Adhesions from surgery

[wubbie3]

I've been reading the posts, and let me just say how wonderful you are to assist everyone with their problems and fears.
A brief history: I was sent to ER with fairly severe side pain believed to be appendix, CT scan found a partially ruptured cyst on R ovary. Went to gyn and cyst was monitored for 3-4 months. No major changes except in different diameters (like it was spreading wider, but not larger). Gyn thought dermoid, scheduled surgery for 5/17. Cyst turned out to be endometrial, and the spreading was due to the endo leaking pretty much constantly, which is why it didn't get bigger in size. She removed cyst and as much endo as she could, and was put on Depo-Provera after surgery to try and stop endo from growing more.(Never had endo or symptoms of endo before)
I'm four months out of surgery, and the pain has been increasing for the past several weeks, from dull ache to sharp pains and ache (like a constant muscle cramp). Gyn did put mesh over the ovary to try and prevent adhesions. Period started (very light) about the same time, and even with moving shot to 8 weeks instead of 12 weeks, and doubling the dosage, period continues.
What are the odds that these are adhesions causing all this? Is there any test that can see the extent of them? Or could an endometrial cyst re-form that quickly?
Can endo become cancerous? (there are some cancers in the family line.. nothing uterine that I know of, but most of family was adopted, so records are incomplete).
Thanks for any help... I really appreciate it.
~Marianne

[wubbie3]

Thank you for your reply...
I have moved my appt up for a repeat ultrasound, and if that doesn't see anything, I'm going to insist on further tests. I have had a low grade fever for three days, increasing intermittent pain, and spotting despite doubling the dose of the Depo Provera. So... hopefully I can get to the bottom of this, and the fact that endo turning malignant relieves on set of worries greatly.
Thanks again!
~Marianne

[Annekathryn Goodman, M.D.]

Hi Marianne,
It sounds like you have endometriosis. Rarely, cancers can arise within endometriosis but the majority of people will never have a malignancy.
Pain can occur during menstruation when areas that are involved by the endometriosis bleed. Pain when you are not having a period or when your periods are suppressed is less likely to be due to endometriosis.
Other reasons for pain include infection, growing cysts, a cyst that has twisted around its blood supply (called "torsion"), an adhesion that is causing a segment of intestine to twist. If you are still having periods despite lupron, you may have something else going on such as a polyp or growth inside your uterus.

I would recommend that you ask your gyn about the following evaluation options:
repeat ultrasound to look for recurrent ovarian cysts
labs to check for infection (a white count, urine culture)
if pain is persistent, consider a laparoscopy for further evaluation of adhesions
a biopsy of the lining of your uterus.
best wishes