adv. and disadv. of bikini and vertical incisions?

[elyza97]

I have ovarian cyst on both of my ovaries, according to the ultrasound its a complex mass and the biggest measures 10 cm, it stated their that its probably dermoid. I already visited 3 doctors, the first one said i can undergo the operation with a bikini type incision, the second one said any type of the incision can be used, i ask her which is better then she said, "its just the same which do u prefer?". the third dr. said vertical incision should be used, bec. it allows more visibility inside the abdomen and so that they can see the other organs.. but then i read somewhere in the internet that if you used that kind of incision you will not be allowed to have a normal delivery when u give birth, u will always undergo ceasarean, is that true? My first choice of course is the bikini type because of cosmetic reason, u can hide it and accdg. to what i read its possible that you will have a normal delivery but then the visibility inside the abdomen is limited.

I need your help guys to decide, which type of incision should i choose.. what really are the advantages and disadvantages of bikini incision and vertical incision? I am 25 years old and i want to have a baby someday of course.. Im hoping for your reply guys. Thank you very much for your time and advice!

[hopeshell]

It sounds like a dermoid and not a mucinous tumor.  The appendix is often an area of concern for mucinous tumors (which are tumore filled with thick yellow mucin).  But, dermoids don't usually affect the appendix.  It is likely benign and won't recur!  :)  Be sure to take it easy for six weeks and don't lift heavy objects or do housework that strains your abdominal muscles.  Get plenty of rest!  After your doctor gives you the all clear at approx. 6 weeks, you may still have a couple of weeks before you truly feel back to normal.  Best wishes on a speedy recovery!

[elyza97]

yes thanks its over, by the way what is mucinous tumor? well my dr. told me it contains some hairs and fats and something like bones, my dr. also gave me a picture she had taken and what i can clearly distinguish is the fats or something like oil ,i can also see something black, that's the hair maybe, I don't have the pathology result yet, my doctor said i'll get it after a week..does it really take that long? well anyway i hope that the results are good. so what are the DOs and DONTs after surgery, forgot to ask my doctor, Thank you so much for answering all my questions..

[hopeshell]

I am so glad your surgery is behind you.  I am sorry the incision is higher than you hoped.  Your doctor probably did the smallest possible incision to safely remove your mass.  Your mass was pretty large.  Do you have your pathology back yet?  I am guessing if they wanted to remove the appendix that you may have had a mucinous tumor?  Was it in fact a dermoid?  Either way, if they did not note malignancy, you are likely in the clear now.  

You can expect to have pain for a while until you heal.  I had back pain just from laying in bed.  Once your stomach muscles have been cut, it puts more pressure on your back muscles. Try heat on your back and see if it helps the pain.  A microwave heat pack works great!  If this helps, then it is probably muscular pain.  If you get pain in one area that gets worse with time, then you may want to get it checked.  The soreness can last for a few months after this type of surgery.  You will feel much better as each day passes!  I hope you have a speedy recovery!  Congrats on being past the surgery!

Shelly

[elyza97]

hey! forgot to tell u they also called a surgeon to perform appendectomy on me, is it true that the cysts affects the appendix...or i dont know, i might misunderstood what she said. by the way regarding what i mention above its the lower back that hurts, more to the left. Cough and sneeze really hurts, any advise?

[elyza97]

hi there! i just got home yesterday(sept.19) from the hospital, i was admitted last wed.(sept.15) afternoon and have my surgery sept. 16. I have a vertical incision from my belly button down to my pubic bone, I'm just a bit sad, because i thought it would be at least below my belly button but it's okay the surgery went well. I also thought my menstruation will be delayed because of the surgery but then it came(sept.18). My dr. said I'll have a follow up check up after a week and discuss the lab results so i hope its all fine. By the way is the back pain normal, its more to the left than the other side..

[hopeshell]

Well, my case is not typical because I did end up having early staged ovarian cancer.  I received a staging surgery so my incision begins at my pubic bone and goes about 1-2 inches past my belly button.  Normally, without having the omentum removed and staging, the incision would have begun at the pubic bone and ended 1-2 inches below the belly button.    

My recovery was also not typical because I developed complications and was in the hospital for ten days.  But, you will need a full six weeks to recover from this type of surgery.  After about two weeks, you will feel more like your old self, but you can't lift or put pressure on your abdominal muscles until they heal.  If you do too much too soon, you run the risk of getting a hernia or other complications.  It is helpful to have someone who can prepare or bring you meals and handle any of your necessary errands and housework.   Just plan to watch movies, read books and sleep.    Best wishes for a great surgery and speedy recovery!

[elyza97]

Thank you very much for that info. it's very helpful.. I just want to ask you how long was your incision and how long was your recovery.. thanks again and God Bless!

[hopeshell]

Both my gynecologist and my gynecologic oncologist said that I must have a vertical incision for a 6cm complex cyst.  I was hoping for a bikini cut and my family doctor said it could be done through a bikini cut.  But, the gyn and gyn/onc both insisted I had to have a vertical incision.  I was treated at a major cancer center in a large city and I do really trust my gyn/oncs opinion.  

I am really thankful that I had vertical incision and the tumor was removed intact.  My stage of cancer was 1a which meant I did not need chemo.  If my mass had burst or spilled any contents, I would have been faced with chemo.   I am now three years out and cancer free.  

Dermoids are usually benign.  In a very small percentage of cases, they are malignant.   It is truly a personal choice if your doctor is willing to do a bikini cut.  I have heard of a couple of ladies who did have a bikini cut and they did end up having benign cysts.  But, dermoids can also cause infection if the contents are spilled, so that is something to consider too.

I think the issue you are thinking about with a vertical incision is when the uterus has been cut...such as in a previous caesarean section.  The wall of the uterus is weaker after it has been cut and that makes it safer to have future deliveries with c-sections again.  You will not have that risk since your ovaries are on the outside of your uterus and your uterus will remain uncut.  Even some women who have had a c-section are able to work with their doctor and deliver vaginally...this is commonly called a VBAC.  You can read about it here:

http://en.wikipedia.org/wiki/VBAC

So...this is a tough decision that only you can make.  From a safety, cover your bases standpoint...a vertical incision is best.  But, your doctors are better able to answer this question.  Good luck in making your decision.  Keep us posted on how you are doing!

Shelly