Pelvic Masses
What Are Pelvic Masses?
Gynecologic causes of pelvic masses (enlargements) include adnexal cysts, ovarian masses and tumors and uterine abnormalities. Adnexal cysts and ovarian masses and tumors are much more common than uterine abnormalities in girls and young women.
What Causes Pelvic Masses?
The most common reason (outside of pregnancy) the uterus would become enlarged in a girl or young woman is due to accumulation of menstrual blood, also known as an outflow tract obstruction. Menstrual blood needs an exit from its origin in the endometrium (lining of the uterine cavity), through the cervix and out through the vagina. Any blockage along this pathway may result in an obstruction. Birth defects involving the uterus, cervix, vagina or hymen may result in an obstruction.
Uterine fibroids and adenomyosis are relatively common causes of uterine enlargement in adult women, but are infrequently seen in teens and younger adults.
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What Are the Symptoms of Pelvic Masses?
The nature, size and location of the pelvic mass will determine whether the patient experiences symptoms. Possible symptoms include:
- Pain
- Fullness
- Pressure
- Bloating
- Urinary or bowel changes
- Decrease in appetite or feeling full quickly
- Menstrual cycle abnormalities
If large enough, the mass may be seen or felt as a bulge in the lower abdomen.
How Are Pelvic Masses Diagnosed?
Pelvic imaging with ultrasound and/or MRI is the most common tool to determine the nature of the pelvic mass. Sometimes if an outflow tract obstruction is suspected, an pelvic exam in the office or with anesthesia may be required.
How Are Pelvic Masses Treated?
Treatment of a pelvic mass depends on the nature of the mass. While most ovarian cysts will resolve spontaneously, other causes will most likely require surgical intervention with focus on addressing the underlying abnormality and preserving/maximizing reproductive function and potential.