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:
- 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 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.
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A hymenectomy is a procedure that is done to remove extra tissue from the hymen that partly or totally covers a female’s vaginal opening.
Ovarian Masses and Tumors
Ovaries can become enlarged due to cysts, masses or neoplasms. The vast majority of ovarian neoplasms in girls and young women are not cancerous. Most ovarian cysts do not cause significant symptoms and resolve spontaneously.
Larger-appearing labia minora, known as labial hypertrophy, may be completely normal. Labia vary in appearance with a wide range of normal regarding the size, shape and color. The majority of patients who have concerns about labial hypertrophy have normal labia.