Bladder/Uterus Problems Upcoming Surgury In Need Of Advice

[twinkletwinklelittlestar292]

My uterus is enlarged measuring 10.6 x 4.9 x 6.4 cm and the endometrial stripe is thickened measuring 1.34 cm (shown on several ultrasounds). I have grade 2 vaginal cystocele (bladder prolapse), interstitial cystitis, overactive bladder & stress incontinence. I had a pelvic exam done confirming a mass in my uterus. I was told after the last ultrasound that I have a submucosal fibroid though the fibroid was not stated on the ultrasound. My CT scan stated my uterus is mildly prominent and nodular and may be related to fibroids. I recently had an IVP done which showed my bladder would not fill properly during the test, I was told this may be due to the tumor in my uterus. They had to give me 2 glasses of water to drink to get the contrast to go down into my bladder. The test confirmed that I have a deformity in the dome of my bladder from the overlying uterus and a small amount of post void residual. I am scheduled very soon to have my uterus removed and to have a stent put in my bladder. My gynecologist thinks my uterus is adding on to my bladder problems though he mentioned the deformity is pretty common in people. My urologist said the fibroid would only be a problem depending upon it's size and location. But they didn't bother to call me back and discuss the issue with me as they said they would. My major concern is if my uterus is causing extra problems to my urinary tract. My problems have been frequent urination (40 to over 100 times a day), night-time urination, incontinence, burning sometimes with urination, hesitency occassionally, frequent UTI's, large amounts of microscopic hematuria, pain after peeing (feeling like I have been split into), alot of pressure, pain & tenderness in the pelvic region, bladder spasms, and pressure, pain & tenderness in both kidneys, with the left side being extremely worse (one CT showed mild bilateral hydronephrosis, other kidney tests have been normal) and widespread numbness/tingling sensations (and that I know somehow is linked with my pelvic problems). My question is wanting to know what my IVP test results mean with the bladder deformity from my uterus and my bladder not filling properly during the test. Can you please explain to me what that means and let me know if I should at all be concerned about the situation? Also does that mean that the urine is slow about draining out of my kidneys and into my bladder, would that put pressure in my upper urinary tract causing the pain I'm having in my kidneys? I know that the prolapse is causing some of my problems but I haven't found out why there's all this pressure/pain in my entire urinary tract and I have been through one test after another over the past year trying to find out why and my doctors just don't do much explaining. I don't think I can honestly go through with this upcoming surgury without even understanding why it's needed. I would really appreiciate any help here. Thank you.

[Kevin Pho, MD]

I cannot give an accurate interpretion of the IVP without reviewing the test myself.  Any kind of obstruction can lead to a deficit in the bladder filling during the IVP.  Depending on the size and location of the fibroid, this may contribute to the problem.  

Another GU abnormalities should be considered - a cystoscopy would be the most comprehensive test to evaluate for other possible obstruction.  

If the urine is slow to drain, it can lead to kidney failure and swelling.  Kidney swelling (hydronephrosis) can lead to discomfort.  

Tese considerations can be discussed with your urologist.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
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