complex ovarian cyst

Hello, I need another opinion about the appropriate course of action I should take regarding a complex ovarian cyst. I had a pelvic ultrasound(I was having vague discomfort) about 3 months ago. A right 1.7cm complex ovarian cyst was found. I had a followup pelvic Ultrasound after 6 weeks that said "Interim resolution of the right 1.7cm ovarian cyst when compared to 11/17/06. normal appearing pelvis with only a small amount of free fluid in the cul-de-sac probably physiologic in nature." My problem is that I had an abd CT done about a week later for other issues and it said, " There is a low density area in the right adnexa, probably reflecting ovarian cyst. This appears somewhat thick walled and clinical correlation and US is suggested." OK, I talked to my OBGYN doc and she said she would not even order another US for followup because at my age (41y/o) these are going to happen. I asked her about the apparent cyst on CT that was supposed to have resolved according to US. She said it was probably another complex cyst and she let it drop. Should I persist and ask for another US or let it go? Everything I've read said they should be removed. Is that the case all the time? Your opinion would be appreciated.

[Lennox Hoyte, M.D.]

Please see the answer to question 39. It contains an explanation to our questions.

Ultrasound is usually the best imaging method for detecting ovarian cysts.  If the cysts are coming and going, they are very likely related to ovulation.

[momto2]

I'm sorry but I'm not very familiar with this site. Where and how do I find question 39? Thanks

[Lennox Hoyte, M.D.]

Apologies for the confusion. The question numbers are not listed, so it would have been impossible for you to find #39. I recopied my answer here..

Simple cysts (fluid filled inclusions) form on the ovary every month in women of reproductive age. They can grow up to 3-4 centimeters in size and not be a problem. They are a natural consequence of monthly egg development and ovulation. That is why they come and go. If they are under 4-5 centimeters, they should not be causing pain. Hemorraghic (a form of complex) cysts are nothing more than a simple cyst which ruptured to release an egg, then reclosed and filled with blood (also can happen often). Small amounts of free fluid in the cul-de sac is also normal.

If you are having pain requireing narcotics, a source needs to be found. a sub 3cm cyst does not explain it. Possible causes: pelvic infection, fibroids, musculoskeleta, bladder (stones)l.

Many women with pain after hysterectomy can have myofascial trigger points in the pelvic floor or abdomen and back which can refer pain into the pelvic.

Get evaluated by a gynecologist. If this workup is negative for any credible causes, then go see a pelvic floor physical therapist, to see if pelvic muscle issues may be at work.

[sourpickles]

A related discussion, complex ovarian cysts was started.