40 yr old female who has not had periods since may 2009, after 3rd diff doctor recommended uss and found 6cm complex cyst and 6cm sub mucosal fibroid, have extreme pain in left side and have massive bloated belly,sore breasts, painful back, aching legs, need to urinate often after couple of gyno visit and ca 125 tests my cyst will be removed however as it is not deemed cancerous i have been put on normal waiting list, had preop 9th april and wont be operated on until end july beg august ?! is this normal ?? never had op before??
I assume that the fibroid is in your uterus ? Uterine fibroids are nothing to worry about unless they cause you discomfort. Almost all of us have them.
As for the ovarian cyst, how do they know that it is not cancerous ? Have they perhaps identified it as a dermoid or a hemorraghic cyst ? Most cysts are non cancerous but with complex ones, it is better to err on the side of caution. If your surgery is not for a few months, I would at least request followup ultrasounds and CA-125 tests in order to keep an eye on the situation. Keep in mind that 90% of complex cysts (and over 95% of simple ones) are benign but keep your eye on everything just the same. You may also want to get a second opinion from another gyne, just to be on the safe side.
Do you know how they are removing it ? Is it by laparoscopy or laparotomy ? Are they taking out only the cyst or both the cyst and your ovary ? You may want to request that the cyst (and or ovary) be put into a bag when they remove it. This keeps the contents of the cyst contained. This is a good precaution to take until you know with 100% certainty that the cyst is benign (after the pathology report).
If your doctors are so confident that the cyst is benign then you should try to relax. However, keep an eye on everything and try to get a quicker date for the surgery. At the very least in order to get rid of your discomfort and anxiety. These cysts can cause a lot of (often needless) worrying, I know this very well.
thankyou, oncology gyne said the ca125 level was normal at 13 so was not concerned, it will be laparoscopy to remove the cyst and ovary and she said maybe fibroid which is in behind the womb, she has only ever called the cyst a complex one?? and now she says that my sex hormone binding globulim(?) is low and may show underlying PCOS ?? so just have to wait for the surgery really they say that is Histology shows any surprises then i am aware further surgery maybe required. also will they say if there are any futher surprises after the op or a few weeks after?? also been told will be off work 2-3 weeks? does this sound a realistic time? thanksand take care
It's great that you are seeing a gynecological oncologist. This kind of specialist is much better trained in these situations than a regular gynecologist.
The CA-125 is an OK test but does not have the confidence and accuracy of a completely reliable test. It is a better indicator in postmenopausal women than premenopausal. It can give a high reading when no cancer is present and it can also miss stage 1 ovarian cancer in a significant number of cases. That being said, it is better than nothing and when taken with other results, like the ultrasound, it can help to paint a better picture of what is actually happening. However, you cannot bank the farm on this test and other things must be taken into consideration .. such as your age, your symptoms, the size and morphology of the cyst (ie. what the cyst looks like on the ultrasound) and your family history. I am sure that your doctor did this and based his opinion on those things as well.
As for the surgery, they usually know with a very strong amount of certainty what is going on after they go inside so you will be well informed when you come out of the anaesthesia. Surgeons are very experienced and usually know if a situation is sinister or not just by looking. Sometimes they also do a frozen pathology of the cyst during the surgery so that they can be even more certain. A frozen pathology is not as reliable as the regular one that takes around 10 days BUT it is a very good indication of what is going on. If they do a frozen pathology they will also do a regular one later.
For the surgery, here is what you can expect:
If you are having a laparoscopy then your recovery will be much quicker than a laparotomy. You will also be home the same day which is good. The less time you spend in a hospital the better. In my case (I had my left ovary and tube removed due to a 9 cm cyst), I was walking around the same day (slowly, of course) and the next day I was able to go to the park with my family for a short walk (again slowly). Within a week I was in very good shape. Keep in mind that although they say that recovery is usually about a week, this does not mean that you will be able to do jumping jacks in that time. You will be tender for a while and you do have to take it easy. It is still surgery. However, the surgical incisions are very small and they heal much quicker as a result. There is also much less risk of infection because of this. In addition, the pain you experience after surgery will be less than in a laparotomy and can be handled with medication such as Naproxen (anti inflammatory) and Advil (ibuprofen). My doctor also wrote me a prescription for a pain killer but I did not need this .. I took a Naproxen the night of the surgery and after that, over the counter ibuprofen was sufficient for a day or two. I had my doctor write the prescription before I went in for the surgery and I filled it and had it ready for my return from the hospital. You may want to do this too.
I took care to eat right after the surgery and to drink plenty of water. This, along with moving, is necessary in order to get your bowels working again. Surgery will silence your bowels for a while and you may experience some gas. You may want to add a fibre supplement (like Metamucil) or even a stool softener to your diet afterwards, in addition to eating plenty of natural fibre (spinach, lettuce and other veggies plus fruit). If you do this, you will not experience any problems. Also keep in mind that you will have some menstrual bleeding after the surgery so take a pad with you to the hospital. During the surgery they will insert something into your uterus in order to move it out of the way and this causes some bleeding afterwards. In addition, you may experience some shoulder pain due to the gas they must inject into the abdomen in order to see properly. If they heat up the gas before they put it in and they are careful to remove most of it after the surgery, you should not experience this. I experienced absolutely no shoulder pain at all but I did notice on the boards that people complained of this (and my hospital pamphlet mentioned this possibility). Speak to your surgeon about this (I did). Other than that, you may want to take a throat lozenge with you to the hospital as you will have a sore throat afterwards due to the anaesthesia tube .. this is very temporary. In addition, the catheter may cause a bit of irritation to your urethra but this is also very temporary .. just be sure that you can pee before you are released. They usually keep an eye and should not release you until you can pee on your own. Drink plenty of water when you wake up so that you will be able to empty your bladder. This is what I did (in addition to eating some crackers since you cannot eat from midnight until the morning surgery). If you are prone to nausea, mention this to your anaesthesiologist and they will give you something for this. In my case, I took something called Granisetron, a drug that is good for 24 hours as opposed to the Ondasetron that they give you in the hospital which is good for only 6-8 hours (ie. sometimes people get sick in the car as they are going home !). Of course I went over all of this with my physician .. I did not simply medicate myself. Over here the Ondasetron is given simply because it is less expensive so I opted to pay for the Granisetron myself and got my doctor to write the prescription so that I could take the 1 mg the morning of my surgery, just before leaving the house. The anaesthesiologist is the one who is responsible for this, in addition to pain control, so you may want to arrange for a meeting with them before the surgery as well. They will come and see you just before the surgery anyway, in order to ask you questions etc..
This is mostly what you can expect. You will be very well taken care of and surprised at how quickly you will be back at home. In my case, I had my surgery at 8 am and I was back home by lunchtime (although I did not eat anything .. I just wanted to take a nap .. then I had a light dinner .. I was very thirsty though so I drank a lot of water). The laparoscopy is truly a marvel and will save you a lot of recovery time and trouble.
You may also want to speak to your doctor about what kind of drugs you can or cannot take prior to the surgery. Be very careful about any supposedly "natural" medications as some of these can increase bleeding and they must be stopped for quite some time before the surgery (things like Ginseng, Ginko etc..). Also, be careful during the week prior not to use a razor for shaving. If you have a bad cut, this may get infected. Use only an electric shaver. These are things we never think about which are still important.
Anyway, I hope I have informed you a bit more about the surgical procedure and what you can expect. Doctors often do not have time to explain all of this to you and I think it is good to know what to expect. If you want more info, I have a post about my own surgical experience with a laparoscopy, dated around the beginning of May 2009, right after my procedure. It is entitled, My own (positive) laparoscopy experience or something like that (just do a search). It may help you to prepare and give you questions to ask your doctor.
i now have a date 24th june whichis good, my boss is anticipating me being off for at least 5 weeks as my job involves lifting in all aspects and there is not light duties, would you deem this reasonable or too long?
It is best to check with your doctor about this. If you have heavy lifting then it is best to count on at least a few weeks of recovery. Although you are able to get around after a lap after only one week, you are still tender. If you have a lot of lifting to do in your job and if it is heavy lifting then it is best to err on the side of caution.
Of course all of this depends upon your financial situation and if you are being paid for the time you are off from work. However, it is best to take the time that you need to get back to normal.
had the left ovary and tennis ball size cyst removed and biopsy all fine so really good... have taken 6 weeks off work as in a physical job, however still have the pain in the left area as before,,, im sure this is just recovering from surgery and nothing to worry about they wouldnt take the fibroid even though it is over 6cm because it was a more complex surgery as it is behind my womb, periods have returned also with a vengance 2 weeks and counting lol, just hope this isnt something that will reaccur on the right ovary now... this site has been so helpful when your not in the know !! take care everyone and laparoscopy is the way forward i had just 1 night stay in hospital as the middle incision was slightly larger due to size of cyst but feel almost as good as new nowx