Bilateral Ovarian Cysts

[MVanS]

I am 29 with some history of endometriosis.  I recently had to go to the ED with intense abdominal and rectal pain.  Since then the pain has lessened but not subsided.  I followed up with my PCP and OB.  PCP sent me for a CT.  CT results were:

Bilateral low attenuation adnexal lesions are noted, ranging up to 3cm in diameter.  No significant pelvic fluid.  No other evidence of pelvic mass or inflammatory lesion.

CONCLUSION:

BILATERAL CYSTIC ADNEXAL LESIONS, LIKELY REPRESENTING OVARIAN CYSTS.

What does bilateral low attenuation lesions mean?  Is bilateral same or worse than having unilateral?  What should I do next?
I have a pelvic ultrasound scheduled in a week.  As I am still having occasional intense pain, should I try to get in sooner or should I go to the ED again?  Torsion or rupture possible?  Help!

[Annekathryn Goodman, M.D.]

Dear M,

you have been on birth control pills which are thought  to suppress ovulation. persistent cysts on the ovaries especially in the setting of being on the pill, may represent something other than cysts of ovulation.

At age 29, the possibility of ovarian cancer is low. it can happen but is the least common possibility. the most common reasons for painful ovarian cysts are endometriosis, other benign cysts, or infection in the fallopian tubes (tubo-ovarian abcess0 the latter is associated with fever, elevated white blood cell count , and usually the person is quite sick.

it does make sense to consider a laparoscopy to understand better why you have pain and cysts. that will give you a definite diagnosis.
Sadly there is no such thing as an ovarian cancer screening test at this time. When there is a question about a growth on the ovary, the only way to make a diagnosis is to look surgically
best wishes

[MVanS]

Also, I have been consistently on birth control since 8/06.  Should I proceed with ovarian cancer screening?

[MVanS]

I had a pelvic ultrasound today.  I have 3 cysts on my right ovary averaging a 1.5" each.  I also have numerous "bubbles" in my left ovary, about 7-10.  The tech thought they could be immature eggs.  My questions now are why is anything there if I have been on birth control for almost a year solid re eggs or follicular cysts?  Would I have pain on my left side, as I am, with immature eggs?  Should I demand cancer screenings?  Should I have a laproscopy or does surgery not sound needed?  I should think they aren't the cyclic cysts with menstruation due to the birth control.  Is that right?  Any advice is so appreciated.

[cnmeerburg]

A related discussion, Bilateral Ovarian Cyst was started.