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How can myoma uterus with abdominal pain and bleeding be treated?

Answered by
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Dr. Purushottam Neurgaonkar

OBGYN

Practicing since :1992

Answered : 2159 Questions

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Posted on Wed, 1 Aug 2018 in Women's Health
Question: My mother is having slight pain and cramps in the uterus for several days. she is 60 yrs old. We consulted local doctor who suggested USG, URINE and BLOOD TESTS. Reports show myoma uterus. Traces of blood is also found. Mother also spotted blood in urine sometimes but not always. Please advise.
doctor
Answered by Dr. Purushottam Neurgaonkar 1 hour later
Brief Answer:
Please attach her reports.

Detailed Answer:
Hi there,
I welcome you to HCM virtual clinic.
I have understood your concern and I will suggest you the best possible treatment options.

First of all do not panic.

Your treating doctor has rightly suggested to get the investigations done.
I would really appreciate your care for the patient.
I will be in a better position to help you out , if you can attach her test reports also.

At her age and stage fibroids should not cause her any problems.
But if USG reports show blood inside uterus , we need to be more careful.
Secondly, blood in urine can be due to various reasons like urinary tract infection or calculus.

So I will request you to share her reports.
I would also like to know if she has any history of bleeding after her menopause?
Does she have any urinary complaints?

I hope this answer helps you.
Please feel free to communicate with me again.
Thanks.
Dr. Purushottam Neurgaonkar

Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Purushottam Neurgaonkar 10 hours later
Good Morning Doctor,

I have attached all the reports received from the lab. There are total four(4) reports attached. Kindly check and provide your suggestion about my next step.

- My primary concern is whether operation is required or not. Currently I am in Indonesia and my mother is in XXXXXXX Hence, if immediate operation is required, then I have to fly on an urgent basis. However, in normal scenario, I am returning to XXXXXXX by mid of February.

- What are the precautionary measures required?

- She do not have any urinary complaints. However, she complains about the lower abdominal cramps which feels like menstrual cramps. This pain is frequent but bearable.

- She reported about bleeding after her menopause. Its not every month but few months back this happened. This lasted for 2 days and bleeding was not heavy.

Thank you very much for your prompt reply. I look forward to your valuable suggestion.

At your disposal for any further information required from my end.

Thanks & Regards
Ajanta XXXXXXX

doctor
Answered by Dr. Purushottam Neurgaonkar 1 hour later
Brief Answer:
Urine culture and sensitivity Hysteroscopy with endometrial biopsy.

Detailed Answer:
Hi there,
Dear XXXXXXX thanks for appreciating the answer and reverting back.

I have gone through the reports.

Certainly there is presence of blood in the urine.
As there is no calculus in the urinary tract in USG, I will suggest that she should get urine culture and sensitivity test done.

Secondly, for her post menopausal bleeding hysteroscopy with endometrial biopsy is advisable.
This small surgical procedure must be done before taking any decisions about the uterus removal.

At present, she should seek prescription support from treating doctor for antispasmodic like Dicyclomine and tablets containing Tranexamic acid and Mefenamic acid as needed for vaginal bleeding.

I hope this answer helps you.
Thanks.
Dr. Purushottam Neurgaonkar
Above answer was peer-reviewed by : Dr. Kampana
doctor
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Follow up: Dr. Purushottam Neurgaonkar 23 hours later
Thank you very much for your valuable suggestion.

I would like to ask whether the mentioned biopsy is required to be done soon or can be done after a month? Problem is I am not in XXXXXXX right now and will be returning back next month.

Regarding bleeding, I further enquired with my mother and she told that this occurred last year only for one month like menstrual period and continued for two days. After that there was no bleeding. And this month only traces of blood was spotted that also occasionally.

Kindly suggest.

Thanks & Regards
Ajanta XXXXXXX
doctor
Answered by Dr. Purushottam Neurgaonkar 8 hours later
Brief Answer:
Tranexamic acid. Hysteroscopy with endometrial biopsy is must but not urgen

Detailed Answer:
Hi dear, thanks for appreciating the answer and reverting back.

At present if she has minimal bleeding, she can seek prescription support from her treating doctor for Tranexamic acid tablets, as required to stop the bleeding.

Secondly, diagnostic Hysteroscopy with endometrial biopsy can be done at your convenience. But this should be done to prevent any kind of mismanagement of post menopausal bleeding.

I appreciate your feelings and concern for your mother.
Please do not worry.
The things will be fine in the due course of time.
God bless you.

I hope this answer helps you.
Please find out some time to rate our communication and write a few words about the usefulness of the answers.
I will highly appreciate it.
Thanks.
Dr. Purushottam Neurgaonkar
Above answer was peer-reviewed by : Dr. Kampana
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