Advice on test results -- Update -- Right course of action?

My story begins in August when I went for a Spiral CT scan to check for kidney stones. Not only did the scan find stones but it was also noted that "the uterus shows a high density mass in the region of the fundus projecting into the endometrial canal". Primary dr called and said to take films to my OB/GYN. I had my annual schedule for the following week so I picked up the films and took them to him. He wanted me to have an ultrasound. Also did a quick scrapping of my uterus since I was getting my PAP done, basically to put my mind at ease because my grandmother died at 39 yrs. from gyn. cancer. Got the call - everything was normal.

I went for the ultrasound & transvaginal ultrasound. Report reads: " 1 cm mass seen along the posterior fundus. An additional mass is seen along the posterior aspect measuring 1.8 x 1.7 cm. There is a mass seen within the superior endometrium measuring 2 x 1.5 x 2.2 cm that also demonstrates arterial flow on color examination. The endometrial strip is also thickened at 2.1 cm. Left ovary contains a 1.6 x 1.6 cm cyst. There is no free fluid in the cul-de-sac."

I am 37 yrs. old. My period began on Sept. 1st and the ultrasound was done on Sept. 13th. I have been experiencing extremely heavy periods which cause me not to leave the house because I go through a super plus tampon every 1-2 hrs. I also pass enormous clots and am in sometimes severe pain. The flow has been erratic at times starts very heavy, period stops, then wham back to heavy duty gushing again. Sometimes it will lighten up changing color to a brownish then start back to bright red and almost seems watery. I have been experiencing mild low back pain since August - not sure if it is kidney related. Most of the time sex is a bit painful.

Not sure what to make out of all this. I am a bit scared because of the note on the endometrial thickness. Could that scrapping done have been wrong or not enough for a biopsy? What do I make sure my dr. does next? Am I being crazy and this is all nothing to worry about and I should just sit back and relax?

Please, any advice I can get will be greatly appreciated!

Definatly talk to your dr and get some good advice on what to do and ware to go from here. have you had a Laparoscopy yet ( i know its srugery but it is a great way to tell what is going on).
hugs
Lisa

Hi Lisa,

I haven't talked to my dr yet. I picked up a copy of the ultrasound report myself a couple days after. I assume he has the report by and am anxiously waiting for him to call me. I haven't had anything done except the ultrasound and a quick uterine scrapping when he did my PAP.

Heard from doctor today. He suggested doing a hysteroscopy and endometrial ablation.

He said the two on the outside are most definite fibroids and aren't much concern. The one inside is of concern. The ultrasound can not definitely say that it is a fibroid or a polyp - only way to tell for certain would be to do a hysteroscopy and if possible it can be removed depending on how much apart of the uterus it is. At the very least a sample will be taken to determine for certain what it is. He doesn't feel that it is anything serious because the small sample of lining he took (blindly) in the office didn't show anything suspicious. He said the endometrial ablation will help with the heavy horrible periods and if the masses can't be taken out during the hysterscope this will vaporize it. Only downfall is this doesn't promise any return fibroids/polyps/masses. The only thing to ensure that would be a hysterectomy and wouldn't suggest that route just yet. He said the endometrial thickening is from what is inside there even if it is just a fibroid that can cause it. The ovarian cyst isn't of concern because it could just be an egg - if it doesn't go away and gets bigger than it is of concern.

I asked if this would be the cause of the mild low back pain I have everyday mainly when sitting or on my feet for long periods of time - he doesn't feel this would be the cause because the fibroids aren't grossly huge. I also mentioned the low abdominal pain (strange feeling this one sort of crampy and tingly) again worse when sitting - he couldn't say if there was any relation or not. Again, I felt crazy for asking, like this is all in my head.

Does anyone else have any experience with these procedures or symptoms?

Have you had a second opinion regarding all your test results so far? A second opinion may either confirm what your doctor is suggesting or may have an alternative treatment plan that would be benefitial. A second opinion may also have more ideas as to what is causing the back pain.

We have several Fibroid Resources you may want to read to learn all you can about fibroids and the various options available.

I wish you all the best and hope you and your medical team can decide what is best for you!

Hi Star3, I too had very heavy periods, with a tampax and pad getting filled every hour for 2-3 days during my 8-10 day periods. the pain sometimes was so bad I had to go home from work and couldnt stand upright. My mood swings and other hormonal symptoms seemed worse than usual also. In January my P.C doctor put me on Welbutrin because of the pms. Last week I was diagnosed with 'at least a dozen" small fibroids and polyps, all over the place. My gyn says my uterus is not that enlarged, just about 10-12 week pregnancy. This is all a shock to me. We cant afford to do a sonohystogram, so she said lets go right to an endometrial biopsy to rule out cancer and start birth control pills to stem the bleeding. Does this sound right? I need someone to tell me they've been there. Thanks for any advice and encouragement!

Hey imajrzygrl2!

I know exactly how you feel! I either stay home from work or come home early in the first few days of my period. If I do work all day forget cooking dinner and cleaning up because it hurts too bad to stand. I don't notice any worse mood changes but I do have bloating everyday except for a couple days during my period.

I had been on birth control pills for years, loved it because no cramping, knew exactly when period was coming and my periods were so light and only 3-4 days. But I can't take them anymore because they cause me to have severe migraines no matter how low dosage a pill.

I would say the biopsy is a good choice. I found that doing research online, talking to other women with similar or same symptoms helps me in knowing options and what questions to ask the doctor.

I hope your biopsy turns out well and the pills work for you!

Keep us posted!!

Thanks for replying Star3! Sometimes I have a 'marbley' feeling and a heaviness down low in front. The bloating is outrageous right before my period. I look pregnant! I am pretty small, 5'4 and 115lbs. I said in the last post that we didnt want to do the sonohysterogram, aka saline infusion, because of money, but after talking to my husband we decided we feel better knowing what is in there. The trans vag. sonogram is not as definitive. Perhaps a d and c will be a better solution. The lab can do the tests on that tissue as well as a biopsy, right? I believe if there are polyps they can be removed during a d and c. I have never had any problems like this before, and my mom says no family history, either. Its a mystery. Thanks again for the encouragement.

Having the sonohysterogram will let you know if they are polyps or fibroids. At least that is my understanding. My dr said the transvag I had can't determine what exactly the growth inside my uterus is so the hysterscopy will let him know. The D&C will allow your dr to take a tissue sample to test and remove any polyps or fibroids - from what I have read. Also reading I found that a D&C is better than the endometrial biopsy I had done in the office - mainly since the dr can see excatly where he is taking the tissue from and ensuring he gets enough - one thing I am a bit concerned with myself that he didn't get enough tissue or near the lesion site - just didn't feel comfortable on the phone with him when he kept saying he is concerned about this growth and doesn't know if it is too deep to remove.

What do you mean by "marbley" feeling?? Sometimes I feel like everything in my lower abdomen is being jostled all over when I walk, sort of like olives in a jar being shaken up. It is tender, hurts, and annoying.

Keep us posted of your test results!

Hope you feel better!

Hi Star3

I went the same route you are thinking about. I had a (rollerball) endometrial ablation and hysteroscopic myomectomy. They removed some of the submucosal fibroids but during the surgery they also discovered that some of the growths were not fibroids - but nodules of adenomyosis instead. The adenomyosis can't be removed, so I did later have a hysterectomy, but I just wanted to let you know that the two procedures - the E.A. and hysteroscopic myomectomy - were not bad at all. I can honestly say having the procedure was easier than having my period.

Your periods sound similar to what I experienced with very heavy bleeding, large clots and severe pain. I would also think I was just about finished menstruating, then *wham* the flooding would start again. My bloating was awful and I had a lot of back pain with it too. Reading your posts reminds me of myself and my goes out to you (as well as any sister suffering each month)

My U/S had also shown a thickened endometrium & my endometrial biopsy was okay. I had a 3 month dose injection of Lupron prior to my procedures - to shut down my ovaries in hopes of shrinking the fibroids and thinning out the endometrial lining.
My neighbor's doc had her schedule her EA for right after her period ended - saying that's the optimal time for an E.A. since that's when the lining is at it's thinnest, but I don't usually see much mentioned about the timing of it.

My older sister and 2 neighbors have had great success with their ablations. I hope you have wonderful success with whatever you decide also.

Endometrial Ablation Discussion Group

Endometrial Polyps

Best wishes & s
Beth