sorry to read the ordeal you went through for an ovarian cyst & complications that followed.

Since there are different types of ovarian cysts that can be encountered, I would request you to let me know the type of cyst for which you were operated (as per the post operative diagnosis).

As per your description, there are three possibilities which arise:
a.     Chocolate cyst of ovary: This is also called endometriosis of ovary where menstrual blood collected over long time leads to excruciating pain especially during menses. Unfortunately this cyst recurs frequently after surgery.
b.     Dermoid cyst: This is a cyst containing embryologic remnants like tooth, hair etc. This is common in women of your age group. This becomes painful if infected or twisted.
c.     Torsion: Any type of ovarian cyst, if it undergoes torsion, leads to pain.

Since you are describing adhesions, it could be endometriosis (chocolate cyst). Since it has been operated and removed, it is advisable to take injections of gonadotropin releasing hormones agonist (GnRH agonists) (like Lupride) depot. Your gynaecologist can prescribe these for you.
But if it was for some other cyst, let me know so that I can advice accordingly. If there was no cyst and it was plain adhesion, it is likely to reoccur as adhesion form again soon. There are different treatments for reducing repeated adhesion formation

Awaiting your reply.
Above answer was peer-reviewed by
Follow-up: Abdominal pain even after surgery, abdominal lump. Could it be adhesions that grew in placed of the removed ones? 43 hours later

Thanks for the reply.
I'm sorry, it went to my spam box and I didn't realize it.

The surgery that I had was for adhesions.
The ovarian cysts happened a few years back.
I believe there are still some there, and that is why my gyno had me on Yaz.
I switched from Yaz to Lo Loestrin because of some regularity and pmdd issues.

The pain that was the adhesion I have had for years. I do not remember when it began exactly. But I know now it off and on hurts badly. And I still feel the lump..
After my surgery, the surgeon had to put a little bag in my side to drain any blood that may still leak. I had it removed the following day, but it feels like it is still there for some reason. It is a really odd feeling.
But I know that the lump is still there.

I am not sure what type of Ovarian Cysts I had before. All the doctor told me was that there are cysts and that birth control would help treat them.

Can you explain how the two would be related? And what I should speak with my doctor about exactly?

Thank you!
Answered by Dr. Mahesh Koregol 20 minutes later

Thanks for reverting back.

Yaz or other pills will not help much if there is endometriotic (chocolate) cyst. Hence first get a proper diagnosis done for type of cyst. If it is endometriotic cyst, it spreads to surrounding parts and cause adhesions as you have described. Hence your adhesions and endometriotic cyst are related. Still there could be endometriotic spots in the pelvis and surrounding organs which are causing you pain.

Following are the points you need to discuss with your doctor.

1) You had no surgeries prior to this adhesion release surgery, then what could have caused infection? Any infection? Endometriosis?
These 2 are possible reasons in your case.

2) You mention about PMD and pain from a long time. In your age group endometriosis most common cause and is associated with history of recurrence soon as you are mentioning in your history.

I recommend you see a gynecologist to get an ultrasound done and see if any new endometriotic cysts exist. I don’t see any other possible gynecological cause in young lady in your age group.

I hope I answered your questions. Please accept my answer if no more queries.

Above answer was peer-reviewed by
Follow-up: Abdominal pain even after surgery, abdominal lump. Could it be adhesions that grew in placed of the removed ones? 3 hours later
I apologize. I forgot to mention. I had bilateral inguinal repair.
That is where he believes the adhesions are from.
As for the cysts, the doctor only said they are ovarian, and i have normal follicle cysts.

Answered by Dr. Mahesh Koregol 5 minutes later

Thanks for reverting back.

That is an important piece of history you failed to mention earlier. The bulge what you were experiencing were inguinal hernia. It is possible that adhesion could be from there. If you still feel the lump, it might have recurred. Please have a consultation with surgeon also along with the gynecologist as I mentioned above.

I hope I answered your questions. Please accept my answer if no more queries.

Above answer was peer-reviewed by
Follow-up: Abdominal pain even after surgery, abdominal lump. Could it be adhesions that grew in placed of the removed ones? 17 minutes later
The bulge that I felt and currently feel is years after that surgery. I had that surgery many years ago.

Would it still just be more adhesions?
Answered by Dr. Mahesh Koregol 1 hour later
Thanks for getting back.

It is possible that the hernia might have recurred. Inguinal hernia is known to recur years after surgery. Adhesions rarely present as a lump. A recurrent inguinal hernia is possible given your current complaints. A simple examination by your gynaecologist will confirm it.

I would suggest that you consult your gynaecologist who can examine you and appropriate treatment can be started.

I hope I have answered your query. Please accept my answer if you have no further queries.

Above answer was peer-reviewed by
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