Ovarian cyst report

IMAGECAST RESULTPELVIC ULTRASOUND WITH DOPPLER 10/1/2012 11:28 AM

HISTORY: Right lower quadrant pelvic pain.

FINDINGS: Transvaginal images were performed to better evaluate the
patient's uterus, ovaries and endometrial stripe.

The uterus is retroflexed but normal in size measuring 7.8 x 3.1 x
4.1 cm. No fibroids are evident. Endometrial stripe measures 4 mm and
is normal for patient's age. Nabothian cyst is noted in the cervix
which is within normal limits. The right ovary measures 6.1 x 4.3 x
5.4 cm and contains a complex appearing cyst with low-level internal
echoes measuring 5.3 x 3.7 x 5.1 cm. No abnormal color Doppler flow
is present within this complex cystic lesion. The left ovary measures
4.0 x 2.3 x 2.2 cm and contains a simple appearing follicle or cyst
measuring 1.3 cm. Color Doppler waveform analysis demonstrates normal
arterial waveforms within each ovary. No adnexal masses are present.
A small amount of free pelvic fluid is present.

IMPRESSION:
1. Large complex appearing right ovarian cystic lesion is present
with a small amount of free pelvic fluid. A large endometrioma or
hemorrhagic cyst are possible. Followup ultrasound in 2 or 3 months
could be performed to assess for interval resolution.
2. Dominant follicle left ovary measures 1.3 cm.
3. Uterus and endometrial stripe appear normal.

40 years old, pre menopausal.

Does this look like a benign process?  

[ClevelandErie]

^ My story that produced the ultrasound:

Hi, on September 30th I started having severe lower pelvic pain. I went to the ER on October 1st because I couldn't take it anymore and they did a cat scan and pelvic ultrasound, finding an ovarian cyst, complex.

Went to doctor Tuesday and by then, the acute pain was gone, but I still had colicky pain and diarrhea. He said to watch it then another ultrasound in two months. He ran a CA125 which came back elevated at 180. I went back to see him and his partner who both visually looked at my ultrasound and cat scan and both concluded once again it was a benign process, a benign cyst, the elevation of the CA125 was due to the acute process I experienced and they think I either ruptured or partially ruptured it. The recommendation is surgery to remove ovary and cyst.

I still have bloating, some nausea, back pain going on with some slight spotting but that has gotten better. Surgery is still being scheduled.

I am wondering:

1. What you think of the report
2. I have also read that the CA125 can spike due to acute processes and I was CERTAINLY in one when the blood was drawn, I couldn't even sit up or lie down properly for two days.
3. Do you think surgery is necessary?

[ClevelandErie]

Thoughts, anyone?