Ovarian Cysts

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  • Ovarian cyst removal with oophorectomy?

    (5 replies)

    Recently a CT scan (for possible appendicitis) revealed that I have a large cyst on an ovary and my Dr. recommended immediate removal. During the course of the pre-op appointment I express the desire to not lose my ovary and discovered that their intention was to remove both of my ovaries and fallopian tubes (she said whenever they are in there, they take everything) - the Dr.s point being that after 60 you don't need your ovaries (I'm not 60 yet BTW). I don't have a higher risk of ovarian or breast cancer, and the cyst posed no concerns of cancer to them and I am not in pain. From everything I've read you definitely don't want to lose your ovaries before the age of 65 as your risk of dying from pretty much everything else is higher when you have your ovaries removed than the risk of cancer from keeping your ovaries. Also, that the risk of dementia and Parkinson's are increased by the removal of one ovary as much as by the loss of both.

    I also believe that we simply don't now everything the ovaries do, but that they do play a role throughout our lives.

    That said, I am trying to evaluate the risks of keeping my cyst/ovary. The risks appear to be that my ovary might twist and lose its blood supply causing extreme pain and the death of my ovary requiring emergency surgery, or it might rupture or leak, again causing pain. And of course that the cyst could turn cancerous (very unlikely).

    Finally my question: Is there anyone out there that has made the choice of keeping a large (mine is 7.5 cm) ovarian cyst and regretted it? If so can you tell me why?

    Thank you in advance.

    Oh, my. I have had two major ovarian cystectomies in my life, and am in full possession of both ovaries. You did not raise what I think are very important questions: Should you get a second opinion?, and 2. Should you push back on the removal of your ovaries?, and I think the answer is a resounding yes to both of those questions. Obviously, I am not your doctor, but I think you should get the cyst removed. However, unless there is a known risk to you for ovarian cancer, the notion that they should just take 'em out because "you don't need those old things anymore" is horrible. Ovaries produce estrogen, and we need it for many reasons. 

    I had cysts on both ovaries of around that size about 18 years ago and had them removed, but kept my ovaries (I was still of childbearing age and indeed trying to have a child).  A few years later (16 years ago?) they found another large cyst.  This time the doctor wanted to remove my ovaries.  I was all set to have it done, but asked to have another ultrasound right before the scheduled operation, and the cyst had... disappeared!  The doctor wanted to go ahead with the surgery anyway, because I had a history of repeated cysts and was also having abdominal pain, but I refused.  So far I haven't regretted it.  The pain diminished over the years and there's been no new evidence of more cysts.  

    I am surprised that they insist on removing the ovary.  Can't they just do the ovarian cystectomy?

    To start, it is important to consider the type of cyst that you have - is it a functional cyst, dermoid, or endometrioma? It sounds like it may be a type of cyst that will not, or is unlikely to, resolve on its own. Removing both ovaries and tubes sounds drastic for a number of reasons, mainly future health concerns, which you bring up. If the other ovary/and tubes are healthy, what is your doctor's reasoning? Is it possible to get a second medical opinion? It sounds like she says it is "routine" to remove "everything" - which i personally find alarming. :(

    I agree with the responses recently posted: please consider a second opinion. And please try to keep at least one ovary (if not both) and certainly fallopian tubes. Due to fears of cancer, I have had all (really unnecessarily) removed yrs ago, and  have suffered many difficulties ever since, as I have aged. i.e. loss of energy, sexual desire, constant hot flashes way past menopause, extreme temperature sensitivity --to start. Most docs seem to underestimate the potential unfortunate results, of undermining the hormonal balance in the female body. I recommend taking your hesitations VERY seriously! 

    I had to have my ovaries and fallopian tubes removed due to cancer risk. I can't think of any other reason I'd agree to do it. I was younger than it sounds as though you may be when I had them removed (I was in my early 40s), and it has created all kinds of challenges to my physical and emotional wellbeing. They should be able to remove the cyst without removing that ovary, let alone both ovaries and your fallopian tubes.Get some more opinions before you agree to this!


Archived Q&A and Reviews

Surgery for dermoid ovarian cyst

March 2007

I have a dermoid ovarian cyst and my OBGYN has recommended that I have it removed laparoscopically. Since it has been causing pain and pressure (sometimes quite intense), he has suggested that I have it removed soon. However, I am a bit nervous about the surgery and would like some feedback from other people who have gone through the same procedure. Here are some of my concerns... A) After a few bad medical experiences (including knee surgery that made my knee worse), I am a bit gun-shy about surgery. B) I am currently a full-time mom of an intense 9 month old. He's exclusively breast-fed other than solids and still wakes once a night to be fed. My husband can take a few days off to help and my mom will be able to help a few hours a day for about a week. I'm worried about how long it might take for me to recupe. Will I be able to carry him, get him in and out of the car seat, jumper, crib etc? C) After a very long labor, a rough initial few months and 9 months of being a full-time mom with very few breaks, I'm WORN OUT! I'm a little worried about going into surgery feeling this tired and short on reserves. D) I will, however, need to go back to work in the next few months. Any advice or words of wisdom welcome... Anon

I am sorry to hear you have to have Dermoid surgery when you have just recovered from childbirth. I had Dermoid surgery twice. Your doctor, of course, can tell you if it is imperative it be done, based on the size of the cyst. You did mention though you had to go back to work in a few months. Well...

You are having it done laproscopically which is helpful...you will need someone with you the first couple days to help you off the bed for the bathroom etc. Because of where the cut is, it will hurt to use your abdomen muscles for things like rolling off the bed, lifting etc. I would say limited movement for 2-3 days, no lifting for a couple of weeks and you may not feel like yourself for a month or two. I noticed when I jogged 4-5 months afterwards, I could still feel the incision. Surgery recovery is very similar to that of a c-section.

It might make sense to do it now before you baby is walking and before you go back to work. Don't eat a big meal before the surgery as the gas pressure buildup afterwards can be painful. Good luck to you...I feel badly you have to go through all this and with being a new mom also. Janiele

I had an ovarian cyst removed last fall, and I understand your concerns. Laperoscopic surgery is so much better and easier on your system than it used to be. However, it is surgery and does take time to recover. My ob/gyn said that the surgery qualified me for 10 days disability pay. That's a two-week recovery period that they state says you're entitled to. I found I could hardly get out of bed for the first week, and could not stand up straight for the second. It took me a full month before I felt I could get back to normal activity. However, I was driving and doing lots of household chores after the first week. My husband worked at home for a week, which was invaluable. He made school lunches and shuttled the kids. He made dinner. But he also worked while the kids were in school and I slept. With a nursing baby, your logistics would be that much more complicated. How painful is the cyst, and how much do you want it removed? You will feel better afterwards, but you have to go through feeling awful for a few weeks first. anon.
I had laporoscopic surgery to remove a dermoid cyst in 1998 in Chicago, and it was totally uneventful. The downsides were that I had nausia from the anethesia right after surgery, and that I was sore for a few days -- but healed really fast and was walking around in no time. You should definitely plan a few days of down time but you shouldn't have a hard time nursing and can expect to be back on your feet within a couple days. Good luck, and I'm sure it will go as smoothly for you. It's very routine surgery. anon

Recently diagnosed with an ovarian cyst

December 2002

was recently diagnosed with having an Ovarian cyst after having extreme lower, right abdominal pain and nausea and being admitted to the hospital to rule out appendicitis. Can someone give me information on this? I have looked online but there are so many different ideas on this that it is confusing at best. The only thing the hospital told me is that it is common among women and the one I have is ''fairly large''. I thought it strange that they gave me no further information upon discharge regarding the cyst and the only recommendation to see a gynecologist.

Does anyone have further information? I also have fairly lousy health insurance where the choice of doctors is extremely limited unless I go to UCSF in San Francisco. Does anyone have a current recommendation for a gynecologist that has dealt with them on this in Oakland or Berkeley? Thanks in advance! Concerned about cyst

I have had ovarian cysts off and on for about 25 years. The first time I had a large cyst that disappeared by itself. The next time they were rather small, but because there were several of them and I had not had children yet, the doctor decided to try to shrink them by putting me on a low dose of birth control pills - didn't shrink them but they stayed about the same size. Those disappeared during my first pregnancy. I think I've had a couple of more since then but they were small and treatment wasn't needed - I dont think I've got any now. The good news is that many ovarian cysts are not serious problems and disappear on their own AND ovarian cysts rarely become cancerous. The ''bad'' news is that some CAN grow and become quite painful or present fertility problems(and then surgery may be an option). Also, many women who develop ovarian cysts also develop fibroids (I had a hysterectomy for fibroids about 2 years ago, but was able to keep my ovaries which were problem-free) - particularly African American women. But then, I've known women with both cysts and fibroids that have successfully had children and never had surgery - all depends if they start causing pain, bleeding, or fertility problems (by the way I had 2 kids with absolutely NO problems).
I'm in Kaiser so I have no doctor recommendation. I have had ovarian cysts. When I was 30 I had one that was surgically removed--turned out to be some little balloon of liquid. In my late 30s I was getting them as a result of ovulation. I forget exactly what it was but now I take a low estrogen birth control pill to control the painful ovulation/cyst issue. I hope you get responses that give you more technical insight but at least I wanted to let you know that when I was having them, no one was acting like it was that unusual. However in my circumstance it was clearly related to ovulation and so I was never conscerned about malignancy.
I've had two ''dermoid'' ovarian cysts, which I understand to mean they are made up of solid materials (like skin, hair, etc.) instead of fluid. My impression is the fluid-filled kind are more common, so I don't know whether my experience will be relevant, but here goes. Both were removed surgically, the first in 1976 (when I was 12) and the second in 2000 during a c- section. I didn't know the second one existed until the doctors checked out my ovaries during the c-section. Although the 1976 surgery was an ordeal, my understanding is that nowadays they remove this type of ovarian cyst laparoscopically, which would be much easier. As to size, I was told the second one was 7 cm and that that was large. Both were benign, but the first one caused some discomfort. I've only had the one child, but no fertility problems on that one. Both my surgeries were at Kaiser, so I don't have any non-Kaiser doctor recommendations, although the Oakland Kaiser doctors on the second one were terrific. I hope you will be reassured. My experience is these cysts are inconvenient, and a little disconcerting, but no big deal in the great scheme of things. Good luck! Teresa
A couple of years ago, while I was newly pregnant, the ultrasound showed a large ovarian cyst on my left ovary. Since surgery was out of the question because of the pregnancy, and it was not increasing in size, I was told to wait until after birth to do anything, if at all about it. I was told that many women live with cysts such as this one for quite some time, forever even, without complications. I was also told that if it ever caused me any pain that it should be removed. I asked, what kind of pain? because I had been having unusual cramping and lower abdominal discomfort that I now realized must have been the cyst. The doctor said ''oh, you'll know. It will be really bad pain.''

So, I left thinking OK, so if I don't want surgery right away I'm just supposed to wait for this thing to bother me. Little did I know what the ''really bad pain'' was going to be. A year after my birth I was admitted to the emergency room in the most horrific pain of my life. 10 times worse that birth (and I did that without pain medication). I ended up having to have surgery a week later to remove the cyst and my now dead ovary.

It was only after the fact that I questioned why I hadn't been better warned about the potential pain and complications and loss of my ovary due to leaving the cyst in until I was in severe pain. I then much after the surgery ran across a ''list of warning signs of ovarian cysts'' in a women's health book I have stating clearly that if any unusual sharp and persistent lower abdominal pain, nausea, cramping with bowel movements or intercourse is present that a doctor should be consulted immediately. I HAD NOT BEEN TOLD to watch out for these symptoms by my doctor and if I had I would have realized that the consistent pain I went through for almost a year before the removal of the cyst was indication of a serious problem. I had just assumed that the different pains I was going through was gas or my body going back to normal after pregnancy and birth.

I am sorry for the long-winded story but maybe it helps. My point is that I too experienced an information void with my doctors and if you are having all these serious symptoms and have a large cyst, my advice is to get it removed immediately. I do not take surgery lightly, I had never had surgery before the cyst removal so my recommendation is very serious. I do not want anyone to have to go throught the excrutiating pain I did if it can be avoided. to my understanding, Large cysts like yours (and the one I had) are much different that small reoccurring cysts which can be treated in several ways.

Feel free to email if you have unanswered questions. nicole

I have an ovarian cyst on my right ovary that forms and then disappears as the egg is released with each cycle. From what I remember, there are a few kinds of cysts and mine is supposidly relatively harmless. I have just read a book about hormones and women that recommends natural projesterone cream to shrink or eliminate cysts. Apparently, many (most) women are estrogen dominant due to environmental exposure to estrogen-like substances and this throws the estrogen/progesterone balance off, causing cysts, uterine tumors and other problems. Check out the book ''what you doctor won't tell you about premenopause.''

Worried about ovarian cyst

August 2001

After several months of experiencing mild cramping in my lower abdomen, I saw a gynecologist who informed me she'd felt a small cyst on my right ovary. I am very nervous about the possibility that the cyst could be cancerous. Can anyone out there share a similar experience? I am particularly worried because I am 34 years old and have never been diagnosed with a cyst before. I have friends who've had them, but all in their 20's. I don't have a family history and my doctor doesn't SEEM worried, but has sent me for an ultrasound to rule out a problematic cyst or malignancy. She said the cyst might have formed because my period is only recently returned after over a year of breast feeding and it's possible that it would be gone by the time I have the ultrasound. Has anyone had that experience? I have to wait two weeks for the ultrasound which seems like an eternity, and knowing about other good outcomes will be helpful.

I had an ovarian cyst. It was painful, so I had it removed laproscopically. The ultrasound ruled out any bad possibilities (cancerous-looking) and confirmed why it hurt (it was bleeding). While I could have opted to not have surgery, the cyst really hurt so I wanted to end the pain. With the laproscope, removing an ovarian cyst is an outpatient procedure. I went to work the 2nd day after my surgery with no pain. I know you must be worried, but ovarian cysts can occur at any age. AND they are very rarely cancerous. Best wishes for a quick recovery from your cyst. Kellie
I'm not sure what type of cysts you have, but three years ago when I was 31, I was diagnosed with dermoid cysts on both ovaries, with one ovary being the size of an orange. I didn't really notice any symptoms, other than having to go pee alot since the one cyst infected ovary was so large it pressed on my bladder. The cysts were only discovered during a routine physical exam. In any case, everything turned out fine - they took out both cysts, both were benign (which I think is usual for dermoid cysts), and my ovaries are fine. I now have a 1 1/2 year old little boy and am pregnant with my second. Emily
I've had ovarian cysts a few times in my life - once when I was about 21 and again in my 30's. Each time they've disappeared by themselves. The first time I had one large cyst that disappeared within a year.The second round of cyst lasted some time and my ob/gyn would keep tabs on it to see if it was growing - it grew a little then disappeared. The third time they were VERY small and never grew. In my early 40's I had REAL problems with uterine fibroids (alot of women have cysts AND fibroids - so don't be surprised if that shows up on the ultrasound) and ended up opting for a hysterectomy BUT strangely enough my ovaries were FINE and weren't touched. From my doctor as well as from my friends and family (ovarian cysts and fibroids are VERY common in African American women - and that's my experience) I know that ovarian cysts and fibroids are RARELY cancerous (but doctors always check it out) but CAN cause infertility problems - and sometimes quality of life issues: discomfort, pain, and with fibroids - unbelievably heavy cyclical bleeding. Also in some cases the cysts/fibroids can threaten other organs. Doctors may just leave the cyst alone (same for fibroids) and monitor it for growth and/or see if it disapears- if there's a possible fertility issue and you want to have kids,then laser surgery is usually a viable solution - sometimes growing cysts/fibroids are treated with the pill (not of course if you're trying to get pregnant). If the cysts/fibroids are VERY large, growing, and threatening other organs then traditional surgery removal or even removing the entire ovary(ies) might be indicated. BUT I REALLY WOULDN'T WORRY. It is EXTREMELY unlikely that you have ANYTHING to be concerned about. Its very likely that nothing will need to be done but to monitor the cysts.
I had a tiny, follicle sized ovarian cyst upon getting pregnant which was grapefruit sized by birth - pregnancy hormone mega-excitement. It had to come out, both to make sure it wasn't malignant (it wasn't) and because it was so huge, but despite its enormity the fabulous surgeon to whom I was referred, Dr. James Sakamoto, was able to do it laparoscopically. I was out of the hospital and nursing the baby that afternoon! Your cyst is probably as they described, but even if they decide to take it out to be on the safe side, if they aren't alarmed (they can tell a lot by texture and other clues)you should try not to be either. Christine
Your dr. should have explained that there are functional and non-functional cysts. I've had both. (I've also had surgery on both of my ovaries, once to remove a benign tumor, once to remove cysts.) Functional cysts come and go with your cycle, and are not something dr.s recommend treating -- they self-resolve. Non-functional cysts stay on your ovaries through several cycles or longer. The ultrasound should indicate whether the object is fluid-filled (cyst) or more solid, in which case it may be a tumor, possibly benign. That -- fluid or solid -- should be information you can get out of the ultrasound tech with informal questions during the ultrasound -- ask her/him to let you see the screen during the ultrasound, and ask questions about anything they freeze the screen for and measure.

If it's just a cyst, i.e. not a tumor, then you can a) do nothing; b) treat with hormones and then take a wait and see attitude; or c) opt for surgery to remove it. I've actually done all three, but because of other health issues I ditched the hormone treatment pretty quickly. The main problem with option a is if ovulation is really painful. This is sometimes a function of the size and placement of the cyst, as well as your pain threshold. The main problem with option c is, well, it's surgery.

Good luck. Keep asking questions. Sandy

I have had cysts on my ovaries on and off for many years now. I can tell you that while they can really hurt (I have two right now) they are not usually dangerous. If you'd like to e-mail me I would be happy to talk with you in person and reassure you! Molly
I am a family physician and see patients with this type of pain at least 5 times a day. Ovarian cysts can be very painfull, or a lingering pain that can last for months. They are common at any pre-menopausal age and are not dangerous. The ultrasound will reassure you that it is not cancerous. If there are chambers in the cyst or if it is larger that 5 centimeters, your physician may want to biopsy it. If it is solid, it still may be a benign tumor. Unfortunately, ovarian cancers rarely hurt. The treatment for cysts is advil (I like alleve 1 to 2 twice a day) or if you get them often, going on the birth control pill helps. A cyst forms on your ovary every time you ovulate. You need this cyst to make the normal hormones that make you have your periods. Sometimes the cyst just gets too big, but eventually gets absorbed or bursts. I hope you feel better soon.