I am sorry you are going through this. Actually you do need your ovary, you just don't realize it :) Removal of even one ovary has been shown to cause harm. For one, it increases the risk of dementia and parkinsonism. Removal of the uterus also causes harm due to the anatomical changes, its importance for sexual function and its blood supply and feedback mechanism with the uterus. An intact woman's ovaries produce health promoting hormones her whole life.
Ovarian cancer is rare. Per government stats, 13 women and 1000 will get it in their lifetime.
The key takeaway from the ultrasound is that the cyst is "likely functional". And it is small at 2.9cm. No worries about no blood test (CA125) as it tends to have too many false positives. Things like a benign ovarian cyst can cause an elevated result. There can also be false negatives.
Your gyn sounds very assured that it is not cancer yet at the same time he has to say he can't know without removing it to cover himself. That is standard.
Unfortunately, removal of female organs is far too common for conditions that do not warrant it. So it sounds like you are getting good care.
I had a 9.5cm benign ovarian cyst yet my organs were removed anyway. The effects have been like shattering in every way. I wish I would have known that only 8% of hysterectomies are done for a cancer diagnosis. And I believe an even smaller percentage of ovary removals are done for a cancer diagnosis.
If the cyst continues growing and needs to be surgically removed, it is best to have a cystectomy (cyst removal) that preserves the ovary and its lifelong endocrine functions.
I hope this eases your mind a bit.
For asymptomatic females with ovarian cysts, there are published consensus guidelines available at:
You can skip straight to the figures for the summary.
In general, you first have to determine premenopausal vs. postmenopausal.
In general, premenopausal is more lax with less follow-up.
In general, postmenopausal is more strict with more follow-up.
For symptomatic females (as in your case since you have left-sided pelvic pressure), the recommendations in the paper may also be helpful, but the clinical setting will often determine management in a manner beyond the scope of this consensus panel. In general, if there is a complex cyst on initial pelvic ultrasound, it is reasonable to repeat the pelvic ultrasound in 4-6 weeks or 6-12 weeks. If the abnormality persists, then consider MRI pelvis for further characterization.
To address your case specifically, you had mentioned you had a cyst with internal echoes. Diagnostic considerations include simple cyst (with artifact), hemorrhagic cyst (which is benign, essentially normal to see these in premenopausal female), and endometrioma (which is benign, not cancer, characterized by tissue normally within inner lining of uterus being deposited outside the uterus, but can still cause symptoms such as pain and/or bleeding). The classic look of a hemorrhagic cyst is reticular pattern of internal echoes. The classic look of an endometrioma is diffuse low-level echoes. However, since there can be overlap in imaging appearance, it is common practice to get a repeat pelvic ultrasound in 6 weeks or so, as your gynecologist suggested. If the abnormality improves/resolves, then hemorrhagic cyst is favored. If the abnormality persists, then endometrioma is favored. Hope this answers your question and puts you more at ease!
So, I had my follow up today. The cyst is gone. I am still having groin pressure and muscle spasms in my thigh so my dr wants to do the surgery to look for/remove endometriosis. Does this sound reasonable? Anyone have any experience with this? Thanks!
I had a cyst resolve on its own as well. But my symptoms resolved after. Sounds like the further evaluation is key for you. What were the findings?