Large ovarian cyst...worried

Hello,

I have a lot of questions concerning ovarian cysts. I have always struggled with bad menstrual cycles and a lot of pain and clotting. I was diagnosed with anemia in my teens. I had my first son at 18 with no complications other than my anemia. Following my pain became so severe I had a laproscopy done that found a lot of scar tissue and 3 ovarian cysts that were removed. This past February, I gave birth to my second child and 5days after being home passed some membranes from giving birth. I was in a lot of pain and when they went in to make sure nothing else was left they also removed a large clot, which is not unusual for me. In April I went to discuss with my doctor about some paini had been having and birth control methods. I had a sonogram showing a 2.2 simple cyst on each of my ovaries (bilateral). Which has also always been norm for me. In June I had the IUD inserted even with my pain because the doctors asured me it would help my cyst issues. In September, I had had enough. I wanted it out after several digestive issues (or so I thought they were), exhaustion, and nausea. During my exam the doctor felt a cyst and sent me once again for a sonogram. I had a endoscopy done as well, due to my acid reflux issues and stomach bloating but nothing but gastritis showed. I got a call from my gyno saying the sonogram showed I have a bilobed septated ovarian cyst 8.7cm big and it was the same one I had before that had just grown. I decided to see the same doctor I saw for my laproscopy who happens to be a gyn onc, due to my family history of ovarian cancer and breast cancer and other issues like endometriosis etc. He has schedule me for surgery in November to have my entire ovary removed. I am always sick, nauseaus, headaches, crampy, and bad sciatica and back aches. What is the severity of this cyst and if I get my ovary removed is that the right way to handle it? Is feeling sick normal? And how do I know what kind of cyst it is by the sonogram report only saying it's a bilobed septsted cyst??? I am so confused and need more answers....please help!!!

Hello,

Your cyst is on the large side so removal is probably the best course of action. Whether or not to remove the entire ovary is something to be discussed with your surgeon. Sometimes with cysts that large the ovary is destroyed anyway but you will have to speak to your doctor about this. If you are planning to have more children in the future, this is also something that you need to speak to your surgeon about. With the remaining ovary you should be able to conceive without any problems though.

A bilobed, septated cyst simply means that the cyst has two lobes and is separated by a septation or a division. This may be two cysts that grew together, for example. Keep in mind that we all get ovarian cysts every month but usually these cysts grow to around 2-5 cm maximum. I also had an ovarian cyst that was around 9 cms which I had to have removed, along with my left ovary. I was not thrilled with the idea but realized that this was necessary because the cyst was growing (I "watched" it for a year and a half) and it had most likely destroyed the ovary anyway. Also, I am in my forties and have never wanted children. That being said, ovaries do much more than provide eggs for procreation. They also provide hormones for the body. However, one ovary is usually sufficient and I guess I should thank my lucky stars for the redundancy of having two ovaries instead of just one.

Given your family history, have you considered taking the CA-125 blood test. This tests for a cancer antigen normally found in high numbers when ovarian cancer is present. The test is not super accurate in premenopausal women such as ourselves but it may give you some peace of mind. You may wish to speak to your doctor about this.

As for the pain, if you have a long history of pelvic pain due to scar tissue or endometriosis etc.. then most likely the pain is related to this. Having the cyst removed is definitely the best course of action. Now you have to ensure that having your ovary removed along with the cyst is OK with you (speak to your surgeon). Also, if for any reason the radiologist thinks that this cyst is threatening (usually they have a pretty good idea from looking at the ultrasound, although this is not 100%), you may want to consult a gynecological oncologist to do the surgery, just in case. Keep in mind that even complex cysts are most often benign (90% of them, in fact) but with your family history you may want to pay extra special attention.

I hope this helps and I wish you a very quick recovery from your upcoming surgery. Hopefully removing the cyst will take care of your pain issue (keep in mind that sometimes the pain issue ends up being unrelated .. but perhaps they can remove other things such as more scar tissue or endo while they are in there).

Take good care of yourself.

Regards,

Estria

Estria,

Thank you for taking the time to respond to my post. Ii am having my surgery done by a gynecology oncologist who also took care of my last cysts that were removed. He is doing a robotic surgery and he said to prevent this from happening again it would be smart t remove the entire ovary and he did also say that the ovary is probably damaged anyway but he won't know until he goes in. Hhe was not sure what to think from the sonogram results he just said it wasn't good that it grew so fast but he didn't know if it is was cancerous or not due to the fact that that is not something you can tell until you have a laproscopy done. I have considered getting the CA-125 test done but I don't know how that works or if a doctor would administer that to me just because of my situation. The doctor doing the surgery is an hour and half away from where I live so I would need to see my primary care doctor for the testing. I will call today. Also, I have two children and know I am done. I have a boy and girl and know that although you can still get pregnant with one ovary that it sometimes is more difficult so I am fine with that as long as these cyst stop coming.