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Is General Anesthesia Administered While Doing Cervical Stenosis?
Question: Is is normal to have a cervix which is ceased and therefore I need to have a general to have dialate my cervix in order to do a biopsy. Plus am "I just wasting the Hospitals time having this done as I'm just going through menopause"
I have had heavy bleeding periods for 4-5 years. have frequent urinating issues, often have a sore back and my ultrasounds have come back showing
myometrium heterogeneous
thickness 4mm
cervix nabothian syst measuring 13x11x10mm
left ovary systic structure irregular in shape 36x24x10mm
In 2009 I had polyps removed.
I have had heavy bleeding periods for 4-5 years. have frequent urinating issues, often have a sore back and my ultrasounds have come back showing
myometrium heterogeneous
thickness 4mm
cervix nabothian syst measuring 13x11x10mm
left ovary systic structure irregular in shape 36x24x10mm
In 2009 I had polyps removed.
Brief Answer:
Yes, you might need general anesthesia if the cervix is stenosed.
Detailed Answer:
Hello xxxxxxxxx
Thanks for writing to us with your health concern.
Firstly , please help me out with a few doubts regarding your concern.
Your first sentence states - cervix is ' ceased ' ??
What do you mean by that ?
Do you mean a ' stenosed ' cervix - a tightly closed one ?
That often happens after menopause ?
And then if that is the case, then yes, you do need general anesthesia to dilate your cervix.
What procedure is being intended ?
Endometrial biopsy ?
With heavy periods, that maybe advised, you are not wasting any body's time here.
And yes, if that is what they are stating, then who advised the biopsy for you ?
4 mm endometrial thickness is not very high, and generally not high enough to warrant a biopsy, but if the symptoms of bleeding are severe, then it might be needed.
I actually need more details about your cervix, who advised the biopsy and why.
Also, what kind of polyps, what was the biopsy report etc.
Take care.
Please feel free to discuss further.
Yes, you might need general anesthesia if the cervix is stenosed.
Detailed Answer:
Hello xxxxxxxxx
Thanks for writing to us with your health concern.
Firstly , please help me out with a few doubts regarding your concern.
Your first sentence states - cervix is ' ceased ' ??
What do you mean by that ?
Do you mean a ' stenosed ' cervix - a tightly closed one ?
That often happens after menopause ?
And then if that is the case, then yes, you do need general anesthesia to dilate your cervix.
What procedure is being intended ?
Endometrial biopsy ?
With heavy periods, that maybe advised, you are not wasting any body's time here.
And yes, if that is what they are stating, then who advised the biopsy for you ?
4 mm endometrial thickness is not very high, and generally not high enough to warrant a biopsy, but if the symptoms of bleeding are severe, then it might be needed.
I actually need more details about your cervix, who advised the biopsy and why.
Also, what kind of polyps, what was the biopsy report etc.
Take care.
Please feel free to discuss further.
Above answer was peer-reviewed by :
Dr. Sonia Raina
Hi
Thank you for your reply.
I have never been given a medical term for my cervix condition however I have been told (by my Dr first and now 3 other Drs) that when they try and do a normal procedure to take samples of my uterus they have been unable to due to the fact that my cervix is "tightly closed" or "ceased up".
My Dr suggested an Ultrasound and blood tests.
The full result from the Ultrasound is
Findings
Both transbdominal and transvaginal scans were performed
UIterus: anteverted, normal size 53x75x46mm vol 96mil XXXXXXX and non-tender
Myometrium: heterogeneous. Course focal interior myometrial echotexture containing systs, consistent with adenomyosis
Endometrium: normal: thin & uniform. No focal abnormality
thickness: 4mm
Cervix: nabothian cyst measuring 13x11x10mm
Right overy: 22x20x14mm Normal apperance and size
Left overy: Size 26x29x29mm vol 11ml Cystic structure, irregular in shape measuring 36x24x10mm
No adnexsal abnormality or free fluid
Conclusion:
Left ovarian cyst, with a slightly irregular shape, recommend followup examination in 3 months time to ensure resolution.
When my Dr tried to do the tests of my Uterus, She asked a more experienced Dr to try and she couldn't either due to my very tight cervix. Because of the fact that I have had issues with prolonged bleeding (sometimes 3 - 4 weeks of bleeding) that they thought it was "best to have a general and dilate my cervex in the hospital where everything is there if needed"
My Dr arranged for me to go to hospital for this treatment, the date arrived and off I went a little nervous as I wasn't sure what was going on. All I understood was that I was going to get my cervix dilated under a general so that they could do a biopsy. However when I arrived I was told that they were not sure why I was there and that they were going to do a internal biopsy. So I went through this again, and again the Dr went and got a second opinion because my cervix was closed or tight. The second Dr had the same problem and basically told me she didn't know what I was doing there as there was nothing wrong with me, I was just going through menopause she said.
Another thing that I should mention is that I have been on Provera for about 4-5 years as well. I would go off the pills if I got spotting and allow a natural period, however it would often not stop unless I started up the pills again. A couple of times I just waited to see when it would stop and it would take 3 or so weeks to stop.
The Hysteroscopy that was done in 2009 to remove the polyps was successful as far as I'm aware. I dont have any info of this at hand.
The second Dr at the Hospital suggested that there was nothing wrong with me She suggested that I have a (IUD) Mirena inserted and that while they were at it they will do the biospy even though it is just going to come back clear as there is nothing wrong with me.
She really upset me and made me feel like I was making things up.
I know that for my age I am very fit and healthy compared to most that she normally see's but I am sick of constantly bleeding.
I can feel a tugging on my left side and I often get a sore back from just the most simplest things.
Occasionally I get a sharp pain in my abdomen (I have no idea if these things are related or not just trying to give you more info).
I hope this helps enlighten you of my concern
Thank you
Thank you for your reply.
I have never been given a medical term for my cervix condition however I have been told (by my Dr first and now 3 other Drs) that when they try and do a normal procedure to take samples of my uterus they have been unable to due to the fact that my cervix is "tightly closed" or "ceased up".
My Dr suggested an Ultrasound and blood tests.
The full result from the Ultrasound is
Findings
Both transbdominal and transvaginal scans were performed
UIterus: anteverted, normal size 53x75x46mm vol 96mil XXXXXXX and non-tender
Myometrium: heterogeneous. Course focal interior myometrial echotexture containing systs, consistent with adenomyosis
Endometrium: normal: thin & uniform. No focal abnormality
thickness: 4mm
Cervix: nabothian cyst measuring 13x11x10mm
Right overy: 22x20x14mm Normal apperance and size
Left overy: Size 26x29x29mm vol 11ml Cystic structure, irregular in shape measuring 36x24x10mm
No adnexsal abnormality or free fluid
Conclusion:
Left ovarian cyst, with a slightly irregular shape, recommend followup examination in 3 months time to ensure resolution.
When my Dr tried to do the tests of my Uterus, She asked a more experienced Dr to try and she couldn't either due to my very tight cervix. Because of the fact that I have had issues with prolonged bleeding (sometimes 3 - 4 weeks of bleeding) that they thought it was "best to have a general and dilate my cervex in the hospital where everything is there if needed"
My Dr arranged for me to go to hospital for this treatment, the date arrived and off I went a little nervous as I wasn't sure what was going on. All I understood was that I was going to get my cervix dilated under a general so that they could do a biopsy. However when I arrived I was told that they were not sure why I was there and that they were going to do a internal biopsy. So I went through this again, and again the Dr went and got a second opinion because my cervix was closed or tight. The second Dr had the same problem and basically told me she didn't know what I was doing there as there was nothing wrong with me, I was just going through menopause she said.
Another thing that I should mention is that I have been on Provera for about 4-5 years as well. I would go off the pills if I got spotting and allow a natural period, however it would often not stop unless I started up the pills again. A couple of times I just waited to see when it would stop and it would take 3 or so weeks to stop.
The Hysteroscopy that was done in 2009 to remove the polyps was successful as far as I'm aware. I dont have any info of this at hand.
The second Dr at the Hospital suggested that there was nothing wrong with me She suggested that I have a (IUD) Mirena inserted and that while they were at it they will do the biospy even though it is just going to come back clear as there is nothing wrong with me.
She really upset me and made me feel like I was making things up.
I know that for my age I am very fit and healthy compared to most that she normally see's but I am sick of constantly bleeding.
I can feel a tugging on my left side and I often get a sore back from just the most simplest things.
Occasionally I get a sharp pain in my abdomen (I have no idea if these things are related or not just trying to give you more info).
I hope this helps enlighten you of my concern
Thank you
Brief Answer:
Have detailed my suggestions and future course of action.
Detailed Answer:
Thank you for an insightful and detailed update, dear xxxxxxx.
Let me provide my opinion now.
It is very clear from your description that you have a stenosed cervix.
In essence, it means that it is tightly closed.
A normal cervix is slightly open and admits a small instrument or probe that can obtain a biopsy of the inside of the uterus.
In your case, that is not possible without administering general anesthesia and carefully dilating your cervix with precision.
NOw, your ultrasound scan gives no reason to have an endometrial biopsy actually.
IF the endometrial thickness exceeds a certain level, then a biopsy is indicated, yours is entirely within normal limits and a 3 monthly follow up for the adnexal cyst is the perfect way ahead.
Now it is not normal for you to have excessive bleeding in this manner for the past few years ( letting up only when Provera is started ).
That points towards SOME abnormality somewhere.
What your doctor might have intended was for you to have a second hysteroscopy, and then if necessary, have a biopsy if anything suspicious was seen out there.
And the other doctor might have just tried to simplify the procedure and go for a biopsy.
It is virtually impossible for me to guess what went on in the various doctors' minds.
In my opinion, if this irregular bleeding was due to menopause, it would not be going on since 6 years.
Peri menopausal irregular and heavy menstrual bleeding is common, but it does not go on for years, at the most a year or maybe two .
I also think the biopsy would mostly come out to be normal, but there might be something else inside the cavity ( polyps, fibroids, etc ).
It is actually worthwhile to have a hysteroscopy done, as the continual bleeding is actually not normal, nor healthy to have for a long time.
While the scopy is being done, a biopsy maybe done if any area is seen that is untoward - looking, and then a Mirena might be inserted to provide you relief and succour from taking Provera night and day.
That sounds like a sensible course of action.
The other symptoms do not sound alarming to me, apart from the back soreness.
Around this age, you might be prone to calcium and vitamin D deficiency, it is worthwhile to have these levels checked.
A complete blood count and thyroid profile is in order too.
I hope my inputs helped.
You can contact me directly anytime you wish to, just by clicking on the following direct link -
http://doctor.healthcaremagic.com/doctors/dr-aarti-abraham/64623
Take care.
Prayers for your good healthy and a speedy recovery !
Have detailed my suggestions and future course of action.
Detailed Answer:
Thank you for an insightful and detailed update, dear xxxxxxx.
Let me provide my opinion now.
It is very clear from your description that you have a stenosed cervix.
In essence, it means that it is tightly closed.
A normal cervix is slightly open and admits a small instrument or probe that can obtain a biopsy of the inside of the uterus.
In your case, that is not possible without administering general anesthesia and carefully dilating your cervix with precision.
NOw, your ultrasound scan gives no reason to have an endometrial biopsy actually.
IF the endometrial thickness exceeds a certain level, then a biopsy is indicated, yours is entirely within normal limits and a 3 monthly follow up for the adnexal cyst is the perfect way ahead.
Now it is not normal for you to have excessive bleeding in this manner for the past few years ( letting up only when Provera is started ).
That points towards SOME abnormality somewhere.
What your doctor might have intended was for you to have a second hysteroscopy, and then if necessary, have a biopsy if anything suspicious was seen out there.
And the other doctor might have just tried to simplify the procedure and go for a biopsy.
It is virtually impossible for me to guess what went on in the various doctors' minds.
In my opinion, if this irregular bleeding was due to menopause, it would not be going on since 6 years.
Peri menopausal irregular and heavy menstrual bleeding is common, but it does not go on for years, at the most a year or maybe two .
I also think the biopsy would mostly come out to be normal, but there might be something else inside the cavity ( polyps, fibroids, etc ).
It is actually worthwhile to have a hysteroscopy done, as the continual bleeding is actually not normal, nor healthy to have for a long time.
While the scopy is being done, a biopsy maybe done if any area is seen that is untoward - looking, and then a Mirena might be inserted to provide you relief and succour from taking Provera night and day.
That sounds like a sensible course of action.
The other symptoms do not sound alarming to me, apart from the back soreness.
Around this age, you might be prone to calcium and vitamin D deficiency, it is worthwhile to have these levels checked.
A complete blood count and thyroid profile is in order too.
I hope my inputs helped.
You can contact me directly anytime you wish to, just by clicking on the following direct link -
http://doctor.healthcaremagic.com/doctors/dr-aarti-abraham/64623
Take care.
Prayers for your good healthy and a speedy recovery !
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you Dr XXXXXXX
You have put my mind at ease a little. I think at this stage I will go ahead with the general and see what the outcome is from there.
Kind Regards
xxxxxxx
You have put my mind at ease a little. I think at this stage I will go ahead with the general and see what the outcome is from there.
Kind Regards
xxxxxxx
Brief Answer:
Thank you too
Detailed Answer:
Thank you for your appreciation.
Yes, please go ahead with the procedure, and think about the Mirena insertion while you are planning that, as the Mirena itself will take another general for you to have it.
Keep me posted.
Take care.
Thank you too
Detailed Answer:
Thank you for your appreciation.
Yes, please go ahead with the procedure, and think about the Mirena insertion while you are planning that, as the Mirena itself will take another general for you to have it.
Keep me posted.
Take care.
Note: Revert back with your gynae reports to get a clear medical analysis by our expert Gynecologic Oncologist. Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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