Painful intercourse, pelvis pain, hematuria-what is it?

I am 25 years old and for the past few months have been experiencing bad pelvic pain, painful menstruation, painful urination, and worst of all extremely painful intercourse. Two years ago, I had a laparoscopy to check on endometriosis, but it was negative. I was not having these bad of symptoms then and it prob was done prematurely. I recently had an MRI of pelvis and it showed a “hyperintense myometrium on T2 image and small foci of decrease signal intensity throughout myometrium representing fibroids or adenomyomas.” What does this mean? Could this be endometriosis? Please help, docs want to do another lap, hesitant. Also, constantly show “free fluid in cul-de-sac.” What is this?

Dear Trinity-
Based on your posting, your symptoms are classic for both endometriosis and adenomyosis. Both of these diseases need immediate treatment to prevent further spread. It is possible that endo was not detected on your scope..but the hematura is classic for endometriosis of the bladder.
Adenomyosis is a form of endometriosis that attacks the uterine muscle…please read our website sections on these diseases. Classic treatment for adenomyosis is a hysterectomy…we offer women a laser procedure that treats and removes the disease….the sooner it is treated the less the spread. There is no “cure” for these diseases short of hysterectomy and removal of ovaries..but patients can live almost symptom free if the diseases are caught in time and aggressively treated. Unfortunately, adeno is very aggressive and spreads into the uterus with every menstrual cycle….the more the muscle gets damaged the greater the chances of infertility. Sometimes, in order to effectively treat the disease, our laser FAS may render the patient unable to get pregnant.
The only way to confirm adenomyosis is with a tissue biopsy during surgery…an open laparotomy may not show anything except an enlarged uterus…this disease is inside the uterine muscle.
I know our FAS procedure can help you….please call my office if you are interested in more information.

I had several female problems and had a hysterectomy my ovaries are still in. I was diagnosed with severe adenomyosis and I’m now feeling pain and have developed a tiumor/cyst in my pelvic area…is it possible because my ovaries are still in I have adenomyosis developing inside of me again?

Dear Vicki-
Adenomyosis is strictly a disease of the uterus…once the uterus is removed, the disease is gone. You may have endometriosis in your pelvis.

I am 26 years old and have a very similar case to trinity216 (above). My MRi result said pretty much the same thing regarding the diffusely hyperintense myometrium in T2 weighted sequence. It said it was a “nonspecific finding.” What is that? Is this finding classic for anything inparticular? Also, it showed small foci of decreased signal intensity throughout myometrium probably representing small adenomyomas, but junctional zone not thickened. Help, I am in pain and need advice as to what to do.

Dear Tabitha-
Thank you for your posting. MRIs, although very specific diagnostic tests, do not always give an exact diagnosis when it comes to female issues. Adenomyosis can be suspected, but can only be confirmed with a tissue biopsy. Based on your symptoms, you could have either adenomyosis or endometriosis. Both diseases present with pelvic pain. I would suggest a diagnostic laparoscopy to start, in order to get more information.
If you have adenomyosis, and it is confirmed with a tissue sample, your doctor will probably recommend a hysterectomy. This disease is aggressive and painful…the longer it is left untreated the more it will spread.
Our FAS procedure does effectively treat the condition and allow will you to prevent a hysterectomy.
Good luck