Dermoid Ovarian Cyst

Yes, key-hole/laparoscopy is better in terms of recovery (because they cut through less tissue and leave a smaller scar). In order to do it, however, the surgeon needs to inflate your abdomen to allow for free movement of the camera and tools. If you are particularly petite, or the cyst is very big or in a difficult position, this may not work very effectively. There is a risk they will catch an implement like a surgical knife on your bowels or bladder and cause additional problems (sometimes even requiring future surgery to fix!). There is also some added risk with removal of the cyst. Open surgery would just take out a cyst whole and ta-da it is done. Key-hole requires small pieces to be cut off and removed. It takes longer and should still be fine but in cases were cancer is suspected you are much better having the cyst removed whole than having it cut up inside you. There are definitely cases where laparotomy is better suited to a person's case than laparoscopy. 

It is so nice to find this thread - you all have put my mind at rest already. My dermoid cyst is currently at least 10 cm and has only just been discovered this week. I am 44. I have had 2 children and over the last 10 years have had recurring Kidney Stones - or at leasy that is what I was told! I have passed stones and I was told that I was just a stone former and to just get on with it. However on Tuesday this week I had the worst pain I have ever experienced and went to A&E and the most wonderful doctor arranged a CT scan for me and they found no problems with my kidneys but this massive cyst! A bit worrying as they didn't really know what it was but they moved me to Gloucester Royal infirmary and I had an internal Ultra Sound the next day which confirmed the Dermoid.Apparently in normal Ultra Sounds on the outside of your stomach and pelvic area these type of Cysts often get missed as they can resemble bowel and intestines. My consultant then said she would operate as soon as possible and she thought it would be able to get it out via keyhole but I would lose my ovary and maybe my fallopian tube, depending on how damaged it was when they looked at it during surgery. 

I was told I would be in hospital for 2-4 days and recovery should be no more than a week or two and I should take it easy before the surgery (no heavy lifting or extreme exercise, gardening etc).

The pain I experienced was extreme and I will be glad to know I shouldn't get it again. They said that I probably have had Kidney Stones but as a by product of poor urination because of the cyst. I was told it can also press on your bladder, bowels and cause really uncomfortable periods and sex, although I haven't experienced this. I have experienced the bloating and weight gain though that some people have mentioned!

Roll on the surgery date, I will know then for sure that is is benign and I will be better off without it! Thank you again for putting my mind at rest!

Angela

It is almost 4 weeks since my surgery at Gloucester Royal Hospital to remove a massive mucous (liquid) cyst. I had to have a 8+ inch vertical laparotomy to remove "Roger" the cyst, which was over 24cm and 7lbs in total! He had been squishing my kidneys, liver and bladder no end (and this cyst wasn't even solid, it could move to accommodate my movements) so I can definitely imagine you will notice a BIG impact positive impact on your kidneys etc once your cyst has gone!

To give you an idea of the hospital stay, I was in hospital for 5 nights after my surgery, and women with laproscopic (keyhole) surgeries were usually up and discharged after 2 days or so. Of course, it's not a race, stay 'til you're ready!  

All of the surgeons, doctors, nurses, health care assistants and Pain team specialists on the Gynaecological ward (2a) were BRILLIANT I had such good care and you will be in safe hands. 

thanks so much for your reply. I cannot agree more with you about ward A2 I was there for less than 24 hrs but the staff were so brilliant and I felt like part of the family from the moment I arrived. I will not worry about going back there In any way.You must feel like a new woman after your removal! Wow! I feel a bit like a fraud with my tiny 10 cm one! You must have noticed a great improvement in your day to day life. Thank you for your words of comfort I really am looking forward to no back pain and kidney stone symptoms.So glad you are on the mend - would you say you were back to full health at 4 weeks? Hope you are well. Thanks again ax

Sorry to not reply sooner. My cyst was massive (over 24cm+ across by the end, 7lbs) but it was fluid filled, and it was "mobile" (not attached to my other insides at all, except for my ovary). This meant that it could move around and it didn't cause me any pain until the end. Some nights I would wake up with a very sore chest and shortness of breath, but if I sat upright and rubbed downward from my breast bone, I could feel it move back down! Weird! The pains I got were mostly pressure based - when it got so big it was pressing on my kidneys etc. In some ways I count myself very lucky, because I know dermoid cysts, and non-mobile ones, or ones that cause the ovary to twist, can all be VERY painful. I'm saying this so you feel better about your little cyst! Haha, not so little really! I'm so sorry to hear it's causing you pain. At least in some ways it has helped you identify it sooner rather than later. 

In terms of surgery and recovery, I am unfortunately NOT back to normal yet. It is 4 weeks since surgery and I still have quicte a way to go. I have seen a huge improvement in the last week though, and now I can sit at my computer for an hour or two and walk for a mile. Coming off the codeine has been the biggest improvement, because it was having a major impact on my concentration, and now I am managing on paracetamol and ibuprofen I feel myself again in my head, if not completely in my body yet.

My surgery was a vertical 9 inch cut though! To get the cyst out whole. And I am normally very slim, which apparently can make healing a little slower/more painful due to little fat for stitches, just skin and muscle! Anyway, they normally say 6-8weeks recovery for laparotomy, but the surgeon and physiotherapist said I'd very likely be at the end of that, 8+ weeks. If yours is still at 10cm when they do the surgery, they will probably do laproscopic surgery (key hole) or open surgey with a horizontal (caesarean) cut. Both of those will allow you to recover much more quickly. To give you an idea, I stayed in hospital 5 nights after surgery, whereas women on the ward with key-hole left after 0-1 nights and caesarean left after 2-3 nights. 

Honestly though, the biggest thing I've taken from all this is that there is no competition here! You get no brownie points for refusing painkillers when you are in pain (just take them!), or reaching milestones early (take it easy!). 

I think that, although frustrating, the doctors are not worried that the cysts is of any danger to your daughter and that is why there doesn't sem to be any rush. They do seem to be slow to act sometimes, but I think we are probably clueless as to the quantities of people they have to deal with.

I think you are doing the right thing - keep nagging them and ring them until you have that date. Also from what I have read losing one ovary does not harm fertitlity and you can go on to have children if you only have one ovary and fallopian tube attached to the uterus. I was advised to not do anything too strenous before my op (not a real problem for me ) but just maybe encourage your daughter to take things  a bit slower to prevent a torsion or twisting of the cysts/ovary etc as this may affect what happens during the surgery? It is just advice, I hope you get the op date really soon. 

Just to share my experience with you. I am 31 and now 4 weeks post surgery. My mucous cyst was discovered to measure 21cm across at the first ultrasound, then over 24cm at the CT scan. I was refered first to oncology (in case it was cancerous) but when they decided it probably wasn't cancer they told my GP to re-refer me to the benign gynaecologist which had a 16 week wait list. AHH! Well, my GP got very cross and wrote a number of letters saying I should not have to referred to back of queue at that point etc etc. They ultimately gave me a specialist consultation for 3 weeks later (so I maybe was jumping the queue a bit). I was getting bigger almost day by day though and trying so hard to wait patiently. I looked 6 months pregnant and was in a lot of pain. After another week I went back to GP (almost 6 weeks since first going to doctors) to ask for stronger painkillers. I didn't see my own GP, saw a locum instead, and she got me to tell her the whole story from the start. I burst into tears! She said I was presenting at 24 weeks pregnancy and that this had gone far enough. She called the "emergency reg" at the local hospital gynae ward and asked if she could refer me as an emergency surgery patient for the following day. He said yes and I was told to walk into A&E with a printed letter so they could admit me as an emergency patient and find me a hospital bed. I was operate on at 9am the next day, 24 hours after going to my GP. Such a relief! 

I tell you all this so that you know there ARE options and other routes IF your daughter should get in more pain. She should not sit quietly and wait if she thinks things are really bad. That said, if it is not growing, and she isn't in a lot of pain, there is possibly no harm in her waiting a bit. Before mine started growing much bigger, I had been running 5-10 mile jogs without a problem. The cyst they took out was really quite a strong sack that probably would not have burst. 

In terms of fertility, they had to remove my right ovary and tube along with the cyst as too much damage had been done. Despite the cyst having squashed my kidneys, liver and baldder, though, my other ovary and uterus were FINE and healthy. Doc says I shouldn't have problems with fertility going forward. 

Best of luck to you and your daughter. I am sure she will be OK, but hope she can get this sorted out sooner rather than later. 

Pam