Confused after 2nd opinion

Question

Hi all!  Thank you for responding to my last post.  Went for a 2nd opinion (not a gyn/onc just a gyn who does surgery).  She came up with the following plan...  First, I will have an abdominal US with dopler flow.  If there is flow to the cyst we would need to schedule the surgery right away.  If there is no flow we can wait.  I have not read anything about this test.  Does anyone have an opinion if this is a good test to determine ovca?  One of the reasons we are maybe going to wait is that my mom has an aortic aneurysm and I want to see what is happening there - sx or what?  BUT, I just don't know if the doppler test is a good enough test to make me feel I should wait.  My CA 125 was ok so she said things look good.  Next, the plan for surgery is laparotomy (again!)  If the cyst is a dermoid or a serous cystadenoma (I have no idea how to spell this) then she will try to preseve my ovary.  If it is an endometrioma or cancer she will remove ovary and uterus.  I don't know about you all, but the thought of a 3rd laparotomy in the future makes me want to have all out now anyway!  Are there any odds about cysts returning in the future?  Also, has anyone had a spinal after laparotomy for pain instead of pain meds?  A friend told me this is a new thing that would be better for constipation after surgery?  Final question, the odds are so small that this thing is cancer, do I really need to have the surgery done by a gyn/onc or can my gyn handle this?  I had my first sx done by a gyn with a gyn/onc on stand by just in case.  Any thoughts on this would be great!  Thank you!

lactac1224 · Answer

Linda F - thanks for all of the info! Although I have had sx before there is still so much I do not know about these silly cysts! Doc Gyn Onc -   Anyway,  I know that I will have to have the cyst removed, but would like to wait until we know more about my mom. That is why the doc said we may be able to wait if the dopler is ok.  My CA 125 was ok too.  If I knew my mom would not be having sx in the next few weeks, I would just go ahead and schedule my sx tomorrow!  Thanks for the info.  I appreciate any and all help with these questions!  :)

ShawnP · Answer

I agree with Linda.....and I don't blame you.  A third laperotomy... yikes!  I'd want it all out too.  Best of luck to you!

Shawn

LindaF · Answer

First do the U/S with doppler. If there is no blood flow to the cystic structure, then you are pretty much golden according to my docs. If there is blood flow, then your doc has a reasonable plan. What she is going on is the fact that cancers need to be fed. Since doppler shows blood flow into capillaries, the smallest vessels there are, if there is no blood flow then the chances of the cyst being cancer is almost nill. Mine had no blood flow and was indeed a cystadenoma. Blood flow on the other hand does not mean cancer. Dermoids and hemmoraghic cysts for example often show blood flow. Endometriomas and fibrous cysts can be hard to get off the ovary without damage, thus they tend to remove the ovary and tube that's affected. Cystadenomas often are on a stalk and can be clamped and clipped. Mine was on a stalk and I retained both ovaries, tubes and uterus. I tied my tubes during the surgery by choice. I know they can do a spinal with sedation however I was told there is a slightly higher risk of aspiration. Given my reaction to the general anesthetic, I think I'd take that risk in the future. They can put morphine in the spinal to locally control pain. There is a natural blood/brain barrier that keeps the morphine local. Personally, if there is no blood flow, I feel your surgery can be done by a regular gyno. Mine was and I have no regrets. My doc told me if she even had a hint it might be cancer, she would have an oncologist on-call anyway.

L.

Confused after 2nd opinion

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