Cervical Tears: Frequent Urination and Abdominal Pain Concerns

Cervical laceration, frequent urination, and lower abdominal distension?

I would like to ask, I recently visited a gynecology clinic, and for the past week, I have been experiencing frequent urination and slight pain in my lower abdomen.
Additionally, I have been bleeding during intercourse.
These symptoms have been present for about three weeks.
The doctor performed an ultrasound and found no abnormal masses, but during the cervical examination, there was noted skin breakdown and slight ulceration.
The internal examination was very painful for both my abdomen and vagina, and there was also bleeding.
The doctor suspected pelvic inflammatory disease but could not make a definitive diagnosis.
I was prescribed pain relievers and antibiotics, and I was advised to refrain from sexual activity, which I have been following.
Now that I have finished the medication, I understand the need for ongoing follow-up, but I do not want to return to the same clinic.
I am still experiencing frequent urination and persistent abdominal bloating.
I have bowel movements about twice a day, and I feel that my abdomen is larger than before.
There is also a hard, bloated area just below my abdomen, which feels strange to me.
I am unsure whether to return to the clinic or go to the hospital for further examination.
I am currently afraid of internal examinations.
What kind of tests do I need to undergo, and what could be the cause of my condition? Thank you.

Xin Xin, 20~29 year old female. Ask Date: 2015/07/25

Dr. Lü Lizheng reply Obstetrics and Gynecology

1.
Based on your description, it is likely that there is uterine inflammation or pelvic inflammatory disease.
In either case, antibiotic treatment is necessary.

2.
If frequent urination persists, it may indicate bladder inflammation, and it is recommended to visit a hospital for further examination and confirmation.

3.
If symptoms have not completely resolved, it is possible that the condition has not fully healed, which may be due to insufficient duration of antibiotic use or bacterial resistance to the antibiotics, resulting in incomplete treatment.
It is advisable to seek further examination and treatment at a hospital.
Sincerely, Dr.
Lu Li-Cheng, Taoyuan Hospital.

Reply Date: 2015/07/25

More Info

It sounds like you're experiencing a complex set of symptoms that are causing you significant discomfort and concern. Based on your description, you have been dealing with frequent urination, abdominal pain, and bleeding during intercourse for about three weeks. Your doctor has performed an ultrasound and a cervical examination, which revealed some superficial tears and slight ulceration, but no abnormal masses. The suspicion of pelvic inflammation has been raised, and you have been prescribed pain relief and antibiotics.

Given your symptoms, it is crucial to understand the potential underlying causes and the appropriate steps to take next. Here are some considerations:
1. Cervical Tears and Inflammation: The presence of cervical tears and ulceration can lead to pain and bleeding, especially during intercourse. This could be due to various factors, including infections, trauma, or even hormonal changes. The inflammation could also be contributing to your symptoms of frequent urination and abdominal discomfort.

2. Pelvic Inflammatory Disease (PID): Your doctor’s suspicion of pelvic inflammation could indicate a condition like PID, which is an infection of the female reproductive organs. PID can cause symptoms such as pelvic pain, abnormal bleeding, and urinary issues. It is essential to treat PID promptly to prevent complications, including chronic pain or infertility.

3. Urinary Tract Involvement: Frequent urination and abdominal bloating could also suggest a urinary tract infection (UTI) or irritation of the bladder. The inflammation in the pelvic area could be affecting the bladder, leading to increased urgency and discomfort.

4. Follow-up Care: Since your symptoms persist despite treatment, it is essential to follow up with a healthcare provider. If you are uncomfortable returning to the same clinic, consider seeking a second opinion from another gynecologist or a urologist. They may perform additional tests, such as a pelvic exam, urine analysis, or imaging studies, to further investigate your symptoms.

5. Diagnostic Tests: You may need to undergo further diagnostic tests, including:
- Pelvic Ultrasound: To assess the reproductive organs and check for any abnormalities.

- Urinalysis and Urine Culture: To rule out a urinary tract infection.

- Endometrial Biopsy or Hysteroscopy: If there are concerns about the uterine lining or if bleeding persists.

6. Managing Anxiety and Fear: It’s understandable to feel anxious about further examinations, especially if you’ve experienced pain during previous internal exams. Communicate your concerns with your healthcare provider; they can often take steps to make the examination more comfortable for you.

7. Lifestyle and Home Care: In the meantime, ensure you are staying hydrated and maintaining a healthy diet. Avoid irritants such as caffeine, alcohol, and spicy foods, which can exacerbate urinary symptoms.
In summary, your symptoms warrant further investigation to determine the underlying cause and appropriate treatment. It is essential to continue seeking medical care until your symptoms are resolved. Do not hesitate to advocate for yourself and seek a second opinion if you feel it is necessary. Your health and comfort are paramount, and finding a provider you trust is crucial in managing your condition effectively.

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