Ovarian Cyst, Uterine Polyp, & Free Fluid in Pelvis

[swee2000]

This past Wednesday, I had a sonohystogram done because of irregular & intermenstrual bleeding that I've been experiencing since April, as well as pelvic pain in my LLQ of my abdomen. According to my doctor, the ultrasound shows that I have a "growth" on the lining of my uterus which she believes is a polyp, but can't say for sure. She gave me the option of monitoring it or having a D&C to remove it. I opted to have the D&C done next month.

The ultrasound also showed I have a leaking cyst on my left ovary as well as free fluid in my pelvis. Because of this, she wants me to have a repeat ultrasound in 3 months to check the status of the cyst, etc. What worries me is that: a)the doctor said(and sounded like) she's more concerned about the cyst, but only wants to monitor it at this point; b)I have a strong, family history of breast cancer(2 relatives have died from it, one of them only in her early 30's); and c)from what I've read, free fluid in the pelvis from an ovarian cyst is a possible sign of ovarian cancer.  

I know I'm probably overreacting to all this, but the unknown until I have the D&C and the repeat ultrasound have been constantly on my mind since I was given this news. Any thoughts or opinions?

[Annekathryn Goodman, M.D.]

Hi there,

I think your doctor's plan is good. You may have ruptured a cyst which is why you had pain. The fluid, especially at that level, will usually be gone next time you check if that is the case. I think doing a D&C is very important to evaluate the growth inside the uterus.

Here are some other suggestions for you to consider with your doctor:

repeat the ultrasound sooner. It is causing you anxiety. If it is a cyst of ovulation, it should be gone after one menstrual cycle. waiting 3 months is a long time when you are feeling scared. So see if you can get it done right before your D&C

Ask your doctor about getting a CA 125. This is an incredibly unreliable test especially in premenopausal woemn but with your family history, it may be good to get a baseline level.

Consider seeing a genetic counselor to go over your family history. Should you have genetic testing for BRCA 1 and 2 gene mutations? If you have those mutations, you should consider the prophylactic removal of your ovaries if the D&C is normal.

best wishes to you

[stainless_72]

A related discussion, need help before i go back to see my DOCTOR, was started.

[brittany807]

A related discussion, Ovarian Cyst was started.

[akg]

hi there,
I would recommend a D&C. That will give good information about the lining of your uterus.
take care

[swee2000]

I am getting more confused & worried. As I mentioned in my previous posts, I have been experiencing intermenstrual bleeding every month since April. Like clockwork, it has started exactly 10 days after my "normal" period ended, has been equivalent(in amount) to the last 2-3 days of a "normal" period(meaning it's moderate in amt and requires me to wear a pad and change it a couple times/day), and lasts about 4 days each month. During this time, my regular periods had been normal, in length & amount, meaning they last 5-6 days(in which the first 3 days are heavier in amount and then gradually lighten up till they end).

Fast-forward to this month. I got my regular period on July 1st.......and it was anything but normal. The period lasted 2 days(where my normal periods last 5-6 days), with both days consisting of heavy bleeding before it abruptly, unexpectedly, and abnormally stopped. So, considering this info and the pattern of my menstrual cycles lately, that means the intermenstrual bleeding should've started around 7/13, give or take a day. I had a sonohystogram done on 7/11 and the findings were:

Uterus is 6.44x3.61x4.75cm, in AV position, and contour & echotexture WNL.
Endometrium is 1.1mm with 0.93x0.41cm hyperechoic(?? on spelling) structure mid-uterus that is obscuring endometrium.

There is a 2.06x1.91x2.22cm area of fluid in cul-de-sac.

Left ovary is 2.91x2.78x2.81cm
Right ovary is 3.32x2.02x1.66cm with 1.05x0.80x0.95 hyperechoic area within rigth ovary.

Filling defects: 1.00x0.42x1.15cm hyperechoic filling defect mid-uterus(c/w structure noted above). Has polypoid appearance. Fluid retained.

Also, because the sonohystogram showed a uterine polyp and cyst on my right ovary, the doctor said I would continue to have the intermenstrual bleeding until the polyp was removed(which won't occur until 8/23).

Well it is now 7/22, 19 days(!!!!) since my last regular, but abnormal, period ended and I still have not had any intermenstrual bleeding. Isn't this odd, considering the polyp(and possibly the cyst) is still there? This last week, I have been experiencing ALOT of lower pelvic pain, cramping(including abdominal), sharp pains on my left lower pelvic area, diarrhea(that just came out of nowhere), and occassional thick, clear vaginal discharge. But not a speck of blood in sight! What the heck is going on with me? Should I be getting worried that something else is going on or what is already wrong is getting worse? Should I be calling the doctor again? The stress of worrying is killing me.  
:

[swee2000]

I am getting more confused & worried. As I mentioned in my previous posts, I have been experiencing intermenstrual bleeding every month since April. Like clockwork, it has started exactly 10 days after my "normal" period ended, has been equivalent(in amount) to the last 2-3 days of a "normal" period(meaning it's moderate in amt and requires me to wear a pad and change it a couple times/day), and lasts about 4 days each month. During this time, my regular periods had been normal, in length & amount, meaning they last 5-6 days(in which the first 3 days are heavier in amount and then gradually lighten up till they end).

Fast-forward to this month. I got my regular period on July 1st.......and it was anything but normal. The period lasted 2 days(where my normal periods last 5-6 days), with both days consisting of heavy bleeding before it abruptly, unexpectedly, and abnormally stopped. So, considering this info and the pattern of my menstrual cycles lately, that means the intermenstrual bleeding should've started around 7/13, give or take a day. I had a sonohystogram done on 7/11 and the findings were:

Uterus is 6.44x3.61x4.75cm, in AV position, and contour & echotexture WNL.
Endometrium is 1.1mm with 0.93x0.41cm hyperechoic(?? on spelling) structure mid-uterus that is obscuring endometrium.

There is a 2.06x1.91x2.22cm area of fluid in cul-de-sac.

Left ovary is 2.91x2.78x2.81cm
Right ovary is 3.32x2.02x1.66cm with 1.05x0.80x0.95 hyperechoic area within rigth ovary.

Filling defects: 1.00x0.42x1.15cm hyperechoic filling defect mid-uterus(c/w structure noted above). Has polypoid appearance. Fluid retained.

Also, because the sonohystogram showed a uterine polyp and cyst on my right ovary, the doctor said I would continue to have the intermenstrual bleeding until the polyp was removed(which won't occur until 8/23).

Well it is now 7/22, 19 days(!!!!) since my last regular, but abnormal, period ended and I still have not had any intermenstrual bleeding. Isn't this odd, considering the polyp(and possibly the cyst) is still there? This last week, I have been experiencing ALOT of lower pelvic pain, cramping(including abdominal), sharp pains on my left lower pelvic area, diarrhea(that just came out of nowhere), and occassional thick, clear vaginal discharge. But not a speck of blood in sight! What the heck is going on with me? Should I be getting worried that something else is going on or what is already wrong is getting worse? Should I be calling the doctor again? The stress of worrying is killing me.  
:

[swee2000]

Today I received a copy of the report from the sonohystogram I had done last week. If anyone can give me feedback on what this means, especially regarding the findings on the ovaries and the "fluid in the cul-de-sac", I would greatly appreciate it(the way the doctor sounded last week regarding the cyst and fluid in my pelvis, I've been worried sick that something serious is going on). Here's the US findings verbatim:

Uterus is 6.44x3.61x4.75cm, in AV position, and contour & echotexture WNL.
Endometrium is 1.1mm with 0.93x0.41cm hyperechoic(?? on spelling) structure mid-uterus that is obscuring endometrium.

There is a 2.06x1.91x2.22cm area of fluid in cul-de-sac.

Left ovary is 2.91x2.78x2.81cm
Right ovary is 3.32x2.02x1.66cm with 1.05x0.80x0.95 hyperechoic area within rigth ovary.

Filling defects: 1.00x0.42x1.15cm hyperechoic filling defect mid-uterus(c/w structure noted above). Has polypoid appearance. Fluid retained.

[swee2000]

Correction on above info: the part regarding the right ovary should say "Right ovary is 3.32x2.02x1.66cm with 1.05x0.80x0.95cm with hypoechoic area within right ovary".