Complex ovarian cysts

I had an ultrasound Tuesday because of abdominal pain with a long history of ovarian cysts.  They found a 5.5cm complex cystic/solid right adnexal mass.  It states the differential diagnosis includes Endometrioma, complex hemorrhagic cyst, or cystic ovarian neoplasm.  I have had 3 surgeries in the past to remove chocolate, simple, and deremoid cysts.  I've approximately have had 20 or so either resolve or rupture on there own.  With this one my symptoms range from extreme abdominal pain, to the groin, my back and there are times I feel like there are fingers sticking through my ribs.  I constantly have a full/bloated feeling accompanied by fatigue and severe constipation, and don't let me forget to mention chronic headaches. I recently had to take hormones to induce my period because I hadn't had one in 9 months.  Now when I do they are bad with a lot of clotting.  Could you please give me any thoughts or information I should bring to my OBGYN when he finally has time to see me next week.  The anxiety due to lack of knowledge is killing me.  Thank You Kim

[Annekathryn Goodman, M.D.]

Dear Kim
How you would manage your chronic pain and recurrent ovarian cysts which i assume are from endometriosis will depend on how old you are and whether or not you are trying to have children. For women with your history who have completed child bearing, the most effective solution is to consider the surgical removal of your uterus and both tubes and ovaries. This will cure endometriosis. If you are trying to have child and want to preserve your ovaries and uterus and ovaries at this time, the treatment is usually hormonal. We try to suppress cyst formation with birth control pills or the use of medicines such as lupron that induce artificial menopause.

Finally it is possible that you have endometriosis plus another issue such is irritable bowel syndrome or chronic fatigue or depression. When you met with your doctor, he needs to take a careful history of your symptoms and do a good physical examination. Then together, you need to sort out your goals for fertility, and see if other tests need to be done to rule out other conditions.
best wishes to you

[KrissyD]

Hi Kim- I will be interested to see the answer to your post. I am 36 and have a small About 2.5 cm complex mass that they have been "watching" via ultrasounds for 2 years now. It is now completely solid, although has not changed in size, so I was referred to GYn oncology. My doc says he believes it may be endometriosis..and says laproscopic surgery can help diagnose( by biopsy) and relieve it. I too have been having horrible bloating , nausea and pain ( for 2 years now) I find it very hard to believe that this could be related to such a small mass. Although I have been through lap sx before I am more afraid of surgery than what my growth is because of adhesions etc. I am wondering if I am wrong to question this or if it is safe to have a watch and wait approach even though its solid. I wish u the best and hope all turns out well for u.

[danarose]

Hello... I am 32 years old and have a history of 2 R sided ovarian cysts which I have had laproscopically removed in the past. I have been having terrible R hip and buttock pain noticing that my R pelvic bone is rotated forward...I've had a dislocated hip in the past as well...but recently ruled out with an MRI any problems with the hip. I have been working with a physical therapist and seem to have good days and lots of bad days especially around my cycle. My doctor said I have piriformis/hip syndrome. I recently saw my OB/GYN and she ordered a pelvic US which shows a 7.3 x 7 cm septated cyst with a solid component or hemorrhagic cyst within one of the cysts in my L ovary. Could this be causing all my pain and problems on the R side of my sacrum and pelvic/hip area even if the cyst is on my L ovary. Help me...I'm desperate for some relief...am having surgery on Tuesday for a D&C and to remove the cyst.

    

[tam4givin]

I saw your hip pain and wonder how many other symptoms we have the same of. My hip hurts, I do not hear a poping, I looked up what you said your docter said and read that should not cause pain so is he misdiagnoseing you or you have that and something else wrong to. My docter says arthritis but it  came on bad the first day, I do wonder if it is gout, I have not got them to test for it yet.