Chronic pelvic pressure/mild pain since D&C

[jw1021]

In March 2009 I had a late term miscarriage, induced and delivered but had a wuick D&C to remove the remaining tissue.  After I went home, I had some mild sharp pain in my lower right side, just off of my c-section scar (close to where you would feel ovulation pain).  It was worse when I would use those muscles, such as when urinating or trying to have a bowell movement.  I figured it was just from everything I went through and it started to get better.
By July it was still there, though mild and would come and go.  I would feel it mid-cycle and right before getting my period for teh most part.  Also, my periods since my D&C were VERY heavy and gross.  I went to see my doc and he did a pelvic exam and said he didnt feel anything, prescribed me BCP and pain killers (though the pain wasnt all bad).
My period got better on BCP but the pain (mild) and associated pressure, fullness felling has persisted.  Now that I am off BCP again, my periods are back to gross.  The feelings of pressure have increased, especially right now right before my period is due.  SOmetimes I get a twinge of the pain if I tqist suddenly the wrong way.  I went to see one of the CNMs yesterday - she felt around and said she thinks she feels something...when I feel it, it is like right where they cut through for my c-section...if I stretch all that saggy skin out I dont feel it anymore, so I assume what she was feeling was just fat or tussue or something.  Sometimes I feel this pain straight through to my back.  Its very mild, but the fullness is definitely there.  I never felt any of this before my D&C.  Any ideas on what I'm dealing with?  I am having an ultrasound next week but I am just trying to convince myself that this probably is not anything serious.

[problemsage44]

I had a D&C 6 years ago due to a failed pregnancy at 14 weeks.  The first attempt failed and my cervix was torn, however, after preparation the 2nd attempt went ok.  After going home, I awoke at 3 am awoke to a huge puddle of blood which was something I was warned about since I my uterus was tilted.  Within 6-8 month I started noticing sharp pains now and again.  When I started missing periods  I asked if it could somehow be related to the torn cervix and scare tissue.  No, I was told it was bowel related.  The pains continued and my periods completely disappeared for 2 years.  I was sent for ultra sound and ended up diagnosing me with small cysts on my ovaries.  I was sent to a gynie because he could not exlain why my periods had stopped.  As the months passed I kept complaining about the pain and that it was getting bad enough to think about going to the hospital.  I was told it could me my apendix and to definately go to emerg. next time it happens.  Then I started noticing a discharge that felt as though it was bubbling out.  It was the wierdest thing and I never felt anything like this before.   Then I started noticing an odour, something else I had never experienced.  So again I make an appt. to see a different gynie.  She thought I had vaginitis and put me on an antibiotic, however I got a call today and was told I tested negative for vaginitis and positive for yeast.  She explained that because of the ongoing symthoms she wanted me to finish the meds and also asked me to pick up a yeast kit.  Now I am married and have been for 14 yrs.  We use condoms because I am too old to take the pill at 44yrs.  

So my questions are:

Can this infection have started years ago from the D & C  and when i first started haing the pain?  

Could these problems be caused from untreated yeast infection?

Can untreated yeast infection developed into PID?  

Can it be the reason my periods to stopped?  

I have been complaining for years and now know after a hormone test they find I am not even in  peri menopause.

Any information you give would surely be appreciated..

[jw1021]

Thanks so much for your answer.  It figures that now I just found out I am pregannt again!  So the ultrasound will wait a couple weeks to try and kill 2 birds with one stone.  I'll let you know!

[Elaine Brown, MD]

Hi!
I doubt that this is a SERIOUS ( as in life-threatening ) problem, and if you were my patient, I would try to reassure you.  I would also do an ultrasound!
There are a couple of possibilities that I can think of.  One would be that there may have been a perforation of the uterus ( a small hole made by one of the instruments ) during the D&C, and there could be scar tissue adherent to the uterus at that location.
There could also be scar tissue from a C-section too.  Also, if there was a perforation during the D&C, a likely spot would be at the scar from a C-section.
Scar tissue can form due to infection too, and  often causes the type of discomfort you are describing.
ALSO, it is possible that you have developed a fibroid or a cyst on your ovary, either of  which should be detectable on the ultrasound.  Two other thoughts: adenomyosis (which is a type of scar tissue that forms within the muscle wall of the uterus) can cause extra heavy periods, and an incisional hernia from the C-section are also possibilities.
I think the ultrasound will be helpful in sorting all of this out.
If the ultrasound didn't clear up the diagnosis, I would probably consider laparoscopy next, to take a look around in there.  At any rate none of the things I am suspicious of are malignant ( cancer ), and most are treatable.
I hope this helps!
Dr B