Endometriosis after Unilateral Salpingo Oophorectomy

[NutterMans]

Hi. I'm 38 years old. I've had relatively normal periods all my life, moderate flow and some cramping and lower back ache. Last fall i had a sinus infection which caused migraines and took several different courses of antibiotics to get rid of. As soon as it was cleared up, i got a very sharp, sudden pain in my back on the right side that did not go away. I thought after so many antibiotics maybe i had a kidney stone. After blood tests, CT scans and ultrasounds, it was revealed i had a grapefruit size tumor on my right ovary. It, along with my ovary and fallopian tube, was removed on January 13. It was non-cancerous and fluid filled. The tube had twisted, so i guess the cyst would not have gone away on its own. I was supposed to have a period right after surgery, but it was late, although i did have periodic bleeding after. I have had continuous pain since then, somewhat in the area between my navel and the incision on the right side, but the worst pain has been in my groin on the right. The pain is so bad at times, that i break out in sweats, i can't concentrate and i can't move around. The pain in my groin becomes even worse if i have an orgasm. My gyne thinks it's endometriosis and wanted to put me on lupron, but changed his mind and decided on a birth control pill called Errin. He scheduled a full abdominal ultrasound and vaginal ultrasound which found nothing wrong. I've been taking that for a week and a half. He did say after surgery that i had some scar tissue inside (even though i've never had an abdominal surgery) and endometriosis. My periods since the surgery have been a week late each time, with very heavy flow. Two weeks ago i saw my GP and discussed things with him. He scheduled a CT scan, which found nothing except a possible "T" uterus, which he said wasn't a problem unless i want to become pregnant. He thinks the pain in my abdomin is scar tissue which i should be concerned about, and the pain in my groin is a swollen lymph node and if left alone it will go away. I started my period again yesterday, again a week late, and the pain is so bad i haven't been able to go to work, i've even had trouble walking or getting into bed and i feel like i'm going to pass out - the pain being somewhat in my abdomen, but mostly in my groin. It feels like i'm being stabbed with a knife and the blade is being twisted. Is it possible that this intense pain from endometriosis just started so fast? Shouldn't that be something that gradually gets worse? And why would i have the pain in my groin? I don't know what to do. I've also had some mood swings, hot flashes and the worst case of acne which started about a week after surgery and has yet to clear up. Thank you.

[Cherie762]

Hi your nausea is likely from the Naproxen, best to take with food or milk, the pain is still to be expected post op 3 weeks, if your incision is red, hot to touch or has any drainage do phone your Dr.

in the meantime its best to still be quite inactive, the more you rest the better you heal, adverage heal time is 6 weeks, if your pain is not being controlled by current meds Id advise you to phone dr for advice on possible change.

[therna01]

Was your pain finally relieved? I just had unilateral salpingo oophorectomy about 3 weeks ago and I got a sudden sharp pain on the right side near the incision area. It hurts during inspiration and when I move. The pain is pretty excruciating. I am not sure what this could be. Any ideas? I take naproxen and it does not seem to help. I am also experiencing nausea without vomiting. I wonder if I injured something inside or if I am just sore but it was better and now it is worse.

[Cherie762]

Endometriosis is when the lining of the uterus is partially shed internally as into pelvic cavity instead of coming out in menstural flow ,usually the thicker part of sometimes "clots'

Scar tissue is caused from wounds or surgery...endometroiosis can perhaps..cause scar tissue by connection of (ie) an ovary to the bowel...but the two are differnet things...

Im glad your seeing a new gyn for a differnet opinion.always a good choice, especially before consenting to any surgery.

Pain management is a option..I dont know your other issues (knee) but as for female problems it just masks the problem...what would happen if for example a person had a cyst rupture..but they thought it was just mild cramps because of being on pain management.

Dont get me wrong..I have been on plenty of pain meds get it totally nobody wants to hurt.

Leupron only effects some women w the negative emotional issues...perhaps it wont with you. It may be in your best intrest to try it...could always discontinue if you dont like it.

Hope you didnt take offense to the std comment..just I always feel I like to give all possible causes to you ladies .

If it ends up that you do need a hysterectomy please let me know I have a lot of good helpful pre and post op tips,

Good luck w second Dr..let me know how it goes !!

Cherie

[NutterMans]

Thanks for the info.

No STD's, have been with the same partner for 8 years. I've had numerous blood tests that show no sign of infection. I was told the "T" uterus is also sometimes called a heart shaped uterus and won't be a problem unless i was planning on getting pregnant, but i'm not.

As for the scar tissue, i questioned the Dr at my last appointment about if that could be the cause and he said endometriosis is scar tissue. My options are to go through pain management (of which i already am because of a totally messed up knee - have been for years), have the Lupron injections, or have a hysterectomy. I've made an appointment for Friday with another gynecologist.

[Cherie762]

Hi..when i had my hyster my room mate a 80 year old tiny lady had nearly same as you a "grapefruit" size cyst on ovary..however hers was had not caused a twisted tube (called torsion.,,,,very painful)  I am certain a cyst that size would not go away on own.Wonderful news everything was begnine.


I could not begin to tell you how many times I have recieved posts about groin/abdominal and sometimes thigh pain post op. there are a few different possibilities as to what causes this.

I am not convinced that endometriosis is the cause, (I am not a dr) but heres my thoughts...Jan of this year , just a few months ago your surgeon had your pelvic cavity open..if there was endometrial tissue,,he/she would have noted it and likely removed the most of it, they sure would have been ethically bound to tell you,]

My point is why would endo develop so suddenly and so severly in just a few months I am not convinced,,,is it possible yes,

scar tissue and addhesions, are what I would discuss with gyn also the area you describe is where the appendix is...

Leupron is a interesting med..it has some potentionally serious emotional side effects, many women do not tolerate it as it brings on weepiness and depression. think about that a read on it if your dr may suggest switching to it.

Ultrasounds and trans vag ultrasounds are a good test..however not always able to see everything.....example i had a functional cyst on my right ovary. had about 5 trans vag ultrasounds as the pain( from cyst) landed me in er many times . they sometimes could see cyst and ovary...sometimes could not even find my ovary,,,and i am a adverage size lady...so just know this about ultrasounds.

Sorry to say but disagree w Dr about the swollen lymph nodes,,You should get a second opinion asap,,perhaps a immunologist...your dr should have done a fine needle biopsy to help identify what type of node it is...enlargement tends to commonly result from infection / immune response ( most women who have these ar usually always put on an antibotic to see if it helps) also although I dont think its the case for you,,i think yours is surgery related and you may have a infection, I must let you know swollen lymph of groin can in some cases indicate stds.

Your 100% right about your thoughts on endrometroisis,,,it should gradually get worse, thats why i said I dont think its your primary issue.

Here is one more possible cause of your groin pain and it would be very very hard to get gyn or surgeon to admit to, its possible during surgery that a nerve was nicked or severed...the way to find this out would be to see a neurologist, they have tests that can determine or disprove this possibility.

menopausal symptoms are to be expected...even w just one ovary being removed...they remaining ovary should take on the work of two,,but it takes time for body to adjust from trauma of surgery.

I hope some of this helped..you sound smart....keep advocating for self..I would be most concerned for now about the lymphnodes...and secondly the pelvic/abd pain. could even be cnnected if you have a infection...not all infections produce classic symptoms such as fever....demand a CBC,,and a fine needle biopsy of nodes....
then think about seeing a neurologist for an exam....if your pain is not neurological.

You may need a diagnostic lap so dr can see exactly what your issues are and correct them..it may well be scar tissue, but your quality of life is greatly comprimised and you deserve better than that, find a dr who will help you.

let me know if you have any questions I know I kinda threw alot  of information at you.

best wishes
Cherie

How you could have scar tissue after first surgery visable during surgery is interesting..it is very possible you may have had another cyst at some point that ruptured.

a "t" uterus is just a tilted uterus andmst ladies are able to concieve and carry fine..I have tilted (well till they removed it LOL ) and I have three healthy boys.