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9 cm cyst - is this abnormally large?
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9 cm cyst - is this abnormally large?

I was diagnosed as having a 9.1 cm ovarian cyst in my right ovary two days ago. I had gone into an urgent care clinic due to the excruciating pain radiating from my abdomen to my legs and lower back. I had experienced such debilitating pain only three weeks earlier at night, but dismissed it when it lessened for the weeks between then and now. The cramps were always present, but tolerable - I thought it was just gas due to my mostly vegetarian diet, so I was trying all sorts of OTC gas remedies.

I had an ultrasound to evaluate the cyst and was able to get in with a gynecologist - not my normal one - the day after the ultrasound (yesterday). She was pretty casual about the whole thing and I guess when I didn't scream out in pain as she was pressing on that ovary, she figured I was fine. However, I have been in constant shooting pain since Friday, I have no appetite, my stomach is bloated like I'm pregnant and I have pains when I urinate. I understand ovarian cysts are common, but I wasn't sure if the size of mine made it something uncommon that action should be taken on. I'm a runner and live an active life with a f-t job, so this is dramatically affecting my quality of life. Even when it was less, during the three weeks prior, I was still experiencing occasional sharp cramps and had to stop during runs to let a cramp pass. I have a high tolerance for pain and was raised to not be a complainer; I guess that worked only to convince the Dr. I saw that I can wait the 6-8 weeks for another ultrasound. Any advice, experience would be greatly appreciated. I feel like no one wants to give me any answers that solve the issue.
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Avatar_f_tn
They are considered large enough for surgical removal at around 5 cm.  Mine was 10+ cm when I went in for surgery in January 2009.  You can read my story in my profile.  Once they get to a certain size, they tend to stay large or even continue growing.  Running could cause more harm than good now as it might cause the cyst to rupture...or worse twist the fallopian tube and cut off blood supply leading to organ death/gangrene...in other words a dire emergency.  I am talking worst case scenarios that are not common but are not impossible either. You also need to know more about the composition of the cyst itself.  Fluid filled? Solid/complex?  All carry different degrees of risk for malignancy...again another less common possibility, but possible.  Doctors cannot be completely certain about a cyst and cancer risk until the entire thing is removed and tested (i.e. draining/biopsy of a small section alone really isn't reliable). Cysts are abnormal when they reach a point they are too big to think they are the result of ovulation and capable of resolving on their own in future cycles.

Many of us did the same thing: ignore or dismiss symptoms or try to "suck it up" and deal with the discomfort.  None of which is wise to do.  You really want to be asking for the best gyn surgeon you can get, and if possible, a gynecologist/oncologist since they really know how best to operate and treat any type of abnormal growth, including the benign ones.

Best wishes.  I was not trying to scare you, but want you to be proactive and get this thing treated.  I don't think waiting 6-8 weeks and getting more tests really is the answer anymore.
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Avatar_f_tn
They are considered large enough for surgical removal at around 5 cm.  Mine was 10+ cm when I went in for surgery in January 2009.  You can read my story in my profile.  Once they get to a certain size, they tend to stay large or even continue growing.  Running could cause more harm than good now as it might cause the cyst to rupture...or worse twist the fallopian tube and cut off blood supply leading to organ death/gangrene...in other words a dire emergency.  I am talking worst case scenarios that are not common but are not impossible either. You also need to know more about the composition of the cyst itself.  Fluid filled? Solid/complex?  All carry different degrees of risk for malignancy...again another less common possibility, but possible.  Doctors cannot be completely certain about a cyst and cancer risk until the entire thing is removed and tested (i.e. draining/biopsy of a small section alone really isn't reliable). Cysts are abnormal when they reach a point they are too big to think they are the result of ovulation and capable of resolving on their own in future cycles.

Many of us did the same thing: ignore or dismiss symptoms or try to "suck it up" and deal with the discomfort.  None of which is wise to do.  You really want to be asking for the best gyn surgeon you can get, and if possible, a gynecologist/oncologist since they really know how best to operate and treat any type of abnormal growth, including the benign ones.

Best wishes.  I was not trying to scare you, but want you to be proactive and get this thing treated.  I don't think waiting 6-8 weeks and getting more tests really is the answer anymore.
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Avatar_f_tn
Thank you for the quick response - I finally got through to my midwife and scheduled with a doctor for a second opinion. I agree on all points, and definitely appreciate the concerns. The sonographer said it was fluid-filled and simple (I apologize for not including that above), but this thing is too the point that it's simply not something to wait and watch on. I felt like the doctor wasn't listening to me; it's so frustrating. Thank you again! I do really appreciate it.
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Avatar_f_tn
To add to the info. above, I have been on birth control for around 8-9 years. I know that's a common remedy to the smaller cysts.
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Avatar_f_tn
And it is unfortunate that BC didn't help prevent this, which really is confusing. Perhaps the newer BC have lower hormone doses that work for BC purposes but do not help that much in inhibiting cyst development.  The chemistry of it all (hormones are complicated) is more than any of us here can understand. I wonder if doctors are any better at understanding it themselves.

Fluid filled is better to have and probably is what led it to become so large.  I get discouraged that so many woman have these problems and that surgery often ends up the best solution.  I do not like recommending surgery, truly I don't.  It disrupted my life, my career, and I am still not back on track.  
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Avatar_f_tn
I will be undergoing surgery in 9 days and my doctor's pretty sure the size will push the procedure to laparotomy which is troubling. She was very concerned and said this was the best route to get me back on track. Thanks again.
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Avatar_m_tn
Hi
Could you please help me weather the surgery you undergone was completely successful or not.
Thanks in advance
KS
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