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Oncology (General Cancer)/Uterine thickening and dysuria.

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I am a 60 year old woman. I recently had an abdominal and suprapubic pelvic ultrasound. It was requested by my gastroenterologist to rule out gall bladder problems.I had been experiencing nausea as well as intermittent right abdominal pain. I've had bloating  lately as well as generalized pelvic pain /discomfort.I don't think that the right abdominal pain and the pelvic pain are related.I have collagenous colitis which is being treated with Butesonide (started Butesonide ~ 3 weeks ago). These symptoms are not related to the colitis or side-effects of the meds.
The ultrasound was generally unremarkable. However, they found the right kidney had an extra -renal pelvis with slight fullness, but no significant abnormality. I have had numerous bladder infections over the years as well as one kidney infection. I have some pain before, during, and even after urination. I have  no bladder infection at present, nor do I have interstitial cystitis. The pain in the lower abdominal area persists quite a while after urination.
I also have an 8 mm thickening of the uterus . I only use small amounts of low-dose topical estrogen for senile vaginitis. I never took oral hormones. I have had some spotting of blood in the last few weeks, and minor spontaneous bleeding 2 weeks ago. I have been in menopause for ~6 years. I had one ovary removed ~ 10 years ago because it had a very large cyst which ruptured.The biopsy was negative. I also have negative pap tests.
The radiologist advised me to see the gynaecologist soon. I have an appointment with my gynaecologist mid-January  for a biopsy when he is back from vacation. I had brought the report to the gynaecologist's group office. The other doctor there, who I have never seen told me to wait until my own doctor comes back.
Should I worry? Do you think  that I probably will be a candidate for  a hysterectomy?
I appreciate your kind consideration of this matter.

Thank-you,
Harriet"

Answer
The ultrasound abnormality of the kidney doesn't sound serious; however the frequent bladder infections suggest that something is wrong with your urinary tract, and you probably should have a cystoscopy if you haven't already.  "Cystitis cystica" is a precancerous bladder condition that could give you symptoms like you are describing.  As far as the uterine abnormality is concerned, it certainly should be investigated.  A hysterectomy would be indicated if you have an early cancer, or if there are other things going on that make your health condition less than aptimal.  As for worrying, I think the best thing is to get to the bottom of the problem(s).  I try not to worry unless I know what to worry about.  As for what I think, it doesn't sound like you have anything fatal; if you have a little thickening of the uterus and some spotting, and this is due to cancer (probably isnt') you've probably caught it in plenty of time.  Uterine cancer is usually cured, since it tends to spread slowly and turn up early.  Hope this helps.  

Oncology (General Cancer)

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Donald Higby, M.D.

Expertise

I can answer almost all questions related to the treatment and natural course of most kinds of cancer, especially cancers of prostate, colon, lung and breast.

Experience

I have been a practicing medical oncologist for 36 years, and have been chief of service at a major medical center for 25 years. I've also done research in cancer treatments.

Organizations
American Society of Clinical Oncology

Publications
New England Journal of Medicine American Journal of Medicine Journal of the American Society of Clinical Oncology Hematology Transfusion Medicine

Education/Credentials
MD, Stanford University Internal Medicine residency, St. Louis University School of Medicine, St. Louis, MO Medical Oncology Fellowship, Roswell Park Cancer Institute, Buffalo, NY

Awards and Honors
America's Best Physicians, last 14 years

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