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Have you ever seen a complex cyst go from complex, to simple back to complex?

Hello. I was diagnosed with an 8 cm complex ovary cyst with septations in july. I had a repeat ultrasound in september that showed all solid components had gone and that is was just a fluid filled 6cm cyst. Now I had another ultrasound this month that shows the cyst at 3.5 cm however it is back to complex. Report states that diagnostic considerations would be a hemorragic cyst or endometrioma but an MRI would be recommended to confirm. I have an appointment with my gyn tomorrow and by the sound of the secretary he is going to be talking about surgery.
Was wondering if anybody else has had experience with this altering type of cyst and should i still feel reassures with the shrinkage of the cyst? I am riddled with anxiety and do not want surgery if its not needed. Please any advice would be greatly appreciated.
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I am sorry you are dealing with this. You are right to be concerned about undergoing surgery. For one, there are always risks with any surgery and, secondly, many women lose an ovary or ovaries for ovarian cysts when all that should be removed is the cyst itself. Removal of any part of the "reproductive" system has been shown to cause permanent harm since the uterus, ovaries and tubes have lifelong functions.

Most cysts resolve on their own, no intervention needed. Multiple simple cysts can look like a cyst with septations hence a complex cyst. So it is possible the cyst in July was a cluster of simple cysts. It would seem possible too that this has not been the same cyst(s) but different ones developing as cysts are a normal part of the menstrual cycle. And surprisingly, menopausal women can also develop cysts that do not need intervention.

Typically, they don't do surgery for such a small cyst since most resolve on their own and imaging is not exact so what may appear complex may not be. This site has some good info - http://ovaryresearch.com/ovarian_cysts.htm. This site - http://www.overy.org/ - addresses removal of both ovaries. However, studies have shown removal of even one ovary causes harm such as a significant increased risk for dementia and parkinsonism. It can also cause an earlier menopause which ups your risk for a number of other health problems. And fertility is usually impaired.

What did your gynecologist explain as the reasons for wanting to do surgery for this small cyst? Ovarian cancer is rare with a woman's lifetime risk being only 1.3% (less than 2 per 100 women will get it).

My gynecologist whom I had trusted for 20 years used ovarian cancer scare tactics to get me to consent to what ended up being gross over-treatment. My cyst was 9.5cm at the time of surgery and probably did need surgical removal. But he was deceptive in a number of ways to get my consent for organ removal that was unwarranted. I have been suffering all the negative effects ever since. My surgery was 12 years ago.
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Hi Mindy. Any update?
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Hi! Thank you for your advice. I had my appointment back in Decemeber and my Dr didnt talk surgery at all. Instead he ordered another follow up ultrasound and that will take place this month.
  I wish he would just tell me that since its shrinking i dont have to worry about cancer but he wont.. i have dealt with anxiety from this for almost a year.. it seems obvious that cancer dont shrink on its own right?
Yes, I don't think a cancerous tumor would shrink on its own. So the fact it shrunk should ease your mind a bit. Hopefully, it will continue to shrink... fingers crossed! Please keep us posted.
Hello. So i got results to my newest ultrasound. The cyst the have been following shrunk a little more.. and there is also a new 3cm complex cyst on the same ovary.  I have an appointment with ny Dr on Friday .. but i did talk to him on the phone and he said at this point with how long we have been following it and the fact that its not gone he would recommend surgery. I am petrified of surgery.. my absolute biggest fear.
Are you even sure it is the same cyst. We make cysts every month so it seems it could be a new cyst. Plus 3cm is very small. Surgery is not typically recommended for such a small cyst.
The ultrasound report said the one we have been following is still there. It measured 3.9 cm in septemeber, 3.8 cm in december and is now 3.2 cm.
  The new cyst that wasnt seen on my ultrasound in December 3.5ish cm..
  I have my dr appointment tommorrow..but I did have a small discussion with him over the phone about the results and he said that he would recommend removing the cysts since the one we have been following  hasnt completely resolved in this length of time.
How did your appointment go?
My surgery date is april 5. Im petrified! But my Dr makes me feel completely at ease its just the waiting game. Ive never had surgery and I am petrified of the anesthesia (however u spell it) .. he is going to take out my right ovary and right tube..also my left tube since im done having kids. He said recovery time should be excellent
So im just looking forward to getting it done and over with so the anxiety can stop.
Yikes! Unfortunately, there is much more to fear than the anesthesia. The ovaries have been proven to produce hormones a woman's whole life to keep her healthy if she has all her female parts. Ovary removal is rarely necessary.

Removal of one ovary has been proven to impair the lifelong endocrine functions of the remaining ovary (as well as fertility). Loss of an ovary increases risk for cognitive impairment / dementia and parkinsonism. And it may also have the same increased risks as removal of both ovaries since the remaining ovary will not function normally. Besides dementia and parkinsonism, removal of both ovaries is associated with accelerated aging and increased risk of heart disease, stroke, osteoporosis, hip fracture, memory and cognitive impairment, lung cancer, mood disorders, adverse ocular and skin changes, more severe hot flushes, urogenital atrophy, sexual dysfunction. I can provide links if you'd like or you can find them via a web search.  

Removal of the tubes has also been shown to impair ovarian function predisposing women to many of the same problems.

I wish I had listened to my inner voice that told me something seemed amiss with his treatment recommendation. I also wish I had known half of what I know now and I would not have allowed my gynecologist to remove anything BUT the cyst itself IF the frozen section (done while under anesthesia) showed it was benign (as mine was and most are). I would have made this clear with my revisions on the surgical consent form and made sure my surgeon / gynecologist signed off on any revisions I made.

This is not something to rush into. I hope this helps!
Hello. Update : I went for my surgery.. and he eent in laparoscopically to find that i have severe endometriosis. He drained the cyst told me it wss an endometrioma.. thank god.. and said that with the endometriosis he couldnt get to anything. If he tried to remove the endometriosis he would risk effecting my bowel and since im not in daily pain.. only durint menstruation he recommened not doing anything at this point but would talk about medications at my follow up. Still pretty sore just from the procedure.. but wanted to let you know i still have all my organs in tact.. overall i was pleased to know i dont have cancer and that my body can handle surgery.. i was in full panic attack mode thinking of the anasthesia.. it was so scary and im just glad to say i got through. Thank you so much for your time and advice
. I appreciate it sooo much!
I am sorry for your endo diagnosis but glad you still have all your organs. I know endo can be very painful. It is good you only have pain during your periods. Hopefully, it is manageable. I hope the rest of your recovery goes well. Keep me posted on that and the follow-up with your doctor.
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