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trapped blood
I had radiation treatments in 2003 for rectal cancer. My periods stopped. Now it is 2007, I have 2 blood filled cysts, blood in my uterus and in one fallopian tube (it appears to be a fallopian tube) No ovaries show up in ultrasounds, CT scans or MRI and they also can not be found in pelvic exams. My Gynecologist tested my blood for menopause a year ago & said I was menopausal/post menopausal. Because of radiation damage, The oncologist OB GYN surgeon she referred me to is not sure if she'll be able to dialate my cervix for a D&C to relieve pressure, get me out of pain, in hopes the cysts will diminish. She does not want to operate becauseI had a trans derma flap surgery 2 yrs ago on the left side of my abdomen & I have an ileostomy on my right side- after this procedure/exam? - what should the next step be? Or, is there one more step we should take before the D&C?
Thank you so much for your effort to answer my question(s)! It is confusing and complicated-
last Tuesday they tried to do the D&C, but were unsuccessful-they were unable to find the cervix-possibly also because of radiation damage. The intervention radiologist did not want to try and drain
anything through ultrasound. The MRI confirmed that the uterus and cysts, and tube-according to contrast were also filled with blood. From the only view I have-(since this attempt) I see a black/blue spot I assume might be dried blood, and a mark which looks like an attempt to either enter the uterus, or take a biopsy? Since Tuesday-My Dr. has decided I need a hysterectomy, and is working with the plastic surgeon who did the trans derma flap in 2005. I also have esophageal varices which have to be addressed (and are) before surgery. In the meantime, I am uncomfortable, uncomforted, and have not come across any situation like mine..
Thank you again for considering my dilemma-if you think of anything you can add, please do. I know originally, my doctor did not want to do a hysterectomy because I continue to lose support in my abdomen-since I'm already missing my rectum & colon, etc. So where will support come from?
last Tuesday they tried to do the D&C, but were unsuccessful-they were unable to find the cervix-possibly also because of radiation damage. The intervention radiologist did not want to try and drain
anything through ultrasound. The MRI confirmed that the uterus and cysts, and tube-according to contrast were also filled with blood. From the only view I have-(since this attempt) I see a black/blue spot I assume might be dried blood, and a mark which looks like an attempt to either enter the uterus, or take a biopsy? Since Tuesday-My Dr. has decided I need a hysterectomy, and is working with the plastic surgeon who did the trans derma flap in 2005. I also have esophageal varices which have to be addressed (and are) before surgery. In the meantime, I am uncomfortable, uncomforted, and have not come across any situation like mine..
Thank you again for considering my dilemma-if you think of anything you can add, please do. I know originally, my doctor did not want to do a hysterectomy because I continue to lose support in my abdomen-since I'm already missing my rectum & colon, etc. So where will support come from?
MEDICAL PROFESSIONAL
From your posting, it is a little unclear to me the main issue. I believe that you are saying that you are having pain and pressure and your doctor wants to do a D&C and because of your history, might not be able to do a D & C and does not want to go through your abdomen. It is not surprising that your ovaries don't show up on exam. After radiation, they become rather small and similar in consistency to the nearby tissues and can be very hard to see.
Clearly, it will be ideal to get into the uterus through the vagina and not have to go through your abdomen where you have had surgery and radiation. Sometimes, doing the D & C with ultrasound guidance can help accomplish it. It might be possible just to pass a thin catheter with ultrasound guidance. If that fails and there is a need to empty out the uterus of blood or fluid, it might be possible to use an ultrasound to pass a thin needle through the wall of the uterus via vaginal ultrasound to drain out the fluid. It is also possible that the pain and pressure is due to the fallopian tube being filled with fluid and it is not because of the uterus at all. The same method can be used to drain the tube of fluid and relieve pressure. This is a relatively quick procedure and could be done in an office. However, it is one that your doctor would have to be comfortable with. It is similar to the type of procedures done in in-vitro fertilization.
Machelle M. Seibel, MD
Clearly, it will be ideal to get into the uterus through the vagina and not have to go through your abdomen where you have had surgery and radiation. Sometimes, doing the D & C with ultrasound guidance can help accomplish it. It might be possible just to pass a thin catheter with ultrasound guidance. If that fails and there is a need to empty out the uterus of blood or fluid, it might be possible to use an ultrasound to pass a thin needle through the wall of the uterus via vaginal ultrasound to drain out the fluid. It is also possible that the pain and pressure is due to the fallopian tube being filled with fluid and it is not because of the uterus at all. The same method can be used to drain the tube of fluid and relieve pressure. This is a relatively quick procedure and could be done in an office. However, it is one that your doctor would have to be comfortable with. It is similar to the type of procedures done in in-vitro fertilization.
Machelle M. Seibel, MD
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