Saturday, January 22, 2011

Bulky uterus
















The above ultrasound images show what is called a bulky uterus. This term is used when the uterus is larger than normal for the age of the patient. The common causes include -1) the post partum stage (after delivery/ childbirth), when the uterus is still large in size after delivery (the process of shrinking in size of the uterus to its normal size is called involution), 2) fibroids, 3) adenomyosis etc. These patients often complain of discomfort in the pelvic region and menstrual problems. Another cause of enlarged or bulky uterus in middle aged women is increase in the BMI (body mass index). Higher the BMI and obesity are associated with larger or bulkier uterus. See this link: Bulky uterus and obesity The ultrasound images above show a diffusely enlarged uterus with no evidence of masses (tumors) or other pathologies.

The above is an ultrasound video clip of a case of bulky uterus seen in sagittal section. Observe the increased size of the liver without any other pathology. This was a middle aged (52 year) old female patient with back pain. Bulky uterus is a common finding among middle aged menopausal women.

This middle aged lady with the bulky uterus (same case as above) also has a significant deposition of fat within the liver, resulting in moderate fatty change. Many middle aged Asian women present with both bulky uterus and fatty liver.

58 comments:

  1. Hello doctor,
    i have 2 children of age 6yrs and 3 yrs both are normal deliveries. My age is 33yrs now i am suffering with stomach pain at the belly and lower abdomen. My ultrasound report of Abdomen and Pelvis is bulky uterus and small left renal calculus. is it a problem or can be cured with simple treatment.Please suggest me the better way for relief.
    -Jyothi

    ReplyDelete
  2. Hello Jyothi,
    Small kidney stone (renal calculus) can be treated by certain medicines which can dissolve the stone. Even small kidney stones can sometimes be painful. Bulky uterus is a common problem among middle aged women. Again for this consult a gynecologist who might prescribe medicines to correct the problem. Both the above problems dont appear serious enough for surgery. Please email me images of the ultrasound scan.
    Dr. Joe.

    ReplyDelete
  3. Hello doctor,
    my mother of age 45 is suffering from pain in belly and lower abdomen...she has two children both were sygarine babies, her scaning reports shows fibroids and bulky uterus....suggest me what to do for her further safe life

    ReplyDelete
  4. Dear Pallavi, I can understand your concern for your mother. I would like to have a look at the images/ pictures of the scan or get the full report. If possible contact me by phone:
    91-484-2323088 or 91-484-2403058 ( India- cochin)

    ReplyDelete
  5. Anonymous3:01 PM

    hello,sir i m suferring from tuberculiosious since april2010 ,i am 24 years old not married ,i hav cysct in my ovary in last 1 year.but after the medical checkup after 1 year ovary is normal in condition,but i hav mild bulky uterus.i m sffering pain in my belly and in lower abdomenn .please,suggest me.what to do??

    ReplyDelete
  6. I think you should consult a gynecologist. Mildly bulky uterus is a common and maybe insignificant finding. If possible, please send your ultrasound scan images to me by email.
    Dr. Joe

    ReplyDelete
  7. Keira1:12 PM

    Hi doc, I am 27 years old, unmarried and have undergone removal of a large uterine fibroids about 3 and a half months ago. The recent ultrasound reports still shows uterus is bulky. What does it mean. Also i seem to be putting on a really lot of weight on my stomach area. Please advice.

    ReplyDelete
  8. Anonymous2:03 PM

    Hello sir i have taken some pills for abortion but mc discontinue today i went to for ultrasound & they have given report that a BULKY UTERUS WITH SMALL ECOGENIC STRUCTURE S/O-BLOOD CLOT/RPOC I cant understand should i go for surgery(abortion )or wait for net mc.please suggest

    ReplyDelete
  9. I am a 28 years female from Rajasthan and unmarried, my pelvic is bulky, please advise what to do ?

    ReplyDelete
  10. could you please send me an image of the scan..
    Joe.

    ReplyDelete
  11. Haarit, we are discussing bulky uterus here.. could you specify what you mean by bulky pelvis?
    Dr. Joe.

    ReplyDelete
  12. dear doctor,
    i am suffering from bulky uterus.i am the mother of 4 yrs old one baby girl and interested to take our next baby... is there will be any problem because of my bulky uterus..??should we wait/??

    ReplyDelete
  13. Dear Durri, even with a bulky uterus you can still have your next child. Bulky uterus is not a serious condition. Please consult your gynecologist also.
    Dr. Joe.

    ReplyDelete
  14. Anonymous12:33 AM

    I have a bulky uterus. What does that mean? is it a problem to getting pregnant? can be cured with simple treatment.Please suggest me. I am 30yrs old, married & planning for child next year.Please tell me about bulky uterus.

    ReplyDelete
  15. Anonymous9:33 PM

    Hello,doctor
    my mother is 45 yrs old. She have 4 children.
    Here is her report
    ULTRA SOUND
    pelvis (female) transvaginal 3D ultrasonogram (ultra sound)
    clinical data :menorrhagia
    findings:
    the uterus is bulky in size measuring about 4.7 cm (AP)
    myometrial echopattern is homogenous
    endometrium is of normal thickness (6.6mm) and homogenous
    cervix appears normal in size and parenchymal echopattern
    a nebothian cyst measures 9.2 x 6.7 are seen in the region of mid line of cervix
    RIGHT ovary measures 1.8x1.1x1.4 cm volume is 1.6 cc
    LEFT ovary measures 1.8x.9x1.6cm volume is 1.5 cc
    normal sized follicles are noted in both ovaries

    no collection is seen in cul-de-sac

    irregular period ( even having LYNES)
    IMPRESSION:
    bulky uterus
    no other sonographic abnormality is detected

    ReplyDelete
  16. Respected Sir,

    My wife is 24 yrs old, has ut-bulky and gravid uterus shows early single G.S. with singlefoctur pole maluritn of CRF (18 mm)
    8w 2 days. F HR-166B/PNI

    i would like to know the restrctions and food details for that said time

    and also wanted to know the meaning for the same report.

    ReplyDelete
  17. Anonymous2:44 PM

    Hello, Dr. my usg of pelvis report shows bulky uterus with large myoma. & thichened endommetrial echoes (12.1). my age is 46yrs. is any problems please tell me

    ReplyDelete
  18. Anonymous10:58 AM

    I am 47. For past 10 months I am not getting periods. Is there any possibility of getting pregnancy. I am scared

    ReplyDelete
  19. Anonymous7:02 AM

    DEar Doctor,

    My name is sangeetha. Last december i went to india and had a master check up. The result shows that i have fatty liver and bulky uterus. i feel pain sometimes on my right side front and back at the ribs.
    is it because of the above symptoms? What is the medication for this or does this need any diet. i am 67 kgs.

    please reply me at rai.vijay2@gmail.com

    thank you
    sangeetha.

    ReplyDelete
  20. Anonymous10:23 AM

    Dear Doctor
    my mother is suffering from bulky and anteverted uterus with coarse myometrial echotexture.A subtle area is seen in posterior wall with few hypoechoic lesions in fundoposterior region.Wat does this means exactly?Please suggest some treatment for the same.

    ReplyDelete
  21. Anonymous12:15 PM

    Hello Doc..

    i am 23yrs old, unmarried. But sexually active with my fiancée.
    My sonography report reads i have an enlarged uterus. A size which 28 yr old woman may have. (said by the person who did my sonography)

    What can be a reason of me having a enlarged uterus? Is it dangerous? I am getting married in few months. Will this enlarged uterus cause any problems for me to have a baby in near future?

    ReplyDelete
    Replies
    1. Hello anonymous, enlarged uterus is often the indicator or diseases such as adenomyosis. Do you have pain during menses? Do you have irregular periods? If you dont have any other complaints, then mildly bulky uterus may be ignored. Please consult a gynecologist also. If possible please email me images of your ultrasound study.
      Dr. Joe

      Delete
  22. Anonymous8:00 AM

    Hi Doc,
    I have just had a full check up which included a pelvic ultrasound. I hadn't seen a doctor prior to this for about 4 years as I am very healthy and haven't had any reason too. I am 43 years old so I thought it might be wise to get breast and pelvic ultrasounds and full blood tests just as a check up. I have never had any problems with menstruation, fertility and pregnancies etc. I have been told I have a bulky uterus. What does this mean?

    ReplyDelete
  23. Hi, dont worry about the bulky uterus, if this is the only finding.
    Please tell me the measurements of the uterus.
    Dr. Joe

    ReplyDelete
  24. hi Doc,
    I have bulky uterus abt 43 mm.i have irregular period and extreme abdomen pain.i have polycystic ovaries also.can these cause problem in future for me to have baby?plz let me know..thanks

    ReplyDelete
    Replies
    1. Rinky, I would like to see a more detailed ultrasound report of the uterus. Bulky uterus with polycystic ovaries can hinder the process of having a child. Also your pain may suggest adenomyosis or endomteriosis. I would advise you consult a gynecologist at the earliest.
      Dr. Joe

      Delete
    2. To continue Rinky, I have seen many patients with your complaints still have children...
      Dr. Joe

      Delete
  25. Anonymous9:52 AM

    Hi Doc,
    I'm having severe pain when me and my partner have coitus...Can u suggest me why I'm having pain and how it can be treated...It really effects our relationship now. Please suggest a solution for my problem. Thank you.

    ReplyDelete
    Replies
    1. Hello, please consult a gynecologist and also undergo and ultrasound scan of the pelvis.
      Among the commonest causes of pain during coitus is vaginitis (I presume you are the female partner).
      There are many other causes of pain including infection of the uterus or pelvis, cervicitis etc.
      Dr. Joe

      Delete
  26. hello doctor i am 23 years old unmarried have extreeme pain during menstruation and suddenly having irregular bleedin.so i have a pelvic USG.my report shows that i have bulky uterus,myometrium is heterogenous and 16-17mm endometrium.my usg said that i have a possibility of adenomyosis.plz suggest whethr it is adenomyosis or some other disease.i also feel a slight pressure at the right side of the lower abdomen.i can also feel by my fingers a muscle like mass at the right side of the lower abdomen.suddenly my prolactin level increases a lot it is. about double of the normal range.plz rply doctor..

    ReplyDelete
    Replies
    1. hello klanto,
      you seem to be having a primary complaint of adenomyosis which causes certain typical changes on ultrasound imaging. Also you have some degree of endometrial thickening (17 mm.) which suggests a condition called hyperplasia of endometrium. Please send me the images of your scan via email to : drjoea1 (at) gmail.com
      Also I suggest you consult a gynecologist.
      Dr. Joe

      Delete
  27. Hello doctor,
    thanks for your reply.will definitely email you my scan report.my gynocologist also said that i have early adenomyosis.but i dont know why i am feeling a lump in my lower righ abdomen.can u plz tell me is it something related with adenomyosis.but my usg report didnot show any lump or cyst.my prolactin level is 63.19ng/ml.

    ReplyDelete
  28. Hello Klanto, sometimes a lump or mass may not be seen on ultrasound imaging because ultrasound cannot see through fat, gas or bone.
    Hence if you are troubled a lot by this doubt of a lump in your abdomen, you can undergo a CAT (or CT) scan study of the lower abdomen. This is a little expensive and has a very low exposure to xrays. If you want you can have an MRI scan of the abdomen... this is absolutely safe. Please meet a radiology center or radiologist near you.
    Dr. Joe.

    ReplyDelete
  29. Hello Sir

    I gave a birth to a girl child one year ago since then i did not have periods then after one year I have periods which last for around 25 days. But then it did not stopped. I have periods sometimes. Ultrasonography suggest bulky uterus. can i conceive a child

    ReplyDelete
    Replies
    1. Dear Manish, please consult a gynecologist and rule out any pathology (disease) of the uterus or ovaries. Your condition does not appear serious and if there is no other diseases on ultrasound imaging, you can conceive a baby.. no problem...
      Dr. Joe

      Delete
    2. Hello Sir

      My Ultrasonograpy Suggest The Following Information:
      Uterus: bulky (10.3X5.5X3.0cm)in size with normal outlines. The Myometrial echotexture is normal. Endometrium is thickened (1.42cm). It is in Midline and shows no shift, No focul SOL is seen.

      Just wanted to Know what does this mean and is there anything Serious. the Gyneo has also Prescribed Medicine for 3 Months and then she will check the report once again.

      waiting for you reply sir

      Thanking you
      Manish

      Delete
    3. No Manish, none of this is serious. However the endometrium is a bit thick.
      We call this hyperplasia.
      But this can be treated and you should be able to have another baby.
      Please continue to meet your gynecologist and keep me informed.
      Dr. Joe

      Delete
  30. Anonymous11:29 PM

    Hi Sir,

    I am a 34 year-old woman who has been unable to conceive for 1.5 years. I have just been told I have a bulky uterus (7.9cm x 6.5cm) and a posterior intramural/submucosal fibroid measuring 2.9cm x 2.5cm. Do you think this is the cause for surgery and also the cause of my infertility?
    Thank you,
    Ann

    ReplyDelete
    Replies
    1. hi Ann,
      See my blog at: http://cochinblogs.blogspot.in/2010/11/fibroids-of-uterus-leiomyoma.html
      It is all about fibroids of the uterus. It will help you understand. Fibroids and bulky uterus go hand in hand as fibroids usually make the uterus a little/ or more bulky depending on the size of the fibroid.
      Yes fibroids can also be a cause for infertility as it is indeed the case with submucosal fibroids- this can interfere with the process of implantation and cause menstrual bleeding etc.
      I would like to have a look at the images of your scan to be sure.
      You can email it to me at:
      drjoea (at) gmail (dot) com
      However there are many women who conceive despite the presence of a small fibroid.
      Dr. Joe

      Delete
  31. Anonymous9:09 PM

    Dear Dr.

    Have been married for 4 years and recently, i had ultra scan and the result show bulky uterus and fabroid. Please i dont want to undergo any surgery. Can i take any drug to correct it.

    Ala

    ReplyDelete
  32. Hello Ala,
    if the fibroid is small (less than 2 cms.) medical treatment might work. Please consult a gynecologist.
    Dr. Joe

    ReplyDelete
  33. Anonymous4:56 PM

    My mother is 50 years old. She recently had an endovaginal scan that showed anteverted utereus which is 79.1X 56.8X 59.8 mm in size. Myometrium shows normal echo pattern . No focal space occupying lesion was seen within myometrium. Endometrium echo was thickened. Endometrial thickness is 12.0 mms Right ovary weighs 32.8 X 14.3 mm and left ovary weighs 26.4 X 16.9 mms. No adnexal mass is seen in pouch of douglas. Sonological findings are suggestive of bulky uterus with thickened endometrium.
    What does this all indicate and does she need a surgery? What measures should she take to remain healthy? Can an endovaginal scan be helpful in locating tumours if any?

    ReplyDelete
    Replies
    1. Hello, your mother has a common problem for her age. if she has no other complaints like uncontrolled menses or bleeding per vagina, and not much pain or such, this finding of bulky uterus is not very significant. Endovaginal scan is done by inserting the ultrasound probe into the vagina to view the structure of the uterus; and hence this type of scan is very accurate, as the ultrasound probe goes close to the uterus. The endometrial thickness (mild thickening) needs to be followed up over a period of time by repeating the scan once in 2 months.
      She should have plenty of fresh fruits and vegetables and may have a normal diet. Regular exercise (a walk or swim) is good to improve general health.
      Dr. Joe

      Delete
  34. Anonymous8:24 PM

    I am a lady of 23 n the doctor said I have a marginally bulky and retroverted uterus or 35mm solid mass immediately adjacent to the lateral uterine wall. My uterus measures 49mm AP 55mmTS 76mm LS. My endometrium and ovaries are normal. I feel pain in my left lower abdomen and I do feel that something is in my left lower abdomen and I am scared of reproductive problem in future

    ReplyDelete
  35. Anonymous7:56 PM

    Hi doc
    I'm 33 yrs I did a pelvic ultrasound and uterus is bulky and I have a small fibroid myoma and a complex ovarian cyst on my right. I have tried to conceive for the last 5 years but in vain.please advice

    ReplyDelete
    Replies
    1. Hi, A small fibroid might decrease your chances of conceiving, but cant prevent it.
      You and your husband must undergo a complete infertility work up/ examination at an infertility center.. he should be examined by a urologist and you by a gynecologist. The complex cyst must be followed up and if large (more than 4 cms.) must be removed. Bulky uterus per se cannot cause infertility.
      Dr. Joe

      Delete
  36. Anonymous11:21 PM

    Dear Sir,
    My wife is having trouble during her periods, heavy and irregular bleeding with clots, she has recently developled gastric problems. Sometimes she wakes up at night with heavy and contineous coughing. Her ultrasoung suggests mild heapatomegaly with grade I diffuse fatty infiltration, no focal lesion/IHBR dilatation, bulky and coarse uterus no sizeable uterine fibroid prominent bowel loops at bilateral flanks and epigastrium pelvic inflammatory disease. Pl provide your email so I can sent ultrasound report. Thanking you.

    ReplyDelete
    Replies
    1. I would advice you to please consult a good physician and also if required to meet a gynaecologist.the only thing that concerns me is the possibility of pelvic inflammatory disease. As I have said before bulky uterus and fatty liver per se are not serious complaints. The images that you have sent are not very clear and I would like to have a detailed study of the endometrium by a transvaginal scan. You have not mentioned her age...as a woman approaches menopause she undergoes more irregularity in her menses. The presence of severe bleeding with clots is and can be very serious and has to be managed by a gynaecologist. If it does not respond to medical treatment then it has to be treated surgically including if necessary the removal of the uterus.
      Dr Joe.

      Delete
  37. Anonymous6:24 PM

    Hello doctor, my name is laila.I'm a 27 year old woman.I am having a kid 3 year old.After having delivery my belly didn't reduce to it's normal size.Now also it's the size of 5 month pregnant lady's.When i consulted the doctor she asked me to wear the belly belt.Now i recently undergone a scan and it shows that i have bulky uterus and may have PCOS. Will this be a problem for getting pregnant again?please advise..

    ReplyDelete
    Replies
    1. The bulky uterus alone may not cause difficulty in having children. However the presence of PCOS may interfere with your fertility. Please consult a gynecologist.

      Delete
  38. Dear sir,
    I am 43 years old and ultrasound and ct scan have shown that I have a bulky uterus.i also have a problem of indigestion.
    Is there any connection between the both of these.
    P.s:I also had jaundice 20 yrs ago .

    ReplyDelete
  39. Hello mg rakshith
    No these 2 problems of digestion and bulky utrus are not connected. .the previous history of jaundice might have some significance... If it was very severe... But that is a very remote chance...
    Please consult a physician. .. And have plenty of fruits and vegetable....
    Dr.joe

    ReplyDelete
  40. Anonymous8:24 PM

    Hello doc. I am Ola from Nigeria. Sometimes in Dec, 2012, i went for an ultra sound and was told i had fibroid even though small in size and just about the size of my finger. I have been having irregular, heavy and longer menstrual periods. I also feel severe pain on the left side of my pelvic region. All attempts at getting pregnant have been futile. Just about 2months ago, i went for another pelvic scan and was told i have a bulky uterus. I am so confused. I need you counsel pls.

    ReplyDelete
    Replies
    1. Hi, the good news is that none of what you have said sounds serious! Also the fibroid can be removed surgically without harm to the uterus. I must know the exact size and location of the fibroid to be able to give a better answer.
      Also the bulky uterus is not a serious condition as I have said. But if associated with painful menses .. bulky uterus is a sign of adenomyosis.

      See: http://www.ultrasound-images.com/uterus.htm#Adenomyosis%20of%20uterus

      This can also be corrected.
      Please email me your exact ultrasound report.
      drjoea (at) gmail.com

      Dr. Joe

      Delete
  41. Anonymous3:00 PM

    Hello doc,
    am kitty,my mom has 47 year old,and done a ultrasound scanning of abdomen got result as uterus is bulky measures 9.3x6.2x5.6 cms,also posterior wall shows intramural fibroid measuring 52x48 mm,anterior wall shows intra mural fibroid measuring 20x19 mm endometrium 8.5 mms,right ovary 3.7x2.5 cms,showing follicular cyst measuring,20x25mm,left ovary 3.7 x 2.1 cms.IMPRESSION:FATTY LIVER,BULKY UTERUS WITH INTRA MURAL FIBROIDS,FOLLICULAR CYST IN RIGHT OVARY.,docter do my mom have any problems in this report,please help me,what need to do next,for her good health,she is 70 kg,.please do kindly reply,am waiting ,thanking you

    ReplyDelete
    Replies
    1. Hello Kitty, your mom has a problem or rather..problems...she should consult a gynecologist...fibroids and bulky uterus go hand in hand..and are common complaints. Please see:
      http://www.ultrasound-images.com/uterus.htm#Types%20of%20fibroid
      The cyst is not important.. normal finding...
      Surgery vs conservative treatment of the fibroids is the need of the hour...
      Follow up ultrasound needed every 4 months for the uterus...
      Dr. Joe
      Call me- 91-9388623088

      Delete
    2. Anonymous10:47 PM

      What will be the conservative treatment ...can be given or do it lead to any cancer type...or wat type of surgery docter

      Delete
  42. My wife has bulky uterus and some small fibroids. Big fabroids already remove by the surgery one year before. I want to know about the possibility of pregnancy. She can be pregnant? What is the treatment of bulky uterus?
    Thanks for your time and information regarding bulky uterus treatment.
    Please attach report.

    Best regards

    Muhammad Mateen

    ReplyDelete

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