Help with ultrasound results??/

Hi Lisa,

You've come to the right place! First, breathe. I know it's a lot to take in.

I went in for a general exam, only to be told I had a 26cm mass in my abdomen - which later was indentified to be a extremely large cyst they thought was on my right ovary. I'm only 24, with no history of this before.

Like you, I felt bloated, and looked about 6 months pregnant. I would have trouble controlling my bladder a bit, like peeing when I sneezed, some fatique, but nothing I could have chalked up to a cyst. I thought I had just gained weight. With you saying you look 9 months pregnant, did they tell you the size of the cyst? I would imagine it is probably similiar in size to mine.

6 months seems like an outrageos amount of time to wait, but I know that can be the case sometimes. I'm from Canada, and live in the US - so I paid more to have it done here, but I couldn't have waited to get it done in Canada, even thougn it would have been free. I'm not sure where you're located, but if I were you, I would shop around for other Gyno Oncologist Surgeons, read up, do your own research. When I got my CT results back, I asked to be referred to a well-respected hospital, and due to the size of mine, my GP marked it as urgent. I got my consult with one of their best Gyno Oncoligst Surgeons in the state within 2 days, and then my surgery was scheduled 12 days later. I am now 12 days post-surgery, recovering well, and all I have is a 3inch incision on my bikini line - they saved all my reproductive organs because it was not cancerous. They drained 6 litres of fluid and I lost 13 pounds.

Your surgeon and their plan is probably one of the most important things, but also being active and not passive about your case. 

Best of luck!

Lisa,

You have been through it haven't you? :-(

I had huge cysts on both ovaries. So large my bladder could not be found on ultrasound. Hence peeing every 20 min to an hour. Severe constipation and looked pregnant. All came on gradually but felt cut in the waist with regular clothes.

Mine was all caused by endometriosis. Try to relax and continue to seek new Drs. So sick that the health system moves so slowly. Do men have to wait so long to be treated?

Lisa,

Sorry, hit the send button by accident.

You've had surgery before so you know the drill. This though has progressed over time and you may have forgotten what you felt like before this.

You will feel SO much better once they are gone. They sap your strength and put pressure on other organs causing secondary symptoms.

Abdominal surgery is more invasive and will set you back for a bit. But depending on type of surgery and how much needs to be removed you will feel so much better in a week or two.

You do need to plan for approx. least 2 weeks of full downtime. Then significant improvement from then on. This will flex some depending on laparotomy or laproscopic surgery and how you heal.

I was 49 when I had surgery. I chose not to stress too much because I knew surgery was a must. I wanted them OUT!

The pain wasn't bad as long as I moved slowly. First week shuffling around the house. 2nd week started walking outside. After the first week walking was easier. The most difficult was the fatigue. Being a stomach sleeper, sleep was difficult until the incision healed.

I was directly across from the nurses station so ear plugs would have been good for night time. The nurses were great though. I asked for little so they responded well when I did.

Once home I was alone at my daughter's house during the day for 2 weeks. At 3 weeks started driving and moved back home. Returned to work at 6 weeks. Worked from home by phone and on line for those 6 weeks. Stressful and tiring.

At 6 months I felt stronger but still fatigued. By 12 months I reached my new normal. Incision healed but sensitive if bumped. I had total hysterectomy so some of the symptoms had decreased but they don't tell you how draining surgical (cold turkey) menopause is. Hence, my recommendation to preserve your lady parts. Still get occassional twinges but that's all.

I started taking Vitamin B complex 100 about 3 weeks in. Noticeable difference in about 2 weeks. Good for healing and red blood cell maintenance.

Overall, I do not look back. I feel so much better even with the symptoms of menopause. Some gone, some better, some not. I lost 10+ lbs from surgery. Struggled with weight gain a few years later. In the last couple of years weight has been coming off with minor diet adjustments. Actually easier than when I was younger. Likely because I am more free to walk and be active. Less idle time, life is more precious.

So find new Drs. you can trust and are commited to restoring your health. Make you a priority. Be kind to you and do not be shy to push for what you deserve/need to be healthy again.

I think your report says 'involuting' follicle (?),  

involuting means 'shrinking, disappearing'.

Our ovaries always produce cysts, have to in order to develope and release eggs. 

After the fluid filled follicle cyst burst (ovulation), they become a luteal body (yellow looking thingy) that produces progesterone. Sometimes after ovulation, it bleeds into this follicle and can get 2-3cm big again due to blood in it (hemorrhagic luteal cyst).

Blabla I am sure you know that all anyway.

Now, when they write 'complex' cyst, it is not a homogenous purely liquid filled cyst (as they are mostly in follicle phase) black blob, complex means to see some white structure, which is often fibrin, a blood clot. 

If you look under corpus luteum cyst wikipedia, you see a pic, fully functional benign, but complex looking cyst, a blob with a structure inside.

Helpful is also, if you know (in hindsight once menstruation sets in and calculate backwards) if you were in follicle, ca ovulation or luteal phase at the time of ultrasound.

The most important thing is missing: the size of your cyst

3cm is often a good cut-off size for follicle and luteal cysts.

If something worrying is seen even under 3cm, it is noted (if neoplasm or endometrioma suggestion). Ultrasound is always a guessing game, when it comes to complex cysts, comes down to appearance and experience and follow-ups.

But sonographers have experience and seen 1000s.

as to endometrium lining in uterus.

Again this thickness depends on cycle timing.  Often knowing when last menstruation was, is not as helpful (since follicle phase can be highly variable time, but luteal phase is not, even in PCO not too variable), then counting backwards once menstruation sets in after ultrasound.

If your at ultrasound mentioned last cycle fits into a 28 day calculation (once you get your mens), there is no need to let them know. If it was grossly over 30days, please let them know in case it changes the phase you were in at ultrasound timing.

The endometrium is usually 6-8mm thick around ovulation (so about 14 days before your menstruation sets in, hence I urge to look backwards for correct interpretation of ultrasound results), it will be 10-16mm thick by the time of menstruation (in the luteal phase) and be 1-3mm once bled off and cycle starting again (follicle phase).

So your thickness of endometrium layer is of no concern, not knowing your cycle at that point anyway.

Heterogenous in contrary to homogenous is 'patchy', not one colour, not one shade of grey look, speckled small or big (can be different looks, we don't know, we don't have a pic here). It could be little bleeings within endometrium for benign (very early conception degeneration, inflammation) to not so benign reasons. 

It needs to be checked again.

Chocolate milk....oh, they love that expression for 'blood', but I would say: not well stirred chocolate milk to express the heterogenity.

e.g. When you have an endometrioma in an ovary, they often call it 'chocolate cyst' since it is brown old blood upon cutting through it, bleeding again and again into same cyst. It must not be confused with a blood filled (hemorrhagic) functional luteal cyst.

Seems they also use this 'chocolate' expression for uterus endometrium lining, when it is heterogenous and most likely due to some little bleedings within.

Honeslty your doc should explain to you very well every point of the report that you don't understand and give an interpretation. He has you there, he can look at pics (digital I presume, they can always be ordered as a copy on CD or print for him/her if not online connected and for you too).

It seems nothing to worry about at this point from your ultrasound report re ovaries and uterus.

But yes, you will need a check up ultrasound to see: what the cyst is doing, if it resolved, and what the endometrium lining is doing, if it bled off, if it was back to homogenous.

6 months though sounds an awfully long time for ultrasound check, if your obgyn does it right then at the spot or referrs again for ultrasound? (some do it themselves, some referr again - wait, wait)

Any chance you can have an earlier ultrasound check up on its own before seeing the obgyn? 

Were your kidneys also checked in ultrasound?

Usually sate of the art once doing abdominal ultrasound anyway having pain.

ALL THE BEST!