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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Causes Lower Abdominal Pain Along With Nausea And Vaginal Pain?

Hi, I am a 56 year old female Symptoms for last couple months: Lower abdominal pain (moderate) Nausea Feels like my insides are going to come out when I go pee sometimes. Sharp shooting pains into the vagina. Breast soreness. Back pain - was told I needed the fusion surgery Past medical history: complete hysterectomy age 29. Gall bladder and appendix removed age 22. Had a bladder sling done at age 54. Breast biopsy both breast age 17 Test results: Diagnostic mammogram and an ultrasound - all clear. Urine culture - no growth Urine Test: Specific Gravity: 1.020 PH: 7 Biliruben: 1 urobiliruben: 1 Thought the sling was the issue and had that checked out, all is fine. Something hurt during the process of them checking it out, that made me think that if I was having sex, it would be painful. I have been widowed for the last 14 years. CT and MRI results from 7/22/14 Kidneys: There is a 6 mm low-density lesion in the inferior left kidney too small to fully characterize but probably represents a cyst. Bowel/mesentery: mild diverticulosis L2-L3: Disc desiccation change. Large right paracentral/posterior lateral extrusion with narrowing of the right lateral recess and right neural foraminal narrowing. Mild to moderate left posterior lateral protrusion with left neural foraminal narrowing. L3-L4 Disc desiccation change. Mild left posterior lateral protrusion. Mild left paracentral annular tear and right posterior lateral annular tear. L4-L5: Advanced disc space narrowing with reactive sclerosis and edema. Mild right posterior lateral disc osteophyte complex and mild left posterior lateral bulging. Mild central protrusion with associated annular tear. Mild anterior deformity of the thecal sac and moderate right neural foraminal narrowing. L5-S1: Disc desiccation change. Mild superior extending central extrusion without thecal sac deformity. Mild bilateral posterior lateral protrustion with mild neural foraminal narrowing left greater than right. Then a year ago I had another MRI Findings: Bones: Fairly prominent endplate edema noted involving L4 and L5 which appears to be related to advanced degenerative disc disease at this level Lumbar disc levels L4-L5: This desiccation and moderate/severe disc space narrowing. Moderate-sized broad-based protrusion does not produce canal stenosis. There is mild to moderate lateral recess and neural foraminal narrowing right greater than left. Conclusion: Fairly advanced degenerative disc disease L4-L5 CT on 5/19/16 - EXAMS: CLINICAL HISTORY: - 0000 CT ABD/PEL WO/W CONTRAST LOWER ABDOMINAL PAIN - - CT ABD/PEL WO/W CONTRAST - Clinical: Lower abdominal pain and nausea - Comparison: 2014 - Technical: Axial precontrast images. Axial images after the - administration of IV contrast. 100 cc Isovue 300 IV right antecubital - fossa. 10 minute delayed images were obtained. Coronal reformats were - also obtained and reviewed. No oral contrast was administered. - Automated dose reduction techniques utilized. - FINDINGS: - * LIVER: Normal - * BILIARY:Post cholecystectomy - * PANCREAS:Normal. - * SPLEEN:Normal. - * KIDNEYS:.There is a 6 mm low-density lesion in the inferior left - kidney too small to fully characterize but probably represents a cysts - * ADRENALS:.Normal. - * AORTA/VASCULAR:.Mild plaque within the aorta. * RETROPERITONEUM:.Normal. * BOWEL/MESENTERY:Mild diverticulosis * PELVIS: Post hysterectomy - * ABDOMINAL WALL:Postoperative changes in the right-sided upper - abdomen due to prior surgery clips. - * BONES:Disc disease at L4-L5 and L5-S1. - * OTHER:No further findings - IMPRESSION: THERE IS NO RENAL STONE OR NEW DEFINITE SOLID URINARY - TRACT MASS. Questions: Is this pain coming from my back? If not what could it be? What can happen if I decide not to have the back surgery. I take no pain medication by choice. I do not like the side effects of pain medications nor do I like the Gabapentin. Why the differences in the MRIs? I have an apt with the Gastro Doctor next month, should I go see the Gynecologist also. Since I had a full hysterectomy how often should I see the Gynecologist.
Thu, 6 Feb 2020
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General Surgeon 's  Response
Hello,

The lower abdomen pain can be related to pelvic inflammatory condition via bacterial infection of vagina. Sore vagina can be part of estrogen deficiency via menopause or other infection issue. I would recommend to discuss the need of vaginal swab, lab reports of total WBC counts and ultrasound report of pelvis for finding out the cause underlying for your concern and treat accordingly.

Hope I have answered your query. Let me know if I can assist you further.

Regards,
Dr. Bhagyesh V. Patel, General Surgeon
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What Causes Lower Abdominal Pain Along With Nausea And Vaginal Pain?

Hello, The lower abdomen pain can be related to pelvic inflammatory condition via bacterial infection of vagina. Sore vagina can be part of estrogen deficiency via menopause or other infection issue. I would recommend to discuss the need of vaginal swab, lab reports of total WBC counts and ultrasound report of pelvis for finding out the cause underlying for your concern and treat accordingly. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Bhagyesh V. Patel, General Surgeon