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Ovarian cysts: Complex 2 months and now surgery....

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Old 12-10-2008, 01:08 AM   #1
Join Date: May 2007
Location: California
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Ovarian cysts: Complex 2 months and now surgery....

I had been bleeding for 9 weeks and went in to the OB where she did an U/S. She told me that I most likely had suffered a miscarriage. I had not known that I was pregnant, in fact, I had taken a preg. test and it was neg. She said that she could not be 100% however my uterine lining was very thick. She also measured a functional cyst, but said it was nothing to worry about. I continued to bleed for another 2-3 weeks (she had decided to not give me progesterone due to the fact that it had looked as if I was at the tail end of passing all that remained of the blood) and then began to have moderate abdominal pain.

One night the blood became bright red and the pain became severe and I called the on-call physician who said to go into the E.R. I was given a battery of tests and seen the following day by my OB who then told me that one of my cysts had erupted and I had a 'large' 5 cm. functional cyst on my right ovary. Sadly, birth control has never been my friend thus it would not be an option for my treatment, so we decided to wait 2 weeks and repeat a scan and re-evaluate at that time. The pain continued, though the bleeding stopped. Also,after eating or drinking fluids I have pressure in my abdomen which makes the pain worse.

The next scan (last Wed) showed that the cyst measured 2.7 cm. and another on the left ovary at 2.5 cm. Which was all well and good but we still needed to find the source of the pain...My OB ordered a contrast CT to explore a few options.(hernia, diverticulitis etc)

This Sunday afternoon, the pain became severe and I actually vomited. Again, I called the on-call physician and he said that I should go immediately to the ER. They did a CT and it showed the cysts at 5.5 cm (although as I'm sure many of you know, this is not always completely accurate).
My OB received the reports today and wants to remove both cysts this Friday despite the conflicting reports.

Any insight? I know that the surgery itself is fairly minor being outpatient - assuming it goes according to plan, that is.
Should I be in severe pain with this size of cysts? Have anyone heard of the functional cysts filling up that fast in so many days? I know that the CT is not the mode of choice when measuring cysts. My OB is basically going in on my 'pain'. just wondering if anyone can offer any insight.

Sorry for such a long post. I am no stranger to surgery, however it is my first since being a mom - and it seems different. I've never been too nervous before, this time I am. Even for something this minor.

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Old 12-11-2008, 04:13 AM   #2
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Re: Ovarian cysts: Complex 2 months and now surgery....


Throughout all of this, have you still been bleeding ? If so, and your endometrial lining is thick, then perhaps the cysts have nothing to do with it and it is your uterus that may be causing problems. However, at one point you said you have bouts of severe pain with vomiting which sounds an awful lot like the symptoms of a ruptured cyst. Also, from your CT scans, you seem to be developing rather large follicular cysts. The good thing is that they are normal functional cysts (although in your heading you mention complex cysts ? are they simple or complex ? usually functional cysts are simple cysts that are filled with fluid) but the bad thing is that they may be affecting your quality of living so something will definitely have to be done. As for the pill, current studies show that the pill does no better than watchful waiting for getting rid of cysts so I do not believe that this is a viable option.

I myself have an 8 cm simple cyst on my left ovary that has been there for a year and has not changed much so my doctor is OK with keeping an eye on it with ultrasounds. Since it has been there for so long, it is unlikely to be a functional cyst but you never know. I have heard stories of people whose cysts disappear after over 6 months. I was on the pill and had just gone off of it when this was discovered so perhaps with time ... at any rate, in my case, the only pain I experience is ovulation pain for about an hour or so and it is controllable with a heating pad or with a couple of ibuprofen.

In your case, you need to do something. I am wondering though, and I am sure that you have considered this, if the cysts will come back once they have removed the ones that are there. If they are coming and going, like all functional cysts do, will you not end up with the same problem after the surgery ? This is actually what concerns me if I decide to have surgery and why I have decided to wait it out (however, as I said, I am not in constant pain). The only way to truly be rid of the cystic problem is to have the ovaries removed and unless this is absolutely necessary (as in the case of ovarian cancer, for example) I don't think it is an option. A woman needs those hormones to stay healthy and if you want to have more children .. well that's an obvious one. This is the true dilemma.

You are right that a CT is not the best tool for looking at cysts, an ultrasound is. An ultrasound can better visualize what is inside the cyst and tell whether or not the thing looks sinister or not. As a matter of fact, a radiologist's impression of what a cyst looks like on an ultrasound has a much higher predictive value of what it actually is (something like 90% accuracy) than say the CA-125 bloodtest. I have not found out if the two together increase this or not (I would imagine they should).

If your doctor thinks that the bleeding was due to a miscarriage then why doesn't she follow this through and try to treat the problem from that angle, before going in to remove the cysts ? The pain you are experiencing may be from this and have nothing to do with the cysts, which appear to be functional (if they are coming and going as you mentioned). If the bleeding has stopped and all is well on that front though, then you have to investigate further .. meaning the laparoscopy to have a look at the ovaries.

I am sorry that I could not be of more assistance. I too am struggling with the possibility of surgery and wondering if it will fix the problem for good or not. In your case, it is more urgent because of the pain and intrusion into your life, especially with children. As for the surgery, if you have to have it then do it and get it overwith. If it is a laparoscopy that you are having, I am told that the recovery time is much faster (about a week) than a laparotomy (which is about five). Just make sure that you make arrangements to have some help for a couple of weeks after surgery even if it means having your husband sign a contract saying that he will do certain things while you are recovering.

I sincerely hope that you find a permanent solution to this. All the best.


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