Ovarian Cyst and Kidney Stones

[bowlingchick]

My 15 year old daughter had a CT scan to check for kidney stones.  The doctor told me the results showed stones in both kidneys...more in the right than in the left.  Also showed a 4cm by 4cm cyst on the right ovary. She put her on birth control pills for a couple of cycles to see if the cyst goes away.    So we are starting month 1 with the birth control pills, and waiting for an ultrasound in a month or two. As for the kidney stones...she was told to drink lot's of water, as much as 2 -2 liter bottles a day.  She began drinking the water and in about a week she passed a substance that resembled sand.  She had no pain when this happened.  I reported this to the doctor, who said yes..she had just passed the kidney stones.  She was at school when she passed those and didn't have anything to use to collect the substance.  So we have nothing to take in for testing.  Do you agree that it was kidney stones?  And that we are doing the right thing with the cyst..taking the wait and see approach?

[Keith Downing, MD]

Hello,

I can speak to the management of the ovarian cyst.  You didn't give a description of the cyst beyond its size, however, common things being common it is quite likely your daughter has what is considered a functional cyst (i.e., a physiologic cyst that forms due to the ovarian response to its hormonal environment), or a corpus luteum cyst (i.e., the normal cyst that forms after ovulation).  A functional cyst will appear simple on u/s, while a corpus luteum will appear complex.  

A corpus luteum will resolve spontaneously as a normal process of the menstrual cycle.  A functional cyst may resolve, but also could persist or enlarge, ultimately requiring surgical resection (best performed by laparoscopic cystectomy).

Commonly, oral contraceptive pills (OCPs) are prescribed with the idea of suppressing new functional cysts from forming.  However, most modern low dose OCPs appear to have minimal efficacy in preventing the development of functional cysts.  The plan to repeat an u/s in 3 months is appropriate.  If your daughter has a regular period, best to have the study performed shortly after the onset of her menses.

Lastly, ovarian cysts on occasion may bleed into themselves, rupture, or cause the ovary to torse (or twist).  Your daughter should be wary of any sudden onset abdominal pain and/or nausea.  If this were to happen she should seek medical attention immediately.

I hope this is helpful.

Best regards,

Dr. Downing

[miss_impatient]

i have a cyst on my right ovary as well...the doctor back in april told me to do the "wait and see" approach and i have been doing that

i'm heading back to the doctor today to see if my cyst has gone away...

ill update you on this but bear in mind im 28 years old and TTC and im blaming this cyst for my problems not being able to

i have also heard in many cases and read a lot online that ovarian cysts are common for females and most of the time they burst and go away without knowing...there's a small time they linger and that's when you should be concerned....

hope this helps

[bowlingchick]

I just wanted to check on how your doctors visit went?  Hopefully your cyst went away, do update when you find out.  Thanks!

[miss_impatient]

just got in from the doctor and my cyst has finally gone away...

thanks for checking in

[bowlingchick]

CT Results are as follows:  1) Probable bilateral developing staghorn renal calculi, slightly more prominetntly on the right than the left but witout evidence for obstructive uropathy on the current study. 2) Probable benign simple renal cortical cyst, midpole left kidney medially measuring no greater than 8.0 mm and is considered an incidental finding. 3) No additional significant CT abdomen abnormality. 4) Large 4.3 x 4.0 cm low density right posterolateral adnexal mass most likely represents a benign follicular cyst;  follow-up characterization with sonography versus follow-up sonogram in 4-6 weeks to ensure resolution may be of benefit for further evaluation if felt to be clinically indicated. 5) Increased thickness of the endometrum measuring 16.0 mm, most likely which is physiologic in nature ( she did start her period 3 days later) follow-up characterization with ultrasound may be of benefit if felt to be clinically indicated. 6) No additional significant CT pelvic abnormality; specifically, no evidence for appendicitis.

[joyfulgirl]

Please make sure that your daughter's doctors are evaluating her two conditions together.  I too had a staghorn stone, and those are not to be taken lightly.  They will increase and attempt to fill the interior of the kidney.  I too had bilateral adnexal masses, but the docs were so focused on the kidney that they missed the issue with the ovaries.  Turns out I had undiagnosed stage 4 endometriosis, and I am now under the care of an endometriosis expert hours from my home to correct the situation and she is looking at the whole situation in my abdomen/pelvis. I am not telling you any of this to scare you, simply to urge you to have very skilled docs working with you who are treating both conditions.  Perhaps consider a urogynecologist consult as well.

[bowlingchick]

Thank you so much for your comment.  I also had stage 4 endo...and have worried that my daughter will also have endo.  What age are you?  My stage 4 was found during surgery at age 40.  I'm hoping if she has endo they will find it a lot earlier than they did mine.  Thank you for your comments.