*Warning for anyone who doesn't like to talk vaginas or female problems you'll want to skip this post!

Just over two weeks ago I found a vaginal lump, or more specifically a vulvar lump.  I felt a pinch and a sharp pain as I tried to urinate.  I've had a series of problems over the last few years, including a battle with abnormal paps for which I underwent a LEEP and a Cold Knife and hospital stays, and two abscesses.  I knew the pain was not good. 

During a self exam I found the lump on the left side of the vulva, in the exact same place of an abscess I had in July.  I knew the drill and tried to stay calm, but the difference between July and now is that I'm pregnant.  At the time of finding the lump I was 12 weeks and a wave a panic washed over me. 

I laid in bed for a few minutes to steady my breathing and to overcome the tears.  All I could think about was July.  As I said in July the small lump turned into a large, bulging abscess that required an emergency procedure to drain it.  This lead to a hospital stay, followed by at-home nurse care, the use of a catheter for over a week and subsequent vaginal yeast and bacterial infections through December.  All I could think about was the pain I had experiences.  The wound needed daily packing, meaning to keep the wound draining it was packed with gauze strips that needed daily changing.  I'm sure many have experienced much worse pain than this, but for me this was... well beyond painful and I can't describe with words.  Just thinking now, remembering the pain, I've teared up.

Then came the thoughts of how horrible it had been not to be able to pee.  Before the catheter was used, the abscess had pressed up against my urethra making it impossible to urinate.  I never thought I'd welcome a catheter but I did then.  The problem was after the procedure swelling took the place of the abscess cutting off my urethra once again.  Daily in the hospital the catheter was removed for hours to see if I could go to the bathroom on my own.  After three days of this it was decided to send me home with the catheter and the nurse care. To put it simply none of this was pleasant.

Beyond the thoughts of the pain my head kept swimming around the safety of my baby.  What would this do to the baby?  What if I can't pee again as baby grows pushing against my bladder?  Bacterial infections can be dangerous to unborn babies.  So yes, I panicked.  Once I calmed down I called my doctor.  The nurse told me to come right in.  I called my husband who was teaching to let him know what was happening.  Then I got dressed and headed to the doctor's office.

While I waited for the doctor to come into the exam room I went over again what had happened in July.  I had ridden bikes with my stepsons the morning I first felt pain.  The next day I found the lump.  The doctor decided I'd injured myself during the bike ride.  She called it trauma.  She prescribed vicodin for the pain and went through a list of procedures I needed to do at home to help the trauma heal.  She had felt that I'd just bruised myself and needed to take it easy, take sitz baths and even use ice for the trauma to heal.  This was on a Thursday and the swelling continued some.  But from Sunday to Monday morning the lump had grown and was bulging beyond the vaginal lips. I was immediately admitted to the hospital.  The doctor determined the trauma had lead to an infected abscess. 

I knew we couldn't do the same pain management and preventative procedures in hope the lump would heal as we had in July.  I sat there wringing my hands until the doctor came into the room.  A few minutes seemed like hours.  When she came in I told her about the lump and the pain trying to urinate.  She asked me if I'd been having problems overall urinating.  I thought about it and realized I had been having problems.  It would take me forever to finally go to the bathroom, sometimes I had to push and force myself to go when my bladder was full.  I figured this was all part of pregnancy though.  

She first checked on the baby and found a strong heart beat. At hearing the heart I breathed a sigh of relief.  Next she checked the lump.  She found it as well.  She said it felt full of liquid, unlike in July where it had felt tight.  She thought the procedure in July had damaged the gland to where it couldn't secrete the natural fluids.  This would cause the gland to fill.  She decided to drain it in the office and to insert a worm balloon catheter that would keep the gland open to drain and hopefully create a new pathway for the gland to secrete on it's own in the future.

She and the nurse prepared the room for the procedure.  I was topically numbed and she explained step by step what she was doing.  She said she was going to culture the fluid to make sure it wasn't an infection.  She made the incision and I heard, "Oh good, it's completely clear.  This should mean there's no infection!"  I responded with another sigh of relief.  She talked more about getting just over 1cc of liquid, which is what she had expected from the size of the lump.

Next I hear the doctor with surprise in her voice, "Well, that's not clear at all!"  She asked the nurse for another culture vial as I felt wetness down the back of my thigh.  The doctor said something about this being a chocolate cyst or an endometrioma.  I asked what this was.  She said she'd explain everything in a minute as she was having a problem inserting the worm balloon catheter.  In the end she couldn't get it inserted.  The area had completely collapsed on itself making it impossible to insert anything.

I was cleaned up and the doctor showed me the vial of the second liquid she'd taken from me.  It was dark brown and there was about 6cc in the vial.  She asked me to get dressed before she talked to me.

When she came back in she handed me a brochure on Endometriosis.  I was immediately confused because what I knew of Endometriosis was that it caused problems in conceiving and caused severe pain during menstruation.  I was pregnant and had never had severe pain with my cycle.

The doctor explained that the endometriomas can appear anywhere in the body, even though the uterus and ovaries are the most common areas for the cysts to appear.  "Endometriosis is a condition where tissue similar to the lining of the uterus (the endometrial stroma and glands, which should only be located inside the uterus) is found elsewhere in the body."  She told me of a patient once who got a bloody nose during each of her periods.  The patient had thought the bloody nose was just a symptom of her cycle when in fact it was an endometrioma.

My doctor went on to explain that the cyst will never go away on it's own.  It needs to be removed and I need to be treated for Endometriosis.  The normal treatments are nothing I can undergo while pregnant, plus pregnancy itself is usually helps relieve the endometriosis symptoms.  But, my troublesome cyst pushes against my urethra and being able to pee while growing baby is rather important.

We talked some more about my the surprise find of the cyst and the abscess in July.  She explained the cyst must have been there at the time.  She continued talking of how the body communicates within itself.  My head was spinning by now thinking of surgery and I can honestly say I'm not positive of what she was saying to me.  I left knowing I faced surgery and an assurance that she would talk to an specialist in urology about the location of the cyst and how it could be communicating with the urethra and somehow be related to the abscess.

I got to the car and fell apart.  I called Shawn and called work.  The numbing agent was starting to wear off and I could feel the pain of the incision and the pushing to drain the cyst and to insert the worm balloon catheter.  Logically I knew I shouldn't be a mess of tears as this should be a simple procedure to remove a cyst where the baby wouldn't be in any danger.  But, I'm pregnant, emotional, hormonal and haven't had the best of luck with simple procedures.  So I cried and went home.