Ovarian Endometrioma: Laparotomy and cystectomy vs USO!!! PLEASE help me!

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Hello I am 21 years old and I am having surgery to remove a 9 cm mass located in my left ovary next week. Testings have found that there is no evidence of free fluid or lymphadenopathy. Impression: 9.0 cm left ovarian cystic mass, as described above. Imaging characteristics are most compatible with endometrioma, however given short interval increase in size,( 5cm to 9 cm within a 2 months span) recommend consultation with gynecology oncology service, as cystic (mucinous) ovarian neoplasm is not entirely excluded. 

My Doctor has given me the option to have a vertical incision down my belly button or a bikini cut which will be a long incision. I guess I would rather have a small incision ( vertical) but it will be visible and my mother has had an incision of both types and I am worried about how it will affect me emotionally. I know I should be confident with whatever but I am concerned that this scar will affect the way my stomach will look since my mom says she can't really do abdominal exercises anymore and the way her abdominal skin seperates into 4 parts due to her incision. I don't know if that makes any sense but I just want to know the pros and cons to each type. 


1) Pros and Cons to each incision type (Laparotomy and cystectomy vs USO). 

2) IF you have pictures of the scar or incisions, I would like to see if that is okay.

3) Any remedies for the scars.


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  • Posted

    Hi chanelrly -- it's been a few years since I had a lap(aroscopy) to remove my RT ovary (repeated cysts) and several endo implants. I have the four small scars, about an inch long each. When I was about your age, I had my gall bladder removed and that surgery also left me with 4 tiny scars around the abdominal area. So now I have several scars from two surgeries. Has it challenged my self esteem? Nope. Then again, I wasn't wearing bikinis anyway, even when I was in great shape. Would I think about my  scars now if I would dare wear a bikini? No....I'd be much more concerened with how big my butt looks :O -- just kidding. I honestly don't give my ab scars much thought, if any. I never stressed about it before or after either lap surgery. I do remember when I had the lap for the Endo ablation and oophorectomy that my Surgeon told me she'd go for the smaller, lap incisions first but I may wake up with a bikini line cut -- I remember thinking I'd prefer to go the conservative route first...the lap. No surprises when I woke up except to note that my RT ovary was thankfully no longer inside my body being angry and huge. 

    Sounds like a Laparotomy is a longer incision than my Laparoscopy scars. What did your surgeon recommend for best access for him? This would be my concern - I'd want the surgeon and team to have the best scenario for a successful surgery, even if it meant I'd have a larger scar. Just because surgery isn't something you want to have to do any more often that absolutely possible. 

    I've read that Vitamin E oil is helpful in reducing scaring. But I don't know how reliable that information is..my advice would be to consult with your surgeon or a dermatologist about methods to reduce scarring. Every body heals differently --  I never did anything special or my incisions except to keep them clean and healthy after surgery and they faded pretty well.

    Try not to give much thought to the oncology consult before they have more definitive diagnostics on your specific growth. Doctors want to cover their bases, just to make sure you're getting the best care and they're not being negligent in their duties as your provider. Consult with Oncology is likely protocol given your circumstances, if only to rule OUT anything malignant. 

    Are you in America or other country? Are you happy with your Surgeon and feel comfortable with his (her?) experience level and care he's provided you so far? Is this surgeon an OB/GYN specialist or a general surgeon? Remmber that this is YOUR body -- if you're not comfortable or don't feel you're being taken seriously, a second opinion woudln't hurt. 

    When is your surgery scheduled for?

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    • Posted

      Hi, Thank you so much for your immediate reply!

       My doctor has said the same thing about waking up with more incisions than discussed depending on what they find inside. They think it endometrioma due to the CA125 markers and MRI/CAT scan results but can't rule it out until they get the mass out and send it for pathology. I guess I shouldn't be worried about the scars but I live in Hawaii rn and its BIKINI island literally, and I just became comfortable with my body to wear a bikini and I guess its just hard for me to accept another scar. I will discuss with my Doctor again on my pre OP on 06/08 to weight out the pros and cons and see what his best route would be. My surgery is scheduled for 06/09 which is in a couple of days. 

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  • Posted

    Hi sweetie. 

    I had a laparotomy 4 weeks ago now to remove a 12cm dermoid cyst from my left ovary. I have the bikini line cut, and it's already looking great! You cannot see it unless you're wearing a bikini or a crop top with low waisted shorts as it sits just above the pubic region. The scar is about 4 inches across and after 4 weeks is pink and slightly raised. 

    I've always been extremely self conscious and I was also worried about how it would effect me. I suffer from bipolar disorder (mainly on the depression side) and the weeks after the surgery have been tough, but it's totally worth it. I'm no longer in constant pain and for me that's more important than having a scar. 

    I've been told I should wait 2 months before I try do any abdominal exercises, but with the bikini line incision it should be completely safe to do so. Your body will tell you if there's anything wrong. 

    I will try to attach the picture below. 

    As for scar remedies there are a few things I'm going to be using. 

    1. Bio-oil - i've used this several times before on some scars on my arms and legs and they have faded brilliantly. It's not going to be a one shot job either, you have to keep applying it every day for months before you'll notice the difference. 

    2. Lavender oil - I use this for almost everything, it can help take away that swelling underneath the scar (as at the moment mine is raised by about half a cm) and this I use every other day. 

    3. Tattoos - I plan to have my incision covered by something beautiful, when I have the money! 

    When is your surgery? 

    I hope all goes well for you hun. 

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    • Posted

      Hi, Thank you for sharing your scar remedies and your picture! I will definately purchase those today so I can start prepping for my surgery! my surgery is set for 06/09!! in a couple of days! I hope all is well with your recovery!
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    • Posted

      No worries love! 

      Just to let you know the scar is even more faded now! 5 weeks and 3 days and it's literally just a pink line smile 

      Good luck for your surgery hun! I hope all goes well. 

      I'm finally starting to feel so much better now, managed to go for food, to the cinema and over my mate's for a few drinks today! 


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  • Posted

    Hi, I am also having surgery on the 9th June, possible ovary/cyst removal or hysterectomy depending on what they find. I've been told it will start as a laparoscopy but again depending on what they find I could end up with a bikini line cut. I wouldn't worry too much about a bikini line cut though, I had an emergency cesarean section almost 6 years ago and it healed just fine (I used bio oil).

    Best of luck for Thursday 😊 xx

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    • Posted

      Meant to say it's an 8cm endometrioma that I have on my left ovary but my pelvic cavity is a sticky mess apparently hence the possible hysterectomy 😕 never even knew I had endo until my recent mri scan!
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    • Posted

      Good luck sweetie! They told me it would start as keyhole too, I have one incision in my bellybutton which seems to be healing fine smile Hope all goes super well for you x 
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