Hello, I have a question...Back on Aug. 1, I suffered a ruptured ovarian cyst - in the hospital they did an ultrasound and ct scan showing free fluid in the ab as well as pelvic (due to rupture) 3.2 - 3.5 cm in size - 1 month later I had an internal ultrasound that showed still free fluid (both areas) but now the cyst was 4.1 - 2 weeks later I had mri showing still free fluid (they only did pelvic area) and cyst is now 4.5 - 1st not sure if the size is infact growing or are these estimates.....2nd when I finally saw my OBGYN he showed NO concern about this at all - mind you I am 35 - been with the same man for 16 years without ever getting prego...I am completely bloated for the past 4 months - pain in ab/pelvic area...I am always going to the bathroom as I feel the pressure...When should I worry? Before leaving the room I asked about the bloating and nasua - he said nothing - I am also experiencing lightheadness - now this has been on and off for over a year now, I was diagnosed with a cyst a year ago which he told me was gone.. I feel now it never left but grew...I also have another cyst on right ovarie (which has grown in size as well ) and now follicles? started? I just dont know what reaction I need to have - Should I wait another 3 months for the next ultrasound or go now? and when should I worry about another rupture as (to me) both cysts appear to be growing.. But no concern about endometrosous/cancer/ rupture appear to show in my OBGYN...thank you
Shame on your doctor for not explaining all of this to you ! Follicles on your ovaries are completely NORMAL. All women grow follicles on their ovaries every month. They contain your eggs and about 14 days after the start of your period one of them breaks open to release an egg into the fallopian tube. Therefore the follicles are absolutely nothing to worry about.
As for the cysts, all depends upon what type of cysts you have. If they are simple fluid filled cysts, it is highly unlikely that they are malignant. If they are either solid tumours or complex cysts (part liquid and part solid), then a radiologist may look at their shape and composition on the ultrasound to guide your physician as to what action should be recommended. Most complex cysts are also benign but whenever ovarian cancer is present, it is often in the form of a complex cyst or solid tumour. Ill defined borders and irregular shaped growths usually warrant further investigation whereas clearly defined lines with thin walls are more indicative of benign growths. Of course the only way to be 100 percent sure is to have a biopsy taken under general anaesthesia .. a real hassle. You may also want to ask your doctor about a blood test that tests for a certain cancer antigen called CA-125. This test is controversial because it has a high rate of false positives and negatives but it does not hurt to ask your doctor what he thinks.
As for your concern about rupture, this is valid. If you are able to take it, Advil is highly effective at controlling pain from ruptured cysts. You must, however, take it as soon as you begin to experience discomfort. I carry it around with me all of the time (I have an 8 cm simple cyst on my left ovary which has been present for about a year). As for the measurements, I have been told that these are estimates and can vary. I too thought that my cyst was growing but the changes were so slight that my doctors said that as far they're concerned it is the same size (even the radiologist said this). In that case, I would like to know, why is the variance always an increase and never a decrease ?! Anyway, just to tell you that the measurements don't appear to be exact.
Get a copy of the radiology report and see what the radiologist said in his or her report. Normally radiologists are very good at looking at these things and have read that they have a highly predictive value of what they actually are.
Hello, I really appreciate all the information...I actually do have all reports as I have other health issues and my radiology group always take care of me ... the last report shows dominant 4.3 ovarian hemorrhagic cyst structure with subtle T2 shading consistent with an endometrioma - smaller left cyst is a complex cyst as stated measuring 1.6 (has grown in last year) thickened endometrial echo -it also states in all 3 reports this free fluid..at the hospital they told me this caused the nausea and pain but should go away by the next cycle, it has not- now im just bloated and have nasuea all the time...I cant take advil as I have a bad reaction to ibruprophen but I do eat a lot of excedrin lol - which only helps with the pain - I cant fit into my jeans as I really am Bloated but my doctor said dont worry, repeat in 3 cycles and I will see you next year...I just dont know what to do as far as going to another OBGYN? I am going to wait, i went through 1 cycle and will wait the 2 more...then I guess I will see what they suggest then..Does any of the information above make sense? As really noone has explained...Im sure I could call my radiologist as they are very good to me but with all my other issues I really hate to bother them...Sorry to bother you...lol...thanks for any information...
PS...aren't you worried about your cyst ruppturing even though you say its a simple cyst? I thought after 5 cm they need to remove them? I hope all is well...thank you soo much again for all your help with me...oh and I re-read my reports after writing and both cyst appear to be complex cyst, not really sure what that is..I just dont know what to think, dont really trust doctors around here...lol..thanks again
The persistent bloating issue is something that should concern your doctor and if it does not, you need to do your best to find another one. Discomfort like this should not be ignored. A complex cyst simply means that the cyst is filled with both liquid and solid components. Around here they normally recommend removal because they want to biopsy the cyst just to be sure. Keep in mind that MOST complex cysts are benign but they usually do the surgery anyway, to be on the safest side. If your radiologist is able to tell what your cyst contains, this is a good sign. Radiologists have become extremely good at being able to see possible signs of malignancy and at the moment they are all we have excluding more invasive techniques like surgery.
You can also take a CA-125 blood test where they look for levels of a cancer antigen that is supposedly present in large numbers when ovarian cancer is present. However, this test is notoriously unreliable and can miss Stage I cancer when it is present AND show high levels of CA-125 when no cancer is present (usually numbers are high during menstruation and for other benign reasons such as endometriosis etc..). That being said, my doctors still had me go for the test saying that if the numbers were really high this would indicate the need for further testing. A level of 40 and under is supposed to be normal (mine was at 7). A friend of mine who was diagnosed with stage 3c ovarian cancer had a level of about 140 and after treatment her level is now at 10 and remaining stable. It is a good indicator for those who have been diagnosed and you may want to consider going for the test (keeping in mind its limitations).
I think the fact that your doctors do not think your cysts are dangerous is a good sign but the pelvic fluid and bloating definitely warrant further investigation (like an MRI or a CT scan). For all they know you may have an issue unrelated to the cysts that is causing this. Be persistent and insist that they look further. Telling you to wait and see when you are uncomfortable is simply unacceptable. Don't ignore your body when it is trying to tell you something.
As for me, rupture was a concern at first and I suppose it still is. My gynecologist wrote in her report that the risk of rupture is rather remote and I have read that when a cyst is on the left side it is less likely to twist or rupture because it is "cushioned" by the descending colon (ie. held more in place). Around here they only go in to remove a cyst if it is 10 cm or more. I know that in the US they tend to be more aggressive and go in at 5 cm. The magic number is 10 over here so no surgery has been recommended in my case. Everytime I go in for my ultrasound, the radiologist just looks at the thing and says it looks just like a follicular cyst and wonders why it simply refuses to regress (don't I know it!).
Take good care of yourself and let us know if you manage to find someone to give you a second opinion on your health situation. It certainly doesn't hurt to have someone else check it out. When my cyst was first discovered, I actually sought out two other opinions and had an internal ultrasound done, just to be sure. Everyone said the same thing so this waylaid my fears somewhat. I figure, three gynecologists (one of which is a gynecological oncologist), one general practitioner and two radiologists cannot all be wrong ... right ?
Let us know how everything is going and I hope you get a handle on this soon.