
What Causes Persistent Pelvic Pain Despite Having Fluid Collection In Sacrum?

Question: I am having various tests and consults. I have been in severe pain since a sacral colpopexy with mesh last march. I am know applying for disability because of this. I finally got a doctor to help and believe me. She does not know about part of my MRI of the pelvis. I have a fluid collection in front of the sacrum that could be a possible culprit of my pain but she is not convinced I also have spondylolisthesis, grade 1 L5 on S1 and l4 l5 diffuse bulgng disc and pain doctor calls my condition sacroillitis. Please excuse my spelling. So the part of my MRI states mild heterogeneous bone marrow signal in the pelvis and lumbar spine may be due to a heterogeneous bone marrow fat and the collagneous bone marrow. No definite destructive bony lesion. High ETT signal structure on the left gluteus musculature measuring up to 2.8 cm appeared inferior incidentally noted. Could this have to do with my pain? I have had SI joint injections and been in PT for months without much relief. I just seem to getting worse and am growing a tolerance to narcotic pain medication. My doctor, a urogynecologist, who I obtained just recently is helping me get some answers but nothing seems to be outright apparent. I also have trouble with coordinating BM's. I don't think it is related to the pain medication because the stool is soft. the last test I have ordered is a defecography, the GI doc seems to think it is more neurological. So as you can see my case is slightly complicated. My question is really about the MRI and if it is relevent to my pain. Thank you.
Brief Answer:
I want to know little detail about your pain
Detailed Answer:
Hello,
I have studied your case. Your pelvic pain can be due to fluid and also due to sponylolysthesis of l5-S1. Also disc bulge can cause this.So all these finding in MRI is suggestive of causes of pelvic pain.
You can discuss these finding with your doctors. Let me know if you want to ask any further questions.
Thanks
I want to know little detail about your pain
Detailed Answer:
Hello,
I have studied your case. Your pelvic pain can be due to fluid and also due to sponylolysthesis of l5-S1. Also disc bulge can cause this.So all these finding in MRI is suggestive of causes of pelvic pain.
You can discuss these finding with your doctors. Let me know if you want to ask any further questions.
Thanks
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar


Thank you, I am aware that my pain could be due to the fluid and spondylolisthesis. Please tell me I didn't not pay to hear that. I want to know if the findings on the MRI mean anything. I am referring to what I have already quoted;
Mild heterogeneous bone marrow signal in the pelvis and lumbar spine, may be due to a heterogeneous bone marrow fat and collagenous bone marrow. No definite destructive bony lesion. High ETT signal structure in the left gluteus musculature masuring up to 2.8 cm appeared inferior incidentally noted. I don't want to drive myself crazy trying to find this out before I can see the appropriate doctor. I would like you to please tell me what this could mean. Thank you so much
Mild heterogeneous bone marrow signal in the pelvis and lumbar spine, may be due to a heterogeneous bone marrow fat and collagenous bone marrow. No definite destructive bony lesion. High ETT signal structure in the left gluteus musculature masuring up to 2.8 cm appeared inferior incidentally noted. I don't want to drive myself crazy trying to find this out before I can see the appropriate doctor. I would like you to please tell me what this could mean. Thank you so much
Brief Answer:
Your MRI findings are not specific
Detailed Answer:
Hello,
Your MRI findings are not specific. it is showing findings which can be sen in any Person. Fatty marrow can be seen in any spine MRI. Also there is a 2.8 cm lymph node or a fatty globule present in left buttocks. I do not think any of these finding is suggestive of any disease. These are just incidental findings.
Thanks
Your MRI findings are not specific
Detailed Answer:
Hello,
Your MRI findings are not specific. it is showing findings which can be sen in any Person. Fatty marrow can be seen in any spine MRI. Also there is a 2.8 cm lymph node or a fatty globule present in left buttocks. I do not think any of these finding is suggestive of any disease. These are just incidental findings.
Thanks
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar


Thank you so much for that. The word heterogeneous scares me. I was thinking it had to do with inflammation of the area too. I wish It was something obvious without having my condition being so non specific. I don't understand how the area doesn't show some kind of inflammation or irritation. Now I want to ask about the fluid. it is described as in the inferior posterior pelvis there is ill-defined fluid immediate adjacent to the sigmoid colon. This is located approximately 1 cm anterior to the sacrum and appears to be intraperitoneal. There is heterogeneous collection measures approximately 2.5 x 3.6 cm. Could this be an abscess? Would I have to worry about it breaking open?
I tried to attach my MRI but don't know if you were able to see it. Thanks for your answers. This has been a frustrating process and wish my problems were obvious. I am a nurse and have been unable to work since the colpopex surgery. The pain is a very intense and deep. everything is so tight in my pelvis area. My knees are starting to hurt from pulling of my IT band. (According to PT). I am open to suggestions. Thanks for your help
I tried to attach my MRI but don't know if you were able to see it. Thanks for your answers. This has been a frustrating process and wish my problems were obvious. I am a nurse and have been unable to work since the colpopex surgery. The pain is a very intense and deep. everything is so tight in my pelvis area. My knees are starting to hurt from pulling of my IT band. (According to PT). I am open to suggestions. Thanks for your help
Brief Answer:
It is not showing adhesions
Detailed Answer:
Some amount of fluid is normally present. I do not think that it is abscess because your symptoms are not correlating with infection in peritonal cavity.Also there is nothing which suggest adhesion.Though some adhesion bound to occur in any abdominal surgery.
Heterogenous word is used to describe MRI appearance and it does not suggest that any specific pathology.
For knee joint pain due to IT band pull, you need to apply voletran ointment,rest and brufen tablet.
Let me know if you want to ask any other questions.
thanks
It is not showing adhesions
Detailed Answer:
Some amount of fluid is normally present. I do not think that it is abscess because your symptoms are not correlating with infection in peritonal cavity.Also there is nothing which suggest adhesion.Though some adhesion bound to occur in any abdominal surgery.
Heterogenous word is used to describe MRI appearance and it does not suggest that any specific pathology.
For knee joint pain due to IT band pull, you need to apply voletran ointment,rest and brufen tablet.
Let me know if you want to ask any other questions.
thanks
Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar

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Dr. Dr. Naveen Kumar Sharma
Orthopaedic Surgeon, Joint Replacement
Practicing since :2002
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