Gyn consultation

[waterball67]

Im seeing gyn tomorrow morning for 16.5 x 10 cm complex ovarian cyst. i am 47, pre-meapausal, struggling with abdominal pain and swelling ( much bigger since scan 2 weeks ago) A friend told me they might go for removal right away? Any help on what to ask ( get so nervous and tongue tied at appointments) Thank you

[braijackava]

They will probably want to remove soon at that size since the risk for it to twist or rupture increases with size. Anything above 9cm I believe they consider large and may want to remove it immediately. I had one in November of last year that was 13cm and they removed it. That one actually started as a complex cyst and was much smaller at the beginning. Then it changed (I didn't realize they could) to a simple cyst but they still scheduled to remove it since it had been there for a while and one I had removed several years before was precancerous. It went from 7cm to 13cm in the 10 days from last ultrasound to surgery. All went well though and it was not cancer. Good luck! I know it's scare! Especially when they throw the word cancer around. My last surgery was actually with an oncologist.

[waterball67]

Thank you - am a little concerned they might want me in sooner rather than later.It has seemed to get bigger since the scan. Will update tomorrow! Thanks again

[old_before_my_time]

Welcome to the community. I am sorry you are going through this. If you do not have a family history of ovarian cancer then the cyst is likely benign. But as the other poster said, the size puts you at risk for ovarian torsion which can cause the ovary to die. It is best to have just the cyst removed (cystectomy) if it is benign so that you can keep your ovary and its lifelong function of producing hormones for optimal health. The ovaries have been shown to produce hormones up to at least age 80. Unfortunately, far too many women lose ovaries unnecessarily.

Hopefully, you have made a list of questions for tomorrow. Let us know what you find out. Sending positive thoughts.

[waterball67]

Hi - I was treated very well this morning by GYN and nurse. Scan revealed 2cm growth of cyst in last 2 weeks since scan and it has other little cysts on it. Been referred for emergency CT within next 7-10 days to get better idea if anything sinister - this in turn, will determine if hysterectomy will take place locally or at specialist hospital. Been told that if pain increases or any further issues until then - I can contact Gyn who could perform emergency surgery - though best wait for CT results to give them a better idea of what they are dealing with. Didnt read your post until I was back - although left ovary appears ok - he was still very much pro a full hysterectomy. I am being pencilled in for surgery locally if CT doesnt show any abnormalities up. Thank you for your support :)

[old_before_my_time]

What was his reasoning for a "full hysterectomy" if they don't even know yet if the cyst is benign as most are? And they won't know for sure until surgery when they do the frozen section while you are under anesthesia.

Unfortunately, hysterectomy and oophorectomy (ovary removal) are grossly overused. The American Congress of Obstetricians and Gynecologists (ACOG) determined from a study that 70% of hysterectomies are unwarranted. Only about 2% of hysterectomies and oophorectomies are done for cancer.

My doctor was "very much pro" having all my sex organs removed too but he profited from it and he is not the one paying the price with his health; I am. My cyst was almost 10cm. Even though the frozen section done while I was in the operating room was benign, he removed all my parts anyway. My body and life have been upended...WAY WORSE than the natural menopause of all my friends and sisters whose ovaries are still producing hormones and will to at least age 80. Plus they are not dealing with all the long-term problems associated with not having a uterus.

Please make sure you understand the lifelong non-reproductive functions of the uterus and ovaries before signing the consent form allowing their removal. The long-term effects of losing these organs cannot be overstated.

I frankly miss my uterus as much as my ovaries even though the loss of my ovaries caused horribly rapid aging (lost a LOT of skin collagen, subcutaneous fat, and muscle mass as well as most of my hair which still falls out 9 years post-op) and is associated with quite a few increased health risks, per numerous studies. Use Google Scholar or PubMed to find "bilateral oophorectomy long term health".

The anatomical and skeletal functions of my uterus and its ligaments have taken a toll on my body / figure and bodily functions (bladder and bowel) and my vaginal "vault" is already collapsing without my uterus and ligaments to hold it in place. And I live with constant worry about developing a cystocele, rectocele, enterocele, fistula, and complete vaginal vault prolapse with the loss of pelvic integrity caused by uterus removal. Back and hip pain have already set in. And sex is disappointing plus I have no sex drive.

Just some food for thought.... I know it can be scary when cancer is even a remote possibility but making decisions based on fear is oftentimes not a good thing. I wish I had done things very differently and not trusted my long-time gynecologist and others in a specialty that has been shown to be MUCH TOO QUICK to remove parts that are needed our whole lives. Most of all I wish I had said "no thanks" to my gyn and found a doctor who  was not "pro hysterectomy" and also revised the surgical consent form to not allow removal of any organs if the frozen section was benign.

Sorry for the novel but these organs really do have a lot of functions besides reproduction...hard to be brief about that.  

[waterball67]

That sounds awful - like you  though just get caught up in what's been said! I didnt think to challenge? CT scan to check lymphs today - so will see what that throws up. In UK of course we dont pay extra here, - its done under our national health service. I have a few friends who have had full hysterectomies for various/ similar circumstances - and they all say its the best thing they did. Its on my list to ask at next opportunity ( I also have a close friend who is a theatre nurse who is giving me some advice from her experience) I thank you for sharing your experience, and the forum has been fabulous for sharing and reassurance.I want to follow this through, as there was nothing this in-depth available when I first started looking. Will keep you posted, and thank you again. x

[old_before_my_time]

You're welcome. I have found that many women are hesitant to talk about problems that arise post-hysterectomy especially since we do not tend to talk about sexual issues or bodily functions (bladder and bowel issues and collapsing vaginas). It can be rather embarrassing and degrading! And oftentimes the problems do not happen overnight (especially the bladder and bowel issues such as cystocele, rectocele, enterocele, urethrocele).

With weight gain a common complaint after hysterectomy, it can be hard to discern figure changes attributable to loss of pelvic integrity versus weight gain.

These have been my "observations" in the 9 years since my surgery.