Complex ovarian cyst and family history

[Dro88]

I have been diagnosed with four cysts on my left ovary, one of which measures 5cm.  The other three range in size from 2-3 cm. My left ovary is also described as enlarged on the US report. This all began with an abnormal period lasting 27 days.  Following this I had a pelvic and transvaginal US.  This first US revealed three simple cysts, an enlarged uterus and some free fluid.  My GYN and I decided to wait a month and repeat the US.  The second US now revealed four cysts although they are a bit smaller than on the original US.  However, the largest is now described as complex.  My CA125 was normal.  I have a family history of OVCA.  My maternal grandmother died of OVCA in her early eighties and my mother was found to have "abnormal ovarian growths" when she had a total hysterectomy at age 49.  My GYN has suggested that we wait another two menstrual cycles and repeat the US.  I am still experiencing daily left sided pelvic pain and cramping.  I also have discomfort during intercourse. Any input regarding whether it is wise to wait the additional two months would be greatly appreciated.  At this point my GYN has said that if I choose to have surgery I would need a laparotomy as the ovary is too large to remove by laparoscopy.
Thanks, Dro88

[MickeyVicki]

Just how large is your ovary now?  My surgeon removed my ovary along with the attached endometrioma through laparascopic incisions, and the endometrioma was described to me afterwards as being the "size of a grapefruit."

If I had your family history, then I would want it all removed ASAP.  However, this is your body and you have to decide what you are comfortable doing with it and when. Feel free to get a  second opinion if you are not comfortable waiting any longer.

[Dro88]

Dear MickeyVicki,

Thanks for your reply.  I am considering a second opinion.  My GYN is also a personal friend and, as stupid as this may sound, I do not want any hard feelings.

My US report did not give the overall size of the ovary and cysts.  I have read that larger complex cysts are preferably removed by laparotomy due to an increase in the likelihood of spillage of the contents of the cyst into the abdominal cavity with laparoscopy.  If possible I would much prefer the laparoscopy as it is much less invasive.

Thanks again.

[MickeyVicki]

To prevent spilling the contents of that large endometrioma into my abdomen, the surgeon 'bagged' the entire thing - ovary and cyst - and pulled it up to the incision.  Once at the incision, the contents of the cyst were aspirated (I think that is the proper term; the contents were sucked out with an tool for study under the microscope while I was in surgery).  Once emptied, the now small cyst and ovary could easily be pulled through the smaller laparascopic incision.

[KarinC]

Friend or not, I would go for a second opinion, I would suggest a Gynocological-Oncologist, especially with your family History. Or at least a Dr that specializes in Advanced Laporoscopy.  Obviously the size of the Ovary is not known to us right now,  my Dr (gyn-onc) was able to preform a Laporoscopy to remove an endomtrioma Cyst (baseball size), Ovary and Tube with a Laporoscopy - bag proceedure.  I was told if anything looked suspicious or if the cyst adhered to my uterus (which was a good possibility because of the ultrasound results and exam findings) I would have had a laparotomy.  I was lucky to have the Dr I did. MickyVicki and I had very similar situations and both of us had the same or similar results.  

Good luck to you and keep us posted.

Karin

[Dro88]

Thanks for your input.  I plan to make some calls and arrange for a second opinion.  I live near a major teaching hospital and should be able to find a GYN/ONC there.

I have another question.  I have had two prior C-sections.  The first was performed on an emergency basis and I had to have a long vertical incision.  I therefore had to have another section with my next pregnancy.  I also had multiple adhesions removed with that procedure.  Do you think this might be contributing to my GYN's opinion that I should have the laparotomy instead of a laparoscopy if surgery is needed?

[AmandaD138]

I'am 25 years old and have not had my period in about 6 months. I'am not pregnant. I have a family history from mother to great grandmother of hysterecomies due to fibriod cysts and tumors. Dr wants blood work and ultra sound, if these come back fine he said nothin more to do, I ahve to deal with it. I don't think that is true, I'm only 25, any suggestions?