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What should I know about having an ovarian cyst removed?

This will be my 3rd surgery this year.  I fell and broke my kneecap in August and had surgery with pins to put that together, 6 weeks in bed, 2 months PT. Then a month ago I had an emergency appendectomy with a burst appendix. Now this and I’m just scared of the operation, recovery, and more pain
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Avatar universal
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I'm sorry you're dealing with all this! Did you already have the cyst surgery? If not, when is it scheduled? How big is the cyst and how long have you had it? Most cysts end up going away on their own.
26 Comments
I had an emergency appendectomy with a burst appendix on April 8. When they did a CT scan before that surgery they found the cyst - 5 cm. My CA 125 is slightly elevated and after an ultrasound, the walls of the cyst are thickened. Today I go to a Gyn oncologist to determine next steps. Scary but I’m praying.
Ugh - sounds way too familiar... cancer scares when gynecologic cancers (ovarian, uterine, cervical) are rare. And the CA 125 is notorious for false positives (elevated result when there is no cancer). I don't know why they even do the test.

Removal of women's organs whether all or one (uterus, ovaries, tubes) is grossly overused. Removal of even one ovary has been shown to do more harm than good unless you have CONFIRMED cancer. Removal of the uterus (hysterectomy) also causes lifelong and progressive harm as the uterus has a number of lifelong functions.

Unfortunately, far too many gynecologists remove organs unnecessarily and do not tell their patients the medically documented harms associated with their removal.

I wish I'd known what I know now... 12 years after the unwarranted removal of my organs for a benign cyst. Although many cysts resolve on their own, no intervention needed, mine probably needed to be removed as it was twice the size of yours. But all that SHOULD have been removed was the cyst (cystectomy). I made the mistake of trusting my gynecologist of 12 years and letting the cancer scare tactics take over (including his urging for me to see an oncologist) making for a decision I will regret the rest of my life.

Do you have a copy of the CT scan and u/s reports? How did your appointment with the oncologist go?
The cyst has firm walls with sections which could mean cancer. It was decided to remove it and both ovaries. Then doing a D&C to determine what to do with uterus. Complications like fistulas etc scare the heck out of me. It will be DaVinci robotic surgery so it is more precise than regular laparoscopy. Yes, I have CT reports, actual pictures taken when I had appendectomy, and ultrasounds.
Why did you find removing the ovaries to be a mistake. Btw I am 71 and probably not getting any benefit if hormones at this point. Thank for helping me with this,
Joyce
The ovaries (equivalent of a man's testicles) are part of the endocrine system and produce hormones a woman's whole life. Testosterone levels gradually increase after menopause to reach reproductive / premenopausal levels in a woman's 70's. Some of that testosterone is converted into estrogen. Post-menopausal ovarian cysts are actually more common than many doctors realize. And, like in younger women, the majority are benign.

The uterus is essential for a number of reasons. It is an anchor and separator for the bladder and bowel so they're displaced after hysterectomy. That's why many women have problems after hysterectomy - incontinence, incomplete emptying, fistula, prolapse, -celes (cystocele, rectocele, urethrocele, enterocele).  It's ligaments are the pelvis' support structures which is why women's figures change / torso collapses (shorter, thicker midsection) after hysterectomy leading to progressive back and hip problems. It is also key to sexual function.

What is the reason for the D&C? Is your lining thick?  

My uterus, ovaries and tubes were removed unnecessarily. All that should have been removed was the complex cyst (cystectomy), not even the one ovary. My gynecologist removed the one ovary and then when the frozen section came back benign, he removed the rest of my organs. Unbeknownst to me until the day of surgery in pre-op, I was at a teaching hospital and residents have to do so many surgeries especially hysterectomies to graduate. Based on my medical records, no organs should have been removed. I was deceived about my condition and treatment options as have so many other women with whom I've connected.

Only ~50,000 of 600,000 annual hysterectomies are done for a cancer diagnosis. Even ACOG says that 70% of hysterectomies are unnecessary and most ovary removals are too since a woman's lifetime risk of ovarian cancer is 1.3% (~22,000 cases per year). Yet there are also about 600,000 oophorectomies per year.

That being said, IF the cyst is cancerous (based on frozen section done while you are in operating room), then it would make sense to remove organ(s).

The biggest thing I wish I had done differently was find a doctor who said he would not remove any organs if the cyst was benign. And then made sure the consent form stated exactly that with any necessary revisions signed off by both me and the surgeon. Most gynecology consent forms are open-ended such that they can remove organs regardless of what was agreed upon between patient and surgeon.

Let me know if you have further questions. Keep me posted. I certainly wish the best for you whatever happens!!
The ovaries (equivalent of a man's testicles) are part of the endocrine system and produce hormones a woman's whole life. Testosterone levels gradually increase after menopause to reach reproductive / premenopausal levels in a woman's 70's. Some of that testosterone is converted into estrogen. Post-menopausal ovarian cysts are actually more common than many doctors realize. And, like in younger women, the majority are benign.

The uterus is essential for a number of reasons. It is an anchor and separator for the bladder and bowel so they're displaced after hysterectomy. That's why many women have problems after hysterectomy - incontinence, incomplete emptying, fistula, prolapse, -celes (cystocele, rectocele, urethrocele, enterocele).  It's ligaments are the pelvis' support structures which is why women's figures change / torso collapses (shorter, thicker midsection) after hysterectomy leading to progressive back and hip problems. It is also key to sexual function.

What is the reason for the D&C? Is your lining thick?  

Based on my medical records and all the reading I've done since my surgery 12 years ago, my organs were removed for financial gain and to train medical students. They are required to do so many surgeries, especially hysterectomies, before they can graduate. Even though the frozen section done while I was in the operating room was negative / benign, they removed my other organs after they got the pathology / biopsy results.

Only ~50,000 of 600,000 annual hysterectomies are done for a cancer diagnosis. Even ACOG says that 70% of hysterectomies are unnecessary and most ovary removals are too since a woman's lifetime risk of ovarian cancer is 1.3% (~22,000 cases per year). Yet there are also about 600,000 oophorectomies per year.

That being said, IF the cyst is cancerous (based on frozen section done while you are in operating room), then it would make sense to remove organ(s).

The biggest thing I wish I had done differently was find a doctor who said he would not remove any organs if the cyst was benign. And then made sure the consent form stated exactly that with any necessary revisions signed off by both me and the surgeon days before surgery (versus day of when sedation may have already been started). Most gynecology consent forms are open-ended such that they can remove organs regardless of what was agreed upon between patient and surgeon.

Let me know if you have further questions. Keep me posted. I certainly wish the best for you whatever happens!!
This is enlightening. Up to now I keep hearing from friend mostly to have the whole hysterectomy. I just have a 5 cm cyst and we don’t know if it is benign until surgery which is a wee from today. The dr said we could just remove cyst and ovaries and not do uterus. Do a D&C while I’m under to check that. Thoughts?
I suppose your friend doesn't know how critical our organs are. In my experience, those who'd had hysterectomies and/or oophorectomies (ovary removals) didn't reveal any of the problems it caused until after I'd had mine. Some said they didn't want to "scare me." I wonder too if they were jealous of the fact that I still had my organs and looked very young for my age. I aged 10-15 years in just 4 months post-op. I lost more than half my hair and developed streaks of gray. I also lost a huge amount of skin collagen causing my skin to sag and wrinkle. I lost my joy and zest for life as those hormones make up who we are.

I was almost 50 when I had my surgery. Granted, you are 71 so the hormonal fall-out probably won't be as severe. But this is MAJOR surgery with quite a few surgical risks as well as the long-term after effects of living without these organs.

If frozen section shows you don't have cancer, there should be no need to remove any of your organs. What is your doctor's reason for doing a D&C? That will increase surgical risks including bleeding out / hemorrhaging as uterus or arteries can be perforated. If there is no good reason, then why take that extra risk? I was just reading a woman's experience of exactly that.

Your cyst is only 5cm so it could resolve on its own. I personally would want an ultrasound before having surgery to see if it's even still there or has grown or changed in any way. There was a woman who insisted on a u/s before surgery and her doctor did not want to do one. She insisted and, lo and behold, the cyst was gone.

Have you checked out the HERS Foundation's website? This is also a very helpful site developed by ob/gyns - http://ovaryresearch.com/ovarian_cysts.htm. It specifically addresses cysts in post-menopausal women in the section titled "CAN AN OVARIAN CYST FORM AFTER MENOPAUSE?"

Last but not least - If you are uncertain of how to proceed, you can always cancel your surgery until you have completed your research. You don't want to live with regret of having organs unnecessarily removed and having the after effects. And you can get other opinions.

Hope this helps!
I have an ovarian cyst and surgery is next week. Th e plan is to remove cyst, test for cancer and take out ovaries and maybe uterus. This is the first time I have read about a reason for leaving uterus. Where could I find medical info on the. What about leaving ovaries and just taking out cyst? I appreciate your help. Joyce
Thanks to your information I have been doing a lot more research including the HERS site and the American Cancer Society.
I have put a limit on my operation - the Dr. Advises taking the cyst with the right ovary to keep the cyst intact so as not to spread any cells from it into my bloodstream.  The cyst will be frozen and a cross section examined for cancer cells. If there are none then that will be it. IF there are cancer cells and only then take the other ovary and hysterectomy.   I have prayed so much about this and it seems the best way to go. And no D& C  
Again thanks for your info.
Joyce
Good for you Joyce.
Glad to hear your doctor will only remove additional organs if the cyst is cancerous per biopsy. Hopefully, the surgical consent form will reflect that.

I hope your surgery goes well! Let us know when it is and keep us posted.
Surgery is Tuesday, May 29, at 12:30. He said I will sign a new consent form and I asked that the other one be voided. I also requested no D&C since if the cyst is cancerous, the uterus would be removed anyway. Less is more. Thanks again for your help and prayers.
Btw do you live in CA?
With Monday being a holiday, I assume you won't see the consent form until the morning of surgery. I'm sure you know but feel the need to mention - make sure you have time to read and sign the consent form before they take you back to pre-op. I know of women who were presented with the consent form after they had already started sedation.

I am in the midwest.
I met with a medical team member to change my consent form and she enlightened me as to what the ultrasound report said. The lining of my uterus is 14 mm and I’m awake in the middle of the night reading about this.  I feel so dumb about this whole thing. I thought the 14mm thickness was talking about the cyst and not the uterus. I guess I will have to see if I can still change it again.
Yes, 14mm is thick for being menopausal. I'm surprised the doctor didn't better explain everything to you.
Although that's not unusual. :( Oftentimes, they'll just do an in-office biopsy of the lining. Did he want to go the D&C route because he was already doing surgery to remove the cyst?

14mm (1.4cm) would be a very small cyst (one that would not warrant surgery). 5cm isn't that big and could still resolve on its own at least in a woman still menstruating. But maybe it's more concerning after menopause. Of course, its traits are the main thing they look at to determine if it needs to be removed. Those would be detailed in the imaging report.    
You are so knowledgeable about these things. Where do you get your info?
He also tried to do an in-office biopsy and couldn't get into the cervix so that's when he suggested the D & C but I didn't know why other than to check if there were suspicious cells since having the cyst.  This has been so confusing.
I have been researching medical literature and connecting with hundreds of women since my unwarranted hysterectomy and oophorectomy 12 years ago.  
OK I missed / didn't know that he couldn't do an in-office biopsy (probably due to a stenotic cervix) nor that your lining was 14 mm. Regardless of what procedures and diagnostics / biopsies are done, organs should not be removed if results are benign.  

If you are not comfortable with proceeding with surgery due to needing more explanation and info, don't hesitate to cancel. You can always reschedule. It's your body and health that will be affected. I wish I had not felt rushed and without all the necessary info to make a well informed decision when I was in your shoes.

Of course, since I'm not a doctor I cannot advise you how to proceed.
Hi Joyce,  did you end up having surgery. If so, how did it go?
It’s all in the past for me now. Surgery was over 2 weeks ago and I still have pain but I’m managing on just Tylenol and I’m almost back to most activities - although still tired. The ovary with the cyst and the tubes were removed only since there was no cancer. A D& C was also done under anesthesia with a polyp removed and I’m still spotting a bit from that. There was a LOT of bruising but that is getting better each day. I just have to limit picking up more than 10 pounds for a few more weeks because of internal stitches. Thanks for your information. The Dr wanted to take everything but I persisted with keeping the uterus and other ovary.
I appreciated your comments.  Joyce
So glad to hear you persisted and there was no cancer so kept your uterus and one ovary! It's a shame we have to fight so hard to keep our parts. :( I hope your recovery continues to go well!
Now it’s 3 weeks ago and I still have painon my left side where the tools for robotic laproectomy went in along with 4 other holes. A stitch (es) was done internally to keep from getting a hernia - don’t get that. I’m still bloated and was spotting. I went back in and he said that was due to the D&C and a polyp removal and he caurerized the spot. Now I have more discharge.  Not sure what to do now.
3 weeks is still early so the pain may be normal. It would be concerning if you had discharge from the incision. I would think that some spotting is normal since you had a D&C and polyp removal. Ditto for the vaginal discharge since he cauterized the spot. However, if there's a foul odor from either the incision or vagina or bleeding worsens, you should definitely call the doctor. If you are not comfortable with any symptoms, don't hesitate to insist on being seen. If you don't think you're getting good response or care from your surgeon, see your primary care doctor. I hope this helps!
Thanks.
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