Help with choosing my options

I have been having a lot of pain for the last few years both on my right side and also my uterus. Had test and they found my womb is bulky and i had a 5cm cyst. I had a laparoscopy two months ago to remove the cyst and check for other issues and fit a mirena coil.

The cyst now 2cm (although now i believe this to be a different cyst) and they removed, scar tissue and womb size of 10 weeks. Fitted mirena.

3.5 weeks later i had severe pain, had been bleeding continues and now the right hand side pain really bad followed by three days of pain in area, saw doctor ended up in hospital and they scanned to find another cyst had ruptured leaving fluid floating which they said was now causing pain (shoulder tip as well as in abdomen area)

On pain killers since the and then after four weeks it all ahs happened again, i saw gyny this week and told her that i felt another had ruptured.. She said best option was hysterectomy with removal of ovary on right side, i want just ovary removed as I feel it is the cysts and fluid after rupturing causing the pain, and if that was gone my uterus may settle and think it is worth trying that first.

This week the pain is getting worse,shoulder tip, pain in back, pain down leg, pain over abdomen and pinching pains on right side, surely if it ruptured 4 days ago the fluid would be leaving by now, not had it so bad before.

Any ideas, or advice? I am 44 and know that having ovaries removed or failing is not good at my age, so worry that just leaving one ovary and having uterus removed the other ovary might not continue working. Hence why just ovary removal and leaving uterus seems better option in my mind, and gives my left ovary best chance of survival.

I cant take Birth Control pills, have tried zoladex (no good) and mirena is now removed.

She said she cant give me hormonal treatment due to blood pressure and migraines i have. I am now on top dose of tramadol, paracetamol and also diclofenac sodium but in pain still.

[Elaine Brown, MD]

Hi!
Your case is not clear cut!  Because the ovary can theoretically be removed laparoscopically, it might indeed be worth a try to do just this first.  The hysterectomy may not be needed at all, and is definitely a bigger surgery.  Removing the uterus DOES reduce the blood supply to the remaining ovary, and can speed menopause.
If you have issues such as dysplasia or heavy bleeding with your periods, the hysterectomy might be the way to go -- as it avoids repeated surgeries.
Good luck!
Dr B