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Dr. Andrew Rynne
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What does bulky uterus mean?

Answered by
Dr. Deepti Verma

OBGYN, Maternal and Fetal Medicine

Practicing since :2009

Answered : 5068 Questions

Posted on Wed, 19 Jul 2017 in Women's Health
Question: What does bulky uterus mean ?
What about non-invasive treatments to cure it without going through hysterectomy, as the patient is yet to go to manupausal state ? Previous diagnosis of 2 years ago, was showing polycystic ovary now it is bulky uterus. Is there any apoptotic growth going on inside? What are the measures of treatment we should opt for?

Patient details-
age : 41
Symptoms: frequent pain in lower abdomen, irregular periods with pain, unable to walk long that feels heavy at lower abdomen.
Symptoms are prevalent since last four years.
Body weight: 76
History: fatty liver, hypothyroidism, polycystic ovary.
Medication on-going: thyroxine sod. 50mg, atorvastatin 10mg on daily basis.
Answered by Dr. Deepti Verma 56 minutes later
Brief Answer:
Hysterectomy not needed now

Detailed Answer:
Hi dear,
I have gone through your question and understand the concerns.
Bulky uterus is a slightly enlarged uterus and can be a normal finding in the woman who had children earlier.
It can also be present in the pelvic infection.
Pelvic infection can lead to pain lower abdomen, irregular bleeding and discharge from the vagina.
She should be given antibiotics to cure the infection and the symptoms will resolve.
There is no need for hysterectomy on the first go.
If the medical management fails to resolve the symptoms, then hysterectomy can be done.
Hope you found the answer helpful.
Dr Deepti Verma
Above answer was peer-reviewed by : Dr. Kampana
Follow up: Dr. Deepti Verma 10 hours later

The same condition is existing since 2010.
Severe Lower abdomen pain reported by the patient.
1. Year 2010 USG report : Uterus was normal in size. Anteverted. Normal myometrial echotexture.
Gynaecologist had diagnosed uterus bulky/tender on movement.
Given medication.
Issue resolved.

Again pain
2. Year 2013 USG report : Uterus is having Multiple fibroids (mostly subserous 19mm X 18mm) along with bilateral pelvic adhesion.

Treated with domeperidone, cinnarizine for muscle relaxant. Fluconazole 150 and carnisure 500 and fungal diastase syrup.
Pain resolved.

Frequent pain during the period of 2013 till now..
3. Year 2017 USG report : Uterus is bulky showing normal shape.

But size is increasing since 2010 from 54mm X 45mm X 79mm to 54.2mm X 48.6mm X 93.7mm in 2017.
Again its paining. .

Is there any risk if we delay the hysterectomy for few more years?
Then Why is this paining ?
Only infection control can resolve it or is there any preventive measures and medication that can make patient a bit relieved?

Please give us confidence Ma'am.

Sorry for being a bit lengthy.

Thanks and Regards,
Answered by Dr. Deepti Verma 9 hours later
Brief Answer:

Detailed Answer:
Hi dear,

If the problem is existing since 2010, then the other most likely diagnosis is the adenomyosis of the uterus.

Adenomyosis of the uterus is not cured by the medicines or any non-invasive treatment.
If she has taken medications for last 7 years, then hysterectomy is the good appropriate option for her at this time.

Knowing her past history, I'd recommend her to undergo hysterectomy as medical treatment may not help her.

Dr Deepti Verma

Above answer was peer-reviewed by : Dr. Arnab Banerjee
Follow up: Dr. Deepti Verma 4 hours later
Actually we are afraid of postoperative hormonal disbalances that may affect patients' physical and mental health as menopause is far away. Is it like that?

Moreover, if the symptoms are for frequent pelvic infections then removal of uterus can assure that the present symptoms will not arise further after operation?

If the hysterectomy postponed till menopause is there any chance of serious illness manifestation?

Answered by Dr. Deepti Verma 9 hours later
Brief Answer:
Hormonal imbalances unlikely

Detailed Answer:
Hi dear,
The post operative hormonal disturbances are not there if the only hysterectomy is done , leaving behind both the ovaries inside the body.
It is recommended to leave behind the ovaries, if they are healthy, if the removal of uterus is done before 45 years of age.
For adenomyosis, there is no need for the removal of the ovaries. Thus, the hormonal disturbances and imbalances are unlikely to occur.
Chronic Pelvic infection is cured by hysterectomy, and the symptoms are unlikely to occur after the removal of the uterus.
Patient will have discomfort and pain if the hysterectomy is postponed further.
There will be no serious illness in that case.
Hope you found the answer helpful.
Dr Deepti Verma
Above answer was peer-reviewed by : Dr. Vaishalee Punj

The User accepted the expert's answer

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