A pelvic lump can be concerning, but many are benign. These masses can originate from reproductive organs, bowel, or bladder. Medical evaluation determines the cause and guides management.
Understanding Potential Causes
Pelvic lumps in females arise from numerous sources, related to reproductive organs like the ovaries and uterus. Ovarian cysts, fluid-filled sacs on an ovary, are common, especially in women of reproductive age. These include functional cysts (follicular or corpus luteum) that often resolve on their own, and other benign types like endometriomas or cystadenomas.
Uterine fibroids are non-cancerous growths in the muscular wall of the uterus. Their size and number vary, occurring within the uterine wall, on its outer surface, or protruding into the uterine cavity. Bartholin’s cysts, forming when ducts near the vaginal opening become blocked, can also appear as a lump.
Lumps can also originate from other pelvic structures. These include lipomas (benign fatty tumors in subcutaneous tissue) and abscesses (collections of pus from infection, like tubo-ovarian or diverticular abscesses). Swollen lymph nodes in the groin, often due to infection or inflammation, may also be felt as lumps.
Hernias, where tissue protrudes through a weak muscle spot, can present as a pelvic lump, such as inguinal or femoral hernias. Less commonly, masses can originate from the intestines, lower ureters, or bladder. While most pelvic masses are benign, cancerous growths like ovarian, fallopian tube, or peritoneal cancers are possible, particularly in postmenopausal women.
Recognizing Associated Symptoms and Urgent Signs
A pelvic lump may not cause noticeable symptoms, sometimes discovered incidentally during routine exams. When symptoms occur, they vary by the lump’s size, location, and cause. Common symptoms include pelvic pain or discomfort (dull, sharp, intermittent, or persistent), a feeling of fullness or pressure in the lower abdomen, and bloating.
Lumps can impact surrounding organs, causing changes in urination (e.g., frequent urge) or bowel movements (e.g., constipation). Abnormal vaginal bleeding, including between periods, heavy menstruation, or postmenopausal bleeding, can also be a symptom. Pain during sexual intercourse may occur, depending on the mass’s location and size.
Urgent signs warrant immediate medical attention. These include rapid lump growth, severe pelvic pain with nausea and vomiting (indicating ovarian torsion or ruptured cyst), or fever, chills, redness, and warmth over the lump (suggesting infection or abscess). Other urgent signs are unexplained weight loss, persistent fatigue, decreased appetite, or feeling full quickly.
How Lumps are Diagnosed
Diagnosis of a pelvic lump begins with a detailed medical history and physical examination. The provider asks about symptoms, medical history, and family history. A physical exam includes an abdominal assessment for tenderness or masses, followed by a pelvic examination to assess the mass’s size, shape, mobility, and cervical displacement.
Imaging tests visualize the lump and surrounding structures. Transvaginal ultrasound is often the initial imaging for a suspected pelvic mass, providing detailed images of ovaries, uterus, and fallopian tubes. It helps differentiate between simple (fluid-filled) and complex (solid) masses. CT scans or MRI may offer a more comprehensive view, assessing the mass’s extent and origin.
Laboratory tests provide valuable information. A pregnancy test is routine for women of reproductive age to rule out ectopic pregnancy. Blood tests may include markers like CA-125, which can be elevated in ovarian cancer or benign conditions. If imaging and lab results suggest a suspicious mass, a biopsy may be performed for a definitive diagnosis.
Overview of Treatment Options
Treatment for a pelvic lump is individualized, depending on the diagnosis, size, symptoms, and patient health. For many benign, asymptomatic lumps, especially functional ovarian cysts, a “watchful waiting” approach monitors if the lump resolves on its own. This includes regular follow-up and repeat imaging.
Medications manage symptoms or address underlying causes. Hormonal contraceptives might manage dysmenorrhea or prevent new functional ovarian cysts. Antibiotics treat infectious causes like pelvic abscesses. Pain relief medications help manage discomfort.
Surgical removal is considered for larger masses, symptomatic ones, or those with suspicious characteristics. Techniques vary; minimally invasive laparoscopic surgery (small incisions) is often preferred for benign masses. Open surgery (larger incision) may be necessary for very large masses or suspected cancers. Surgery can range from removing only the mass to an entire organ, depending on diagnosis and circumstances.