Bilateral complex ovarian cysts

[ErinMarie123]

Hi -

I had a baby on 1/31 and during the entire pregnancy I had a 6mm "para-ovarian" cyst on my right side.

I had an US in March that showed the 6mm cyst was still there, but I also had a new small one on the left.

Now my US from July shows that the right ovarian cyst is smaller (3cm) with "low level internal echoes and septations."  It says "on review of the prior study a portion of the cyst appeared to be within the right ovary and the current cyst may represent an interval decrease in size of the previously mentioned cyst which had a paraovarian component."

The left cyst is also 3cm and has low level internal echoes & septations.

What are these low level internal echoes & septations?  what does that mean?

The conclusion says that I have bilateral complex ovarian cysts that may represent hemorrhagic cysts or endometriomas.  Follow up in 2-3 months (but my doctor is having me go in 6 months).

What I'm wondering: what are the echoes & septations?  And also, how can they assume that these are not cancerous?  I'm assuming they'd send me for further testing if they looked suspicious?

[rani415]

Iwas feeling pain in the lower abdomen.My doctor reffered for ultrasound scanning.In that it was found that a cyst of 6.2cmwas there in the right ovary. MYdoctor suggested for surgery.Shall Ihave to go for surgerY?My periods was regular.Iam suffering with pain from 4 MONTHS.I need your advise.

[rani415]

Iwas feeling pain in the lower abdomen.My doctor reffered for ultrasound scanning.In that it was found that a cyst of 6.2cmwas there in the right ovary. MYdoctor suggested for surgery.Shall Ihave to go for surgerY?My periods was regular.Iam suffering with pain from 4 MONTHS.I need your advise.

[MarieMichele]

That's up to you.  In the long run, nobody is an advocate for our health other than ourselves.  You can seek the second opinion if you want it.  2 cm and 3 cm aren't much different to the doctors.  They don't get to the mindset of surgicial removal until around 5 cm.  They probably think 3 cm still has a chance to reduce on its own.  If you feel unwell, trust your body's signals.  If you feel fine and have no real health concerns, there's probably nothing to worry about.

[ErinMarie123]

Thank you so much for replying.

What about the one on the left that went from 2cm to 3cm in 4 months?  That one has always been 'complex' and still is.

Would you be concerned that the lab report suggests follow-up in 2 to 3 months while my doctor is recommending following up in 6 months?  I'm leaning toward getting a 2nd opinion.

Thanks so much for your replies.

[MarieMichele]

Well by definition, para-ovarian means something that was near the ovary but never on the ovary and is not even considered an ovarian cyst.  It may have been endometriosis in the beginning and is now showing as cysts with little endo remaining.  The fact the size decreased is good.  Maybe your post pregnancy status is working to your benefit in fixing this.  Maybe that's how the doctors are viewing it.  Maybe the cysts are just a side effect of returning to ovulation after pregnancy.  So many women never get periodic ultrasounds, it's hard to say.  We may have had this stuff forming and disappearing all the time and never know about it.  Just enjoy your new baby and put it out of your mind until your next appointment.

[ErinMarie123]

I'm sorry - I meant to say 6 CM ovarian cyst during my pregnancy.  Whoops.  Yes, the 6 CM seems to have decreased to 3CM.  Sorry for the confusion.

Thank you for replying.  I am concerned b/c my cyst was always "simple" and now it's complex.  I figure that can't be good?  I don't know.

[MarieMichele]

I'm confused.  
mm = milimeters and that is so tiny, it's not a concern.  mm do not decrease to cm.  It would be the other way around.  cm = centimeter which is larger than mm.

Echos are the ultrasound waves.  The pattern of the wave is what tells them how a cyst is built.  They explained that further by saying you have cysts on both ovaries that are complex (septations means sections/compartments, meaning the cyst is complex, not just a single compartment). They may be leaking fluid or blood (hemorrhagic...meaning they may be breaking down) or they could be endometriosis (overgrowth of the endo from the uterus).

They don't suspect anything that needs immediate attention.  The request for followup is routine to see how you are progressing.  If it looks better in 6 months, you'll probably go back to annual exams.  If not, they will continue periodic monitoring or recommend some kind of treatment.