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Complex ovarian cyst - what happens next

I found this site accidentally as I researched the diagnosis I currently have.
On March 11, 2005 I had a total abdominal hysterectomy for what the doctors thought was endometriosis.  I opted to keep both of my ovaries and they were wrapped in mesh to prevent surgical adhesion growth.
Prior to Thanksgiving I started to expereince lower left sided pelvic pain, abdominal swelling, flank and back pain.  I had bowel changes and finally blood in my stool.  This was enough to send me running to the hospital.  I was discharged from the hospital after my blood work came back normal and the bleeding stopped.  Instructed to follow up with my Medical Doctor. A pelvic exam was not done and no other tests were done at that time.  A week later my MD ordered a CT Scan and made an appointment for me to see a gastroenterologist.  The CT Scan results were given to me by the gastroenterologist a week later at my appointment.  The results showed a 3-4cm complex ovarian cyst on the left side.  He ordered an abdominal and transvaginal ultrasound.  He also suggested that I have a colonoscopy done (I'm having it done on the 4th) to rule out colon disease.  
The ultrasound confirmed the original diagnosis stating that I did indeed have a complex ovarian cyst on my left ovary containing debris.  It also showed a fluid filled or simple cyst on my right ovary (measuring around 4-5cm).
I've researched this on the internet for weeks as I wait to see my MD.  I'm at a loss as to what the next step is, where I go from here.  Should the cyst be removed surgically or should I wait and see?
5 Responses
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Avatar universal
Hi Kim,

I was both lucky and unlucky in a way. Unlucky for being the victim but lucky because I survived and appreciate life more thereafter. My boyfriend then (now became my husband) gave me unconditional support and he was the one who advised me to do the blood test. I am then passing on the same advise to you. Here are some my responses to ur questions which I hope would be of much help.

1 - When you're cyst was diagnosed was it done via CT or TVU or both? And how often?
My cyst had white mucus in it which was traced via ultrasound. Because it was too big and the fear that it might break and infect other organs, it had to be removed in order to be taken for biopsy. Subsequently, I went through CT to examine the other parts of my body and it was alright.

2 - How was your pain?
I felt that my lower abdomen was very stiff and hard for a couple of months and I thought I had a belly. I never suspected any health disorders as my family did not had history of ovarian cancer. I only felt the pain on my back and lower back about 1-2 months before the surgery. I recalled a very sharp pain and it was unbearable. I needed to clear my bladder almost every hour even though I hardly drink coz the cyst was pressing against it. However, I've been having night fevers and diarrhea for quite sometime and all those were symptoms which I had ignored because I had regular and normal menstrual flow.

3 - After they found the cyst how long before your surgery to remove it?
Depending on the size of the cyst, the rate that it is growing and how long a person has had it, the gynae will advise if it should be removed. Mine was just too big to be left untouched. However, my mum later discovered that she too had a cyst of 5cm but it stopped growing after constant monitoring and doc confirmed that it was just a uterine fibroid which is non-malignant.

4 - Did you suffer thru the wait and watch procedure that so often is considered norm with doctors (if you cyst was discovered at under 5cm).
Under 5cm is normal. A friend of mine had a 5 cm cyst when she was 5 months pregnant and she managed to deliver her baby safely. I've come across lots of women who had cyst of that size and it usually turned out to be fibroid and it does not bother them. Mine was abnormal and the whole process was really beyond nightmare.

5 - Assuming you had pain.....where was it? Mine had been localized to my left pelvic area until yesterday. Now it seems my entire left side, back flank and uppergastric region is hurting.
As mentioned in 2. Since the cyst is still small and the doc might not want to opt for a surgery, you need to monitor it very closely. You need to make sure that it does not grow and I hope that you will try to ammend your eating diet so that it would not allow any chances for the growth. Some people survived without experiencing surgery and it just miraculously dissapeared after some time. It was their change in diet and lifestyle that reaped the benefits.

Pls keep me posted with your check-up. You have all my support.
Helpful - 0
Avatar universal
Luvthybeagle,

I just wanted to thank you for sharing your experience with me.  My heart and prayers go out to you having experienced what you have at such a young age.  
My cyst is tiny compaired to yours so I can only imagine the pain you may have gone thru.
I am seeing my MD tomorrow to determine what the next step is.  I have been told by her office (as she has been on vacation) that they are referring me to a surgeon. (assuming gyn/onc)
The waiting is taking a toll on me both emotionally and physically.  This has been the longest two months of my life.

Should you have time to answer a few questions for me I would really appreciate it.
1 - When you're cyst was diagnosed was it done via CT or TVU or both?  And how often?
2 - How was your pain?
3 - After they found the cyst how long before your surgery to remove it?
4 - Did you suffer thru the wait and watch procedure that so often is considered norm with doctors (if you cyst was discovered at under 5cm).
5 - Assuming you had pain.....where was it?  Mine had been localized to my left pelvic area until yesterday.  Now it seems my entire left side, back flank and uppergastric region is hurting.

You're strength is admirable and inspiring.  I pray that I can hang in there while I walk thru my new journey.

So often I've heard the waiting is the hardest part.  Even with a minimal risk of cancer it is very scary.  The 'C' word is what we call it around here.  = )

I am sending you a big hug and will keep you in my prayers.

Kim
Helpful - 0
Avatar universal
I totally understand how you feel as I went through the same traumatic experience 5 years ago. I'm 29 this year. I was diagnosed with serous papillary cystadenocarcinoma ovarian cancer stage 1a after I had my left ovary removed and taken for biopsy. I only encountered symptoms of back pain, frequent bladder and bowel movement and night fever just 2 weeks before the surgery. It was quite bizzare as the cyst was then 10cm in size. I did a ca125 test before the surgery and the result turned out to be above average reading and that drove me to seek professional advise from the gynae. Although, ca125 rarely could indicate any early diagnosis of ovarian cancer but there is a 50% chance that it might be able to reveal which had happened in my case. Since there is no harm, I would advise you to go for it. Besides, you should also opt for second opinion from a different gynae rather than waiting. At the same time, I would encourage you to quit smoking and try not to be exposed to second hand smoke. In addition, diet would also help to make things better. You should refrain from all food that contains MSG, high in protein, preservatives, colourings, fats, barbequed food. You need to take more green vege and fruits and consume meat in moderate level. Exercise eg. deep breathing and lots of fresh air is essential as lack of oxygen in the organ will stimulate growth of cysts. I know it's not easy but if I can do it, I believe you can too. You just need to do what is best for you at the meantime and I hope you will try to sort these out and get second opinion as quickly as possible. Take care and I'm sure you will be alright.
Helpful - 0
Avatar universal
I have not had a CA125 done as neither the gastroenterologist or my MD feels it would make a difference either way.  i've read online that a CA125 really doesn't help diagnose cancer at its early stages.  Being that my cyst are so small and only one is complex leaves me believing that a CA125 blood test may not accuratly help with the diagnostic procedure.  I will however have it done if it's necessary.
I'm just concerned at the moment, dealing with the pain, having family history and being a smoker....if I should continue to wait for my two current doctors to concure on what actions to take or if I should actively pursue this on my own.  Surgery or waiting?
I'm not sure if anyone here has had similar experiences with complex cysts and if so.......is a wait and see approach the norm?  What about the pain?  How do you deal with that?
The waiting is taking it's toll and the pain increases in intensity daily.  I refuse to go to the hospital as i have severe anxiety in a hospital setting.  I've dealt with pain so much in my past that I have a pretty high tolerance (I obviously haven't reached my threshold yet).
I've heard that ovca does not normally hurt until it's staged dramatically and that most complex ovarian cyst in women my age (I'm 35) are benign and treated with surgery to remove and biopsy. Is surgery my only option to get rid of the complex cyst?  
I appreciate your response.  I'm comforted knowing I have a place to vent and get useful advice.
Helpful - 0
Avatar universal
I think you are wise to get all your tests done before you decide what the next step is. Hopefully the colonoscopy results are good news and that is one less thing to worry about.
Have you had a ca125 run? It would be wise to have that done if you haven't already. It is a simple blood test; if elevated it doesn't necessarily mean cancer but it does indicate something is going on somewhere.
Also, the best advice anyone can give you if cancer is a minute possibility; see a  surgeon who specializes in gyn/oncology.
I hope all your tests come back the way you want; but if not don't give up; just gear up for a fight! We are all here for you.
Stay in touch and good luck!
Peace.  dian
Helpful - 0
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