Pelvic, abdominal, rectal pain and hematuria and hyperplasia

[mia785]

I am 50 years old and am perimenopausal.  Since last spring I have had periodic spotting, hematuria, an abnormal pap smear, with a normal cervical biospy, an abnormal uterine biopsy ("bordering on simple hyperplasia without atypia"), pelvic pressure on my bladder (which has subsided), dull pain/pressure in the left upper abdominal area under my ribs and around my back, dull intermittent pelvic, back and vaginal pain on the left side, and now dull rectal pain on the left isde that is worse after a bowel movement.  I have had a pelvic ultra sound that was normal, but showed a 2 cm simple cyst on my left ovary, an upper GI series that was normal, and blood work for pancreatic enzimes that was normal.  I have seen my gyn several times, internist several time, and a uro-gynocologist.  My gyn also sent me to a gyn-oncologist to get an opinion as to whether to treat the hyperplasia or not.  I have follow up appt with the uro-gynocolost at the end of Oct. for a recheck.  I continue to have the intermittent spotting and hematuria.

Needless to say I am very concerned and the discomfort and anxiety it is impacting the quality of my life big time!  I am losing faith in my doctors and don't know where to turn next.  I seem to be getting more and more symptoms that are not getting better.  I read online that there are ovarian tumors the produce estrogen that can cause hyperplasia.  I know that my my ultra sound was normal but I also read about cases where things are missed on ultra sounds.  My internist said she didn't think it was anything serious and was holding off on doing a CT scan.  I am thinking about insisting that they do it.  I am also thinking about going back to the gyn-oncologist and bringing her up to date to see if she has any suggestions.  I'm also wondering if I should go to a colorectal doctor.  I had a normal colonoscpy in March.  Would appreciate some advice.

[Annekathryn Goodman, M.D.]

Hi There,
you need at very least a minor surgical procedure called a D&C (dilation and curettage) and hysteroscopy.

here is a nice link that describes the procedure:

http://www.emedicinehealth.com/dilation_and_curettage_dandc/article_em.htm

An office biopsy can miss a more serous lesion such as a cancer.

if endometrial hyperplasia with atypia is discovered there is a 40% change of having an early endometrial cancer. Most gyn oncologists would recommend a full hysterectomy in that setting.

as for your abdominal pain, it may be unrelated.
you can consult with your doctor about getting a CT scan or an endoscopy or both

best wishes

[mia785]

Thank you.  Do you think the hematuria and rectal/ lower back pain could be unrelated as well?