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What are the risks of not removing.......



Hello, I've posted here before but this time I have a different question. What if I where to just NOT have surgery? I mean what would be the risks, if any? Yes I am in pain often and yes I think I will eventually have to treat these cysts but I am scared and worrying myself to death about surgery. I am 32 and I worry about the possibility of having a hyster. I also know that since I already have cysts on both ovaries, that it is a real chance i'll have to remove them both. I am not sure if I do remove them both if i'll have to remove anything else at the same time. All my tests have came back good, so no cancer, nothing life threatening that i know of. Im just really scared of the post surgery life. I don't like the thought of the mood swings, hot flashes, etc.. I am moody and hormonal now and i can not imagine that getting worse. I would be impossible to live with. I know I'm rambling, but at the same time i have no one else to ask. You ladies here are a fountain of knowledge and support! Most of your stories you have had years of gyno problems and most have already had a hyster. I have not and this is all so new to me. Thanks for the advice and support!!!
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Avatar universal
As an update, I had my 12-cm dermoid removed on Tuesday and they also found a small mucinous cyst on the other ovary that they removed during the surgery as well. Pathology says everything was benign.

I was scared to DEATH of the surgery. I stayed in the hospital overnight, but I was up and walking at 5:00 pm (surgery was at 10:00 am). I had a bout of nausea at 5:30 pm, probably from drinking too much water at once with dinner. I was up every two hours during the night walking (I was paranoid about blood clots).

The worst, actually, is that I was PMSing and started my period Wednesday night. My "usual" PMS is not being able to sleep the night before I start my period, lots of anxiety, heart racing/pounding, slight fever, etc. I had all of those during my hospital stay, which I was nervous about thinking it was some complication from the surgery, but then I realized it was just PMS.

As for the gas pains, those were the worst the night of surgery. Walking didn't really help (because I moved so slow), but I found that if I did leg pumping exercises in bed, I could move my legs faster and it helped with the gas, and so I was passing gas by Wed morning and feeling much better.

I was probably in the most pain on Wednesday/Thursday night. I was taking 2 percocet every six hours while in the hospital and through Wednesday, then one percocet every six hours on Thursday, and today (Friday) it's been half a percocet so far. I'll likely go to Tylenol only tomorrow.

No bowel movement yet, so I'm a little worried about that. I'm still paranoid about blood clots, so I'm still up and walking for about 20-30 minutes every two hours.

Thanks to everyone for helping me through the pre-surgery paranoia!!!
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Avatar universal
The usual size when doctors start to talk about surgery is 5 cm or greater.  A 12 cm dermoid is VERY large and must be removed.  It will interfere with bowel and bladder function and cause other systematic problems just for being there.  It will NEVER go away on its own.  

At 3 cm, a cyst is small enough to watch and wait, but "complex" cysts carry a higher cancer risk. It is important to find out why it is complex and how worried a doctor may be about it.  It could also be benign and still have a chance of resolving on its own while at this size.

I have never heard of a cyst being drained that did not eventually refill again and grow again because nothing was done to remove the main structure of the cyst.  If a fluid filled cyst gets large enough, full removal is still the better treatment.  Even a fluid cyst might not be entirely fluid. There could be a part of the cyst that is not benign.  Doctors cannot see the entire cyst and what it is composed of without surgery and pathology.  All the diagnostic tests give only a partial explanation for what a cyst really is.

I understand the fear of surgery all too well.  I was the same way.  My surgery story is in my profile for anyone that wants to know what to expect from the hospital visit.  I had open surgery for a cyst that was larger than 10cm.
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Avatar universal
I called earlier in the week and made another appt with gyn. Im going next week to discuss all of this. I am scared to death but at the same time I know I have no choice, I can not continue like this. Just to confirm I'm doing the right thing, ironically I am several days late on my cycle. And this time I have felt it coming on for the past 2 1/2 weeks and still...nothing. Feel awful for weeks and hope AF comes, and nothing. I am making a list of things to ask the Dr next week. I want to make the most informative decision i can based on my case. Thanks for replying, at least I know that I am not alone in my fears and concerns. :)
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Avatar universal
I havent had experience with a complex cyst, just simple fluid ones. However, i had one drained that was 7cm last april, weeks later a cyst was back, and grew up to 5cm..when i had the surgery in Feb, it hadnt grown in size, but it had grown in the "meat" of my ovary, and basically it caused my ovary wall to collapsed. With it being a complex cyst you likely sholdnt leave it. But with the fluid filled you should be able to keep your ovary if it is fine. If you're having concerns about it maybe look at getting a second opinion to ease your mind that this the best?
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Avatar universal
I've been wondering the same thing. I have a 12-cm dermoid in one ovary. It doesn't cause pain, and I just feel a bump in my abdomen when I lie flat on my back with knees off the bed. Otherwise, you can't see/feel it.

I'm TERRIFIED of surgery, namely that I'm going to cause problems when I don't currently have any. There are just so many things that can go wrong during and after surgery that I'm freaked out about.

Part of me would rather wait for the pain of a torsion IF it happens, and then have the surgery. However, the 1-2 percent chance of cancer scares me too even though these dermoids are almost always benign.
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Avatar universal
Thank you so much for your reply. That is alot to think about. Most of my cysts are smaller in size, one of them on the left side is around 3 cm, it is a complex cyst. I was told all the others are fluid filled. I called yesterday and made an appt to further discuss surgery. If anyone has any questions I should ask the doc please feel free to post them. I am so worried I will forget to ask something important. Part of me feels that I should just go ahead and have everything removed and go on HRT. The other part of me is just too scared to see the reality of how serious this all is.

THANKS
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Avatar universal
How big are these cysts? If it is PCOS it might be a bunch of little cysts treatable with hormones (I think...I know little to nothing about PCOS). However, if these are larger cysts with some weight to them, a big risk is that they can twist around the tubes, cut off blood supply, kill the tube and/or ovary, and cell death can lead to gangrene and that is life threatening. Emergency surgery would likely happen first. If this twisting/torsion occurred, the pain would be unreal and nothing would bring relief from the pain. Another risk is ovarian cancer, and a doctor has to be absolutely positive that cysts are benign to forego surgery.  Trying to remove the cysts and preserve all or part of the ovary to retain hormone production would be the nicest option if it can be done. However there is always a chance cysts could redevelop. Emergency surgery is the last thing you would want . You would probably end up with a general surgeon who will make much larger cuts and sloppier removal than a highly skilled gynecology surgery specialist would do with a planned procedure.
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