Should I have ovarian cyst removed if no symptoms / pain?

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I was diagnosed with premature ovarian failure at age 27 and have been on hormone replacement therapy ever since.  I'm 50 now.  This June after a very stressful few months, I ended up in the ER with excruciating pain in my abdomen, fever, dehydrated.  Doctors weren't sure what it was beyond infection.  Admitted to hospital for 3 days, had lots of antibiotics and felt better immediately.  But, now I'm in the medical rabbit hole of CT scans, ultra sounds, blood work, exams, etc.  Now I'm told it appears to be a 9cm ovarian endometrial cyst - but I've never had endometriosis before.  The gynecologic oncologist wants to remove the cyst laparoscopically in November, probably will take the ovary and possibly more depending on what they decide on the table.  She doubts it's cancer, but  they like to be sure.  Here's my question.  I feel 100% fine.   No pain, no issues, no complications since the infection was controlled.  I'm really leery about surgery.  More so after reading about so many with complications and additional pain after surgery.  Should I go ahead with this?  Or should I just let it be?

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  • Posted

    Hi, I decided to get rid of mine, along with ovary and tube, no symptoms, but I was having a prolapse repair and thought while I was under, I would ask for the cyst etc to be removed.

    Different for me, because I was having surgery anyway, but the ovary was done using a laparoscope, and the prolapse was done vaginally.

    No problems at all, the prolapse has been the hardest to get over.

    If I were in your position, I would definitely have it removed.

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  • Posted

    Hi, in my opinion, I would have it monitored, I'm 40 and in ovarian failure, they wanted to do surgery on my 8cm cyst and take ovary, I refused and my gyno checked it via vaginal ultersound for 2 months, on the 3rd month it was gone (it was a complex cyst, that could have been cancerous) so I would see if they will monitor u and see if it shrinks or grows, I also was hospitalized for 3 days with a infection when they found mine

    Hope this helps, good luck to you ((hugs))

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  • Posted

    I am in similar situation. I had a 2.6cm cyst accidently discovered on my right ovary in 2000. No symptoms at all. Over the years the cyst is not 6.9cm and I can feel a slight pressure a tiny pain at times. My doctor has explained that this cyst might be benign but it has no way of going away and since it draws fluid into itself it will slowly get bigger and bigger with more and more symptoms. So as much as I am freaking out I am going to have it out on Monday. I feel that there is no alternative to prevent further serious risks. I at terrified of losing organs, as you mentioned above they can only see what is going on on the table. No easy answers here...... Wishing you an easy and safe journey with yours.
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  • Posted

    Hi,

    I had a 4 cm endometriotic cyst removed ftom my left ovary in May. They did not find any other endometric tissue and the doctor told me that you don't need to have enfometriosis to get an endometriotic cyst. Mine turned our to be benign and according to docs, 99% of endometriotic cysts are benign and that should offer you some comfort.

    In my view, if it's not causing you problem, you may want to wait and watch. I did too for 5 months and it did not go away so had it removed. I have been having lots of infection type symptoms since after the laproscopy with Low grade fever , cough, sore throat but doctors can't find anything in blood works. The only conclusion they can draw is that it's chronic post infection fatigue syndrome - but post an infection which never came up in blood works! I may be sounding cynical and it's just my experience but if you can avoid getting under the scalpel and wait and watch is an option, then please do. I have had 2 c sections in the past with second one very serious but it's this so called 'simple' laproscopic ovarian cystectomy which has been a struggle for me to get over - still struggling with the infection symptoms. And my gynae was one of the most skilled so think it's just a matter of chance that something happened during the laproscopy which is not 'discoverable'.

    Hope it all goes well for you.

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  • Posted

    Until it is removed, it is speculation, what the obviously complex cyst is made of.

    An endometrial cyst in ovary = endometrioma = chocolate cyst will never disappear on its own. 

    Any uterus lining cells (endometrium cells) implanted outside of its place is called endometriosis.

    One does not have to have pain symptoms to have 'endometriosis'.

    One does not have to have adhesions to be called 'endometriosis'.

    Anyway some have loads of adhesions and no symptoms, others have tiny atypical abdominal wall lesions due to endometrium cell implants and huge pain.

    If the endometriosis was located in an ovary only = endometrioma, I would consider it a lucky endometriosis.

    But there is the problem: you don't know what your complex cyst is until histology is performed and confirmed endometrioma.

    Also the 'symptoms' of a cyst are not only frequent urination or discomfort, managable pain, it also can twist the ovary simply due to size/location = cut off the blood supply to the ovary = huge excrutiating pain and possible necrosis.

    Usually any persiting cyst (no matter if simple or complex) above 6cm is an indication for removal for that reason.

    Of course there are cases where the whole abdomen was filled with a cyst and no twist happened. 

    I had my cyst monitored for 2 years, it grew to 9cm and I just wanted it out even further monitoring was offered being a 'good patient' adhering to monitoring.

    I was completely symptom free, but unlike my benign lipomas directly superficially under skin, I cannot see, if and how it was growing.

    At the end after diagnoses from simple cyst to malignous (at hospital) speculation, it was a dermoid cyst, would have never disappeared, but most likely grown.

    The laparoscopic surgery was complication free, quick, the ovary saved, the drain removed next day and home I went. Bit vibration sensitive, but that was it, back to work after 3 days. (comparing to a liver lob removal surgery really nothing)

    A surgery is a surgery, but laparoscopic medium size cyst removals should be pretty standard and complication free if they follow hygiene and care.

    Might want to ask them, if they work ovary saving and how much experience, how many cyst removals are done at your hospital.

    All the best!

     

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  • Posted

    If you don't have it removed, please have it monitored. And those that are taking hormone replacement be careful!!! I will share my story: in 1998 I had an etopic pregnancy that lead to me having my right tube rupture. It was removed and I received about 3pints of blood...minutes from death! Immediately after surgery I felt pain and pressure on my right side. I couldn't move my own leg because of anaesthesia so I had my sister prop it up to relieve some of the pressure. I had a slight fever, doctors and nurses brushed it off. About 5 days later I was sent home. 2days later I was back in excruciating pain on my right side. Ultrasound showed I had an abscess sitting on my blatter. I was given two more blood transfusions and then a needle about 10" or more long was inserted into my abdomen to drain the so called abscess(yes I was awake). Only a few drops of fluid came out so a draining bag was attached to a tubing and sewn to my right side to drain...it never did. Sent home with antibiotics which was started while I was hospitalized 4 days. I was feeling better. 2days later I was sick, I couldn't explain it. My bowels were clear gel...I had colitis from soo much antibiotics and need another one(vancomycin) to make me better...I never really got better I just went on with life the best I could.

    Fast forward around 2002 my abdomen had gotten huge and painful ovarian cysts were coming and going regularly. I was treated with antibiotics and hormone replacements and birth control. They were all just masking the real problem (PCOS) I decided to contact Emory Hospital in Atlanta. They to wanted to do the "watch and wait". I just wanted a hysterectomy😂. They said what I'd heard many many times, I'm too young😥. I was exhausted physically and mentally.

    Fast forward: 2008 I was in school and working two jobs with 3 teen daughters. I started seeing things that wasn't there, hearing loud noises in my ears. Everything was just loud! Lights, whispers, my own heartbeat. So I went to see a psychiatrist for help. After trying different meds I was convinced my life was way too complicated. Even though I had learn to balance and was the happiest and healthiest I've ever been I had to give it up because my therapist convinced me I needed to slow down. I was even committed to a mental institution for a week.

    Fast forward: 2011-2015 I started having debilitating headaches and migraines. I finally had insurance so my doctor ordered test. They told me you're not insane, you have a rare neurological disorder. Intracranial Hypertension, a rare brain disease that mimics large brain tumors and there's no cure😮. And because of the antibiotics and steroids for asthma I was able to have this a long time without detection. At the same time those meds are known to raise the pressure in your brain. And the hormone replacements and birth control also could have been damaging. Thus is all important to this post because the fluid on my brain has flatten my pituitary gland, causing problems with my hormones. That pressure on my side turned out to be a 7cm mass that over time has engulfed my right ovary. On the table is when she discovered saving my right ovary was impossible. But since hormone replacement is not an option for me the left ovary will work overtime.

    Present: (age40+) Sept 16th I had a total hysterectomy leaving nothing but my left ovary to help with hormone issues. If you have to have surgery I can personally recommend the Davinci robotic surgery. I only stayed one night, haven't had any pain meds. Motrin 800 was prescribed, I'm allergic to the good stuff. But I was able to walk a little on the treadmill at a really low speed yesterday. I only have gas pain and sore muscles.

    I pray you don't need any surgery and have few to no painful days?

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