Cystitis - What's next?

Hello,
I have had the following symptoms:  bloating,frequency to urinate, feeling of fullness after eating, extreme fatigue. Went to my gyno first and found out I have a simple cyst on my left ovary and a slightly enlarged uterus and thickened endometrium. She wasn't concerned about those, but I am tired of the bloating and frequency to go problem, so I pressed her.  She is treating me for cystitis and I had a CA125 and CAE blood test (no results back yet).  My question is, if the bladder problem is not resolved by the medicine, what is my next course of action? All the symptoms are very bothersome and I want to get an answer - I would like to be prepared. If you can help me, thank you so much!

[Lennox Hoyte, M.D.]

Simple cyst/enarged uterus/slightly thickened endometrium does not explain the symptoms. You should get a urine culture to look for a bladder infection. Any infection should be treated. If no infection, and you are urinating often and small amounts, and are otherwise healthy, ask your doctor about a bladder control medication like vesicare or enablex. You should note if/how these bloating symptoms are related to your period. Many women have bloating symptoms in the 2 weeks leading up to their period. Consider also pregnancy. If not pregnant, an oral contraceptive like Yaz can be helpful to minimize these symptoms, provided that you are still having periods. CA125 and CEA may just add to the confusion. CA125 can be elevated in all types of conditions like endometriosis, cysts, so it is not a very specific test for ovarian cancer, which is what you appear to be worried about.  The ultrasound result seems to be saying that you have normal ovaries, based on what you said in the report. This should reassure you. If you are post menopausal, consider a more detailed gyn examination looking for pelvic masses, and consider getting an MRI of the pelvis. If you are post menopausal and really worried, ask to see a gynecologic oncologist for a detailed evaluation.

[gatorfrog]

Thank you for your help.  I am smack in the middle of menopause, I think. Not pre-not post (age 50), so my bloating is not due to pregnancy.  I appreciate the advice of the medicine and to see a gyn/onc if necessary.  I like to be prepared when talking to my gyn so make sure that I am covering all bases. Thank you so much for this information.