pregnant with large ovarian cyst

[Kaerbear]

Hi,

I was recently told I have a large cyst in my abdomen. They think it's from my right ovary. They found it during my 20 week ultrasound and it measures 25 x 17 x 18 cm. They tell me because of the size and because it looks uncomplicated (unilocular) and probably fluid (serous) or mucus filled (mucinous) that it is highly unlikely that it is cancerous. I have been trying to read up as much as possible on ovarian cysts and for the most part I'm finding that the uncomplicated ones are usually benign or borderline. I haven't been able to find anyone else that has had one this big, much less during pregnancy. I have to have it removed by laparotomy next week (Mar.22/07) to keep it from affecting the growth of my baby. I'll be 22 weeks at that time. I was told I had the option of having ultrasound guided aspiration of the cyst by the radiologist who looked at my ultrasound, but the gyne-oncologist recommended the surgery as he wanted to prevent rupture or leakage of the cyst if it should happen to be mucinous and not drain through the needle. The fluid or mucous inside is most likely caustic and would cause inflammation of the abdomen, not to mention a lot of pain.  I would possibly end up having emergency surgery and premature labour anyway.  So, instead they want to remove it intact which means a major midline incision because of the sheer size of it. I'm pretty worried about premature labour but they tell me there is little chance of that. I just wish I could talk to someone who'd been through something similar because I would like to know how it turned out.

[Annekathryn Goodman, M.D.]

Hi Kaerbear,
I think i commented in another post for you. It is really scary to think about a surgery during pregnancy. Your cyst is very large. The general approach is to make an incision to remove it and to not disturb the pregnant uterus while doing the surgery. Sometimes it is possible to start with a smaller incision, look and see what the cyst looks like. if it is very simple, it can then be carefully drained through a smaller incision. You should ask your surgeon about that as well. best wishes

[Kaerbear]

Thank you so much.  I've been desperate to get some kind of feedback before I go into the hospital so I posted in more than one place.  I will ask my doctor about what you suggested.  She had told me previously that she wanted to remove the whole thing intact to avoid any leakage or rupture during the surgery.  But, it makes sense that they would be able to determine the make up of it once they have looked right at it.  They do seem very determined about the leakage thing though so I may end up with a larger incision.  It was very unsettling at first to have two doctors disagreeing about how to treat this, but I've had word from several sources that Dr. Latocki, the gyne-oncologist who recommended surgery and will probably be assisting my ob-gyn during it, is an excellent doctor with a lot of experience and knowledge when it comes to all kinds of cysts and tumours.  So, I will ask questions while I can, but in the end I guess I just have to trust the experts and pray!

[Kaerbear]

I had my surgery one week ago and I am now at home recovering.  The baby is fine.  The mass was larger than they originally thought.  The doctor said my uterus was actually dented from the weight of it.  It was 30 cm and weighed 20 pounds!!  It was serous and benign.  It had taken my whole left ovary over so there was nothing left of it.  So my left ovary and tube are gone.  The fluid inside the cyst was over 6 litres.  My incision wound is almost a foot in length and I just had 33 staples removed today.  I lost 25 pounds in one week and I feel so light.  It really has been an incredible experience.  I know I'm one of the lucky ones to have this over and done with so easily but I hope that anyone else who may be going through something similar might find this and see that it will be alright.  Good luck and God bless to everyone out there!

[adreamangel2]

Hello, I am in a similar situation as you. I am almost 20 weeks pregnant and am facing the decision to have surgery to have my right ovary removed. My ovary is about 8cm right now. The doctor told me it may or may not be
cancer and will not know until they remove it.  He said the 2nd trimester is the best time to do surgery while pregnant because the baby is small. If I decide to wait until the baby is born there could be risk of an emergency surgery and the ovary could get tangled as my uterus contracts back to normal size which could become more of a risk. I am concerned about my baby during the surgery, I still have an MRI to go to and have to see another doctor about the baby. I guess my question is, what helped you make the decision to have the surgery during pregnancy? I am struggling with this, I don't want to loose my unborn child and I don't want to leave one behind. If you have any advice, I would appreciate it.

[Kaerbear]

I really sympathise with your situation right now.  The unknowns are the scariest things to deal with.  I asked every question I could come up with and read everything I could find on my situation when trying to make a decision.  In the end I just had to trust the doctors and rely on prayer to get us through.  I was so afraid for my baby when they told me that there was a risk of premature labour and that they wouldn't even try to save the baby at this stage of my pregnancy because it was too early.  My cyst was so massive it caused me a lot of discomfort and I'm sure was not easy on the baby either.  They were fairly confident about it not being cancerous because of the sheer size of it, but they still wanted to be sure and remove it intact just in case.  I don't know what else to tell you but I can tell you what my surgery was like because it may help ease your mind a little.  I was 248 pounds the day before sugery.  I had gained so much weight (about 45 pounds!!) during my first 4 and a half months, I'm sure a lot of it had to do with having this massive cyst.  When I went in to the surgery ward they made me change and put an IV in my hand.  They gave me a heparin shot to prevent blood clots and made me drink a fizzy antacid drink.  I had been on fluids the day before and fasting since midnight the night before...

[Kaerbear]

(continued)  then I had to wait in a pre-op room while different doctors and nurses came in and introduced themselves and asked me questions.  Teh anesthesiologist told me I would be having an epidural for pain control and general anesthesia for the operation.  They said the baby would go to sleep like me but there would be no long term effects because all of the nerves/organs etc were already developed.  Then an orderly rolled my bed into the operating room and he was so cheerful that I lost my composure and started to cry a little, it was going too fast.  Then they moved me onto the table and a big nurse said to hug her while they put in the epidural.  Nothing they did to me hurt at all.  I laid down and they put an oxygen mask on my face and I was already feeling loopy from the sedative in the IV.  They said, you'll start to get sleepy now, and Boom! I was in the post-op room.  My throat was killing me and I couldn't swallow, they had warned me this would happen because of the breathing tube. I felt a little panicked so I told the nurses and they swabbed my tongue with water and I felt a little better.  I asked about the baby and they said the baby was fine.  Then I told them I was feeling a lot of pain around my belly button so they must have increased my drugs and I felt better...

[Kaerbear]

Then after about an hour they took me to my hospital room where my family were waiting.  My partner fed me ice chips to make my throat feel better.  I had a foley catheter so I didn't need to get up to use the bathroom.  I just slept for the first while.  When they finally took out the catheter and made me get up to use the washroom, it hurt a little and I couldn't pee and I got very nauseous.  I threw up a lot every time I got up, but eventually, as they decreased the epidural, the nausea subsided and I was able to urinate on my own.  I had to hold my stomach over the stiches whenever I coughed or threw up or got up from lying down.  Going number two was a lot more difficult and I had a lot of gas pain and bloating which hurt my stitches.  I had no appetite for a long time, maybe 4 or 5 days, and I hardly ate anything.  I couldn't keep much down for the first few days anyway.  I was only able to have a bowel movement 5 days after the surgery!  I had staples (33 of them) and they hurt the most when I moved.  Getting comfortable is hard but once I'm settled I'm fine.  Your incision would be a lot smaller, so you would have a lot less pain and less recovery time.  Altogether, I don't regret doing it.  It sounds a lot worse than it was in reality.  My boyfriend stayed in the hospital room with me at night and that helped a lot.  I feel wonderful now and I'm glad it's behind me.  The baby is kicking me hard right now and reminding me why I did it.  There's so much more room in there for it to move around.  In the end there was no cancer at all but it's over and done with and now all I have to worry about is healing and looking forward to my baby!  Good luck with whatever decision you make.  I will be praying for you and your little one and for the doctors caring for you.  Stay strong and be positive.  Being a mother is the biggest blessing and challenge you'll ever experience!!  God bless!

[Kaerbear]

http://www.medhelp.org/forums/OvarianCancer/messages/8202.html ; Check out this other thread, there may be some women there that can offer some additional advice and information.

[adreamangel2]

Thank you so very much for sharing your story with me. I am glad to hear you and baby are recovering so well. :) Today I am getting over the shock and starting to look ahead. Your story has defitinely played a role in helping me make my decision. Thank you again, so very much.