Laparoscopy pros and cons

[ab1972]

About 8 or 9 years ago (when I was about 27 or 28) I had been told (after a transvaginal ultrasound prescribed due to painful periods) that I had a few small cysts.   The lab technician told me that they were most likely blood cysts from endometriosis.  She said that it was pretty common and not to worry about it.  
I was however on the pill the pill at the time and therefore shouldn't have had them as I hear that the pill is one of the way to treat this condition.  
My cysts were not followed up since.

About two months ago (I am now close to 36 y.o.), during a routine pap smar, I asked my doctor if it is possible to check on those cysts. Like most doctors had told me over the past few years she told me not to worry about it but she did check me a little more. She found that my uterus was enlarged.  She said it was enlarged like a "10 weeks pregnancy" (close to a trimester) she sent me to get an ultrasound.

First ultrasound:
Uterus measuring 10.3 x 7.5 x 4.5
Endometrium Slightly prominent.  Thickness: 13.2 mm
Fibroids: none
Left ovary: 5.2 x 5.2 x 4.3
Right ovary 6.1 x 4.7 x 3.2
Left adnexa Normal
Cul de sac: no fluid visual
Right adnexa: small amount of free fluid

First Ultrasound comments:
Right ovarian septation measuring: 3.2 x 4.3 x 2.9
Left ovarian cyst measuring 4.2 x 4.4 x 3.1 complex with thick fluid with several solid areas

First Ultrasound Impression:

1. Right ovarian septation
2. Small amount of free fluid in the right adnexa
3. Left ovarian complex cyst measuring: 4.2 x 4.4 x 3.1 with thick fluid with several solid areas within.

After those results I was referred to a specialist who ordered a 2nd ultrasound and blood tests.

Second ultrasound (at a different hospital)
Findings (measurement of both ovaries and cysts seem very different):

Uterus measuring 9.8 x 7.7 x 5 cm.  Endometrial stripe well defined: 1.6 cm.  Myometrium heterogeneous raising the question of diffused adenomyomatosis.  
Left ovary measuring 4.5 x 2.8 containing cystic mass with an irregular border and soft tissue complement measuring 3.6 x 2.3
Right ovary measuing 3.1 x 1.9 x 3.2 containing complex septated cystic mass masuring 1.2 x 6mm most likely represent hemorrage.

Second ultrasound Impressions:
1. Heterogeneous myometrium most likely represent adenomiomatosis
2. Bilateral ovarian complex cystic mass most likely represent endometriomas. MRI can be suggested for better evaluation.

It seems a bit odd to me that the measurement of both my ovaries and my cysts vary so drastically between the two diferent ultrasounds.  Is that possible or could there have been typos???

Most blood tests came up normal.  

My CA-125 came very slightly positive at 24 U/ML.

The GYN I saw recommends a laparoscopy.  I am not sure if it is recommended more in order to perform a biopsy to rule out cancer or if it is for treating endometriosis? I asked him and his response appeared a bit vague to me.  

Would a laparoscopy be recommended both to do a biopsy and to treat?  Or is it more for one then the other?...

I do not have many symptoms at all. Occasional painful periods, not too troublesome.  Occasional slight discomfort around my ovaries.  No pain during sex.

The doctor scared me a little when he told me about the operation and list all the risks of complications...

If I have very few symptoms, do I really need a laparoscopy?...  I wonder about the pros and cons of being operated.

Finally I really want to try to have children.  Should I try before the laparoscopy or would the laparoscopy facilitate my chance of becoming pregnant?

Sorry about writting so much... I have to give my doctor an answer about the laparoscopy really soon and I am undecided about it being that I feel I have few symptoms and I worry about the operation.

Thanks for your help and advice.

Sincerely,

ab

[ab1972]

Thank you very much for your help and advice.  I really appreciate.  Sorry for all the detail I wrote on my post. It is my first time on the forum and I thought I was sending my question to a doctor, this is why I sent so much information.  THANK YOU so very much for taking the time to read and for your answers.  I really appreciate.  So after more research and more thinking I realize I should go ahead an do the laparoscopy.  Only now, my doctor told me to wait for three months and another unltrasound.  
Anyway, thank you very much for your help and advice.
ab

[cirella]

Hi, I'm going to agree with SurvivorSusie.  At the very least, a laparoscopy will give you Dr a chance to look around.  You have some things going on, too, so it's a good idea.  If it's been 2 months since you've noticed symptoms, then even more it's the right thing to do.  The procedure is an easier one to recover from.  

Take care,
Lori

[survivor_susie]

Hi,

Hopefully, there's nothing serious going on with you, but still I'd run, not walk, to the laparoscopy.  It's a very easy procedure with very little pain afterwards.  Doctors don't often enough recommend such simple procedures early enough to catch anything when it's so young and curable.  I was one of the lucky few who did happen to have a laparoscopy just to rule out anything serious, was found to have ovarian cancer, and was caught at stage 1C. I thank God for my doctors who wanted to be thorough!

There's a good chance that nothing will be found, but why worry when you have the chance to find out for sure?  

Best wishes!
SurvivorSusie  : )