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Dr. Andrew Rynne
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Severe lower abdominal pain, contractions, pressure on bladder. Fibroids detected, advised abdominal hysterectomy. Correct diagnosis?

3 weeks ago, began having intense severe lower abdominal/pelvic pain, no bleeding, felt like severe contractions, felt a lot of pressure like I needed to push and my bladder felt as though I was 9 months pregnant by how often it felt like I needed to use the restroom. After all the urine came out, there was a shooting pain sensation that shot up into my abdomen. ER did at CT and U/S, enlarged uterus and 7 cm mass located within the lower uterine segment.
Followed up w/gyno, he did pelvic and said he felt a baseball sized mass and couldn't locate my uterus and said everything felt all twisted up. Referred me to gyno/onc.
Saw one and he also did pelvic & rectal exam, looked at the ct & u/s images and said it was a fibroid and recommended total abdominal hysterectomy.
Saw another gyno/onc and he is saying that I have complete cervical stenosis and Hematometra.
I now don't know who to believe.
Tue, 13 Aug 2013
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General Surgeon 's  Response
HI ! From your history, it seems that irrespective of the pathology ( whether it is a fibroid or a hemaometra) , the mass pressed on your bladder due to which you had to push for passing urine. After passing urine, the pressure on the bladder was relieved, which gave you a sense of relief. One point in your history is perplexing, that is how couldn't both the ultrasound and the CT scan could not differentiate between the hematometra and fibroid. I would suggest you to carry your reports to an experienced radiologist, and get the opinion from him. WIshing you an early recovery.
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General & Family Physician Dr. Aruna's  Response
Probably cervical stenosis with hematometra as your symptoms correlate with hematometra,better rule out cervical carcinoma
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Radiologist Dr. Indu Kumar's  Response
Thanks for writing to HCM

USG and CT can correctly diagnose the pathology and it is reported as fibroid uterus. You should rely on this report.
Symptoms depends upon size and site of fibroid.
You mainly have pressure symptoms due to fibroid and if family is completed hysterectomy is advised.
So, go for it and get well soon.

Take Care
Dr.Indu Bhushan
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