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Ovarian Cystectomy Freak-Out
April 15, 2012 8:07 PM   Subscribe

I'm set to have an ovarian cystectomy (and possible oophorectomy) at the end of the week. I'm pretty scared about the surgery, the recovery and my future fertility.

My OB/GYN felt a mass during my routine, yearly exam back in February. After an ultrasound, MRI, and CA-125 blood test (NOT elevated), I was diagnosed with a large (11 cm) dermoid cyst on one ovary. If you don't know what a dermoid cyst is and want to be grossed out, go ahead and google that. It's the kind with hair and teeth. I'm dealing with some Cronenberg-esque body horror whenever I think too much about it. I didn't have any pain or symptoms before my doctor told me the cyst was there. Now I have a pinchy pain in my lower abdomen, almost like a stitch, when I exert myself, but that could be psychological, I suppose.

I like the surgeon well enough, she's performed more than 200 of these surgeries a year. My OB/GYN referred me to this surgeon, saying that is she had to have this surgery herself, she would want this surgeon to do it. I am in general good health, 33 years old, no diabetes, asthma, anything like that. I've never had surgery before, much less abdominal surgery. It can be performed laparoscopically, she said there was no chance that she would have to do a laparotomy, so that's good. I'm hoping to only miss two weeks of work, if possible. The doctor was nonspecific about how long I'd be out of work, anywhere from 2-4 weeks. I do work a desk job, no lifting, no stairs if I don't want to, no real physical exertion.

Since the cyst is so OMG ENORMOUS (Seriously, how was this thing hiding in there for so long?! HOW?!), the entire ovary might have to go as well. The surgeon has assured me that she'll try to save the ovary if she can, but made no promises.

I am FREAKING OUT at the notion of losing an ovary. I want to have kids, soonish (probably in the next year or two), I'm not married yet, but I have an awesome boyfriend and we plan to in the near future. So, I'm SUPER-WORRIED about being able to have kids (what if that ovary was the GOOD one?!), and also worried about the effect that losing an ovary would have on my body. Will my body freak out? Will that have a terrible effect on my hormones? WILL I HAVE PHANTOM OVARY PAIN? Is that a ridiculous question? Will this risk me out of future low intervention births? Is THAT a ridiculous concern? I have no idea. Both my OB/GYN and surgeon both assured me that this is why I have two ovaries and neither seem concerned about my future fertility.

I read and very much appreciated this previous question, but I didn't see where fertility and potential shock on the body were discussed. (In fact, when I googled "dermoid" immediately after my doctor told me about it, that was one of the first things that popped up and quelled my panic. Thank you all SO much for that.)

In short (too late), I'm concerned about:

-Future fertility: (Will this make it harder to have kids? Will I need fertility treatments? Should I get knocked up as soon as possible before the other ovary gets any ideas about possible expansions?)

-Recovery: (How soon did you go back to work if you had a similar surgery? What was your pain level like? Any tips?)

Surgery: how much will this suck?

Thank you in advance for even reading this novel. I tried to provide all the pertinent info. I know none of you are my doctors, fertility specialists or therapists, but I would really appreciate your wisdom or past experience, if you want to share.
posted by Aquifer to Health & Fitness (20 answers total) 2 users marked this as a favorite
 
I had a dermoid cyst removed 6 years ago when I was 31. It was 9cm, so comparable to yours. Like you there was no pain or anything and my OB/GYN caught it in a routine exam.

- if you have an ovary removed you might find it more difficult to have kids. My surgeon didn't have to remove anything beyond the tumor and its margins. I conceived with no problems and had an uneventful pregnancy and my daughter was born just after my 33rd birthday.

- Recovery: I had my surgery on a Thursday and was back at work on the Monday (working in a biomed research lab. I had a couple of days where I wasn't on my feet at work much, though, although I did have an hour commute by train each way to work.)

- Surgery itself - was fine. As long as you have someone to look after you the next few days. Friday, Sat, Sunday I did not move except from bed to couch to bathroom. My husband did every single little other thing for me. Everything. I am sure that if I didn't have him there to give me three solid days of immobility my recovery would have been much longer. I only took one percoset and maybe a couple tylenol subsequent to the surgery.

One anecdote, and according to my ob/gyn I have a high pain threshold so ymm, of course, v.
posted by gaspode at 8:13 PM on April 15, 2012


If you are scientifically minded you may want to read this paper entitled "The Fertility Potential of Women with a Single Ovary": it presents an analysis of prior studies on the topic and concludes that:

"Women with a single ovary - either right or left - do not in general have a reduced fertility potential to conceive either naturally or by IVF treatment."

So, that seems pretty reassuring to me. Keep in mind that infertility affects 1 in 8 couples anyway, and a lot of times there is never a reason found for the infertility. So you could struggle with fertility later and it might have nothing to do with only having one ovary (if that does happen - I hope you get to keep it!).

Here's a Q&A column about whether there will be any side effects on health from only having one ovary.
posted by treehorn+bunny at 8:19 PM on April 15, 2012 [2 favorites]


I had an ovary removed seven years ago after an ectopic pregnancy that went undetected too long. I had all of the same concerns that you do.

When I decided to get pregnant with my first child, it took six weeks to conceive. My second child took less than that and was when I was on the pill. YMMV-but the lack of one ovary and fallopian tube had zero impact on my ability to conceive. Mine was performed via laparoscopic surgery and I went back to work three days later. I was sore (in the shoulder of all places) for maybe two weeks. Pain was treated for the first couple days with vicodin, then tylenol. Wasn't too bad, just very very sore. I don't recall feeling any weird pains inside, but then considering the god awful pain of the ectopic pregnancy----not a surprise that the surgical pain doesn't ring any bells for me.

The surgery was really not a big deal. I went through some emotional ups and downs at the idea of being mid 20's and potentially compromised fertility wise but in the end, since there was nothing I could do about it, I elected to just wait and hope. Good luck, try not to worry too much.
posted by supercapitalist at 8:19 PM on April 15, 2012


My sister had an ovarian cyst that was larger than that removed when she was in high school or maybe junior high. This would have been a few decades ago so I'm sure the world has changed significantly but even then the surgery [and they did exploratory surgery because hers had been growing and then twisted suddenly which was painful and they didn't know what it was] was not terrible. She was out of the hospital in a day or two and back in school the next week. She had a scar on her abdomen down from her belly button, but no other post-surgical issues. Do not know about her fertility one way or the other but I don't think she wound up with any odd hormone issues, no phantom ovary pain.
posted by jessamyn at 8:27 PM on April 15, 2012


Hi, I had a unilateral oophrectomy when I was 26. Here's what I went through and what I was told by my own doctor.

* Fertility: technically, you will indeed be less fertile than you were, but not "omigod i need fertility treatments" necessarily. What my doctor told me is: when you have two ovaries, they generally "take turns" ovulating; first month the left one goes, then the next month it's the right one that ovulates, and then the left one the month after that, etc. So if you take one ovary away, the other one will still keep to its every-other-month schedule; the practical upshot of which means, for at least a couple years, every other month you'll be "firing blanks". You'll still have a period every month, but you will only be fertile every other month.

But assuming that the other ovary is working fine, then...the other ovary is working fine. So what my doctor told me was that all you'll need to do is pay more attention to when you're ovulating -- and you can do that with some over-the-counter kits now. 15 years ago (when I had my surgery) my doctor said that I could track it with the basal body temperature and such (basically, what people who do natural family planning do, only I'd be looking for when I was ovulating to know when to HAVE sex rather than when to AVOID it). So while technically you will not be as fertile as you were, you will still have the one functioning ovary, so all you'd have to worry about is which months you're "firing".

* Surgery: I had things via emergency surgery, so I may have been more of a rushed case; I showed up in an ER in extreme abdominal pain, they found out it was a case where a cyst caused ovarian torsion, and they had to get it out in a big hurry. I had a 5-inch incision across my abdomen, just under the pubic hairline. I was in the hospital for a day and a half after. The pain wasn't bad so far as I can remember, but I had had the prior pain of the torsion itself as a benchmark (and after that, anything was easier by comparison). They discharged me after a day and a half and suggested I take it easy; I had a new boyfriend who insisted I go home with him so he could play nurse for a week, and a couple days into it I was more bored while he was at work than I was in pain.

* Recovery: for the first week, my incision hurt if I coughed or laughed (and -- and don't ask me to elaborate how I know this -- having an orgasm two days after surgery made me feel like I was going to pop my stitches). I didn't take any strong pain killers for that first week; I think a couple weeks later I went to get the stitches out and things looked good. I walked sort of hunched over for a while, not because it hurt but because the skin at the incision site felt like it wasn't stretching.

Oh, another weird "I wish they'd told me that" thing - for a week, I couldn't bend down while I was seated and tie my shoes. Not that it hurt, it was...my body simply wasn't responding. Those muscles just plain didn't move. I was a little freaked out and called my doctor and she told me "oh, yeah, that happens, it goes away in a week" and it did.

* The cyst itself -- the cyst I had was the same size as yours, and it was also a dermoid cyst. I didn't even know it was there until it caused my ovary to twist -- it did three 360's inside my abdomen, tied off its own blood supply and started dying. At the very least, you want to get the cyst out so THAT doesn't happen (because lemme tell you, that hurts like an absolute mutherfukker). You may be bouncing back a little sooner because you're going to have a planned-in-advance thing as opposed to my "holy crap someone scrub up and take care of this chick now" emergency job.

Good luck.
posted by EmpressCallipygos at 8:31 PM on April 15, 2012


I had a cyst removed when I was 23. They thought they would be able to do it laparoscopically but ended up having to actually cut me open because the cyst was too big. My dr did the melting stitches on the inside and glue on the outside so I didn't have to get any stitches removed. I also didn't need a bandage after the first few hours, which seemed very strange at the time. I have a horizontal scar, which really only bothers me and is usually covered when I'm wearing underwear or bathing suits.

After the surgery, I was in the hospital for about 3 days and out of work for a month. My mom flew up to help me out for the first week. Which, ended up being very helpful because I couldn't stand up straight at first. Like some of the other posters, sneezing and coughing were very painful. The nurses at the hospital told me to put pressure on the incision if I felt like sneezing or coughing, and it really did help. They gave me some prescription pain meds but they made me feel like crap so I ended up switching to Ibuprofen after a few days.
posted by Nolechick11 at 9:02 PM on April 15, 2012


Laparoscopy for ovarian cysts here, just about 20 years ago...

Maybe I am just a sensitive flower, but for the 2 surgeries I've ever had (2nd was a c-section) It was a little emotional. So maybe plan for that?

Knowing I'd be emotionally sensitive after my c-section, I hunted around for a great acupuncturist, and found her. I find acupuncture very relaxing and fortifying, but if massage or even meditation are your thing - do that. Hell, even get someone to take you to the beach or to a forest. Something nourishing and peaceful.

PS, I did not have any trouble conceiving, despite my then-doctor's predictions at the time. YMMV.

PPS, I keep talking about taking vitamins on Askme. It was actually this acupuncturist I speak of who was like, "Girl! Your body has been through a lot. Take supplements for healing!" Yep. She was right!

Take a good multivitamin before and after your surgery.

Be well!
posted by jbenben at 9:02 PM on April 15, 2012


Oh yay, what fun. I sympathize.

I had a serous cystadenoma removed, along with the ovary it was attached to, when I was 32. Mine was a massive thing (seriously, bigger than a baby according to the students who watched the surgery); I went in to the surgery weighing 167 pounds and came out at 125. My scar is huge, running from the top of my pubic bone to two inches above my belly button; they really didn't have much choice but to take the ovary, alas. Pain wasn't too bad: I was on a morphine pump and sedulously pumped away before I sat up or moved, as I had been told. Did get infected and wound up on massive antibiotics which made me nauseated (puking with staples in your stomach is no fun) and kept me in hospital longer than I expected.

My fertility probably wasn't impacted: my libido was, which is something you should be aware of and talk to your doctor about. And it's major abdominal surgery -- be sure you have someone at home to fetch and carry for you, and be prepared not to lift anything or do anything strenuous with your stomach muscles for a month or so.
posted by jrochest at 9:12 PM on April 15, 2012


I will adress those points:
Recovery: (How soon did you go back to work if you had a similar surgery? What was your pain level like? Any tips?)

Surgery: how much will this suck?


Are you going to have an outpatient surgery? Even if, better bring an overnight bag for the hospital. Because you never know for sure if then will have you stay overnight.

Wear soft, low rise yoga pants or something of that sort. The incisions are really small but it helps if there is as less pressure as possible on your belly. Also comfy slip on type shoes are a plus. Bending down might hurt.

Have a blanket/pillow/plushy in the car for the drive home to put between your belly and the seatbelt.

Make sure someone is there to take care of you (pick you up from the hospital and help you at home).

You might find it helpful to prepare a recovery kit - get your favorite chocolate, snacks, crackers, a good book and/or magazine, ipod with podcasts and music, dvd’s, a hot water bottle, tissues, drinks and some fruit. Put it all together in one place so you can reach for it easily.

Anesthesia is different on everyone, you might feel fine soon after but also be prepared for possible side effects like headaches, nausea, pain in the pelvic region, stomach problems. Following such a procedure there is a good chance that you will experience gas pain in your shoulder area. They pump gas (carbon dioxide) into the abdomen and it might take up to two days to resolve.
Ginger /ginger ale helps with nausea, and there are meds that help with gas/constipation. If possible pick up the prescription pain killers beforehand too.

The hospital will most likely provide you with pads, but having some handy might be a good idea.

Have a few pillows nearby so you can arrange them in bed to sleep comfortably. You might have to sleep on your back for a while.

Follow doctors' orders. And listen to your body. If you feel like resting, don't force walking around or going to work. (Its' always good to keep moving for your circulation and digestion; if you feel groggy rest is best.)

Get well soon!
posted by travelwithcats at 9:26 PM on April 15, 2012


I sympathize with you.

I had a huge dermoid cyst removed in the 1980's. Dermoids are weird. The scarring is similar to a c-section. Not bad recovery for me. Rest and take it easy.
I was told I'd most likely have trouble with conception. I had no trouble at all, had two easy pregnancies.

Wishing you a speedy recovery.
posted by jennstra at 9:45 PM on April 15, 2012


You are going to be okay. I know surgery is scary. I had a 16cm cyst on my ovary removed when I was 20. (I have PCOS.) I kept the ovary but lost the fallopian tube because it was mangled by the cyst, so essentially I don't have the use of that ovary in terms of eggs. The doctor said I might have trouble conceiving but then again, women with PCOS often do, so it might not be anything to do with that.

Regarding hormones, I don't think your body is going to freak out. But ask your doctor. I had to be put on the pill so no cysts would grow back and we had to change a few times, because some of them gave me migraines. Finally we landed on one that I've been on for 8 years.

You're not going to have phantom ovary pain. You probably won't notice anything is different at all in that regard. Heck, I don't even remember which one of my fallopian tubes is missing.

I had both a laparoscopy and a 7-inch laparotomy because she was hoping she could get the cyst out through the laparoscopy, but couldn't. I barely felt the laparoscopy incision at all because the pain from the larger incision drowned it out. This was my first surgery and I was scared to death that I was going to feel like I was being cut by a knife afterwards, but when I asked my doc about the pain, she said it would feel like I got punched in the stomach, and the pain did feel much more like that than a stabbing or cutting pain. You kind of get a numb sensation too due to nerves in the skin being cut.

Personally I had to sleep in a Lazy Boy for 9 weeks because laying down pulled on my incision too much, but I stress that I had a big incision. With a laparoscopy it's likely to be much easier.

For my surgery, they let me bring my Discman (this was a year before the first iPod launched) with a CD of comforting music. I was allowed to wear it even into the OR and they gave it back to me as soon as I was awake in recovery.

Also, if you're really scared, ask if they can put you into a twilight sleep as soon as they get your IV in. They did this for me as well. It gives you temporary amnesia. I do have two tiny, blurry, seconds-long memories of the OR (being transferred onto the table from the gurney and having the mask put over my face) but I don't remember anything else.
posted by IndigoRain at 1:23 AM on April 16, 2012


ooh, I missed the question about hormones; I may have some anecdotal experience, as well. In the years following the surgery, I started noticing that some months my usual PMS symptoms (which were never really major anyway) would just not ever show up. Other months they'd be about what they always were. I chalked it up to "oh, okay, maybe the months they're non-existant are the months I just didn't ovulate." But the difference was so slight that it took me a couple years to notice.
posted by EmpressCallipygos at 5:11 AM on April 16, 2012


Bilateral oophorectomy here, done through laparoscopy on an outpatient basis.

The pain after surgery was less than a typical period, though I did have painful periods. I took one dose of whatever pain medication they had supplied me and was otherwise OK.

It was about 4 days before I stood up straight without having to be careful about it.

Getting in and out of the car was the biggest limit on my mobility. If I remember correctly, it was a challenge for about a week.

I work at a desk at home, so I went back to "work" pretty much the next day. I didn't get much done. A much bigger challenge than the pain was the stupidity left by the anesthesia, which if I remember right took more than a week to wear off.

The anesthesia might also be also responsible for the fact that a few days later my face turned bright red and my skin was extra-sensitive. That cleared up in another couple of days.
posted by ceiba at 6:02 AM on April 16, 2012


I had dermoid cysts on both ovaries when I was 21. I had one ovary removed and the cyst from the other ovary. My doctor was able to spare one ovary. I then went on to have 3 kids, 2 of them fraternal twins. Thirteen years later I had another dermoid cyst on my only ovary. My surgeon was able to remove the cyst and leave most of the ovary intact. I then went on to have another kid. I never had any trouble getting pregnant each time that my husband and I decided to try conceiving. Of course, fertility depends on lots of things. The recovery is uncomfortable of course, but you'll be back to normal in no time if you are a pretty healthy person. Both of my surgeries were laparotomies, so it was a 6 week recovery period with most of the pain in the first two weeks or so, but you'll have an even easier time since it's a laparoscopy.
posted by daydreamer at 6:34 AM on April 16, 2012


I've had three laproscopies. One for tubal litigation, one that was exploratory/endometriosis related and the last one was to remove the gall bladder.

For everyone of them, I only missed a day or two of work and was back up quickly. Everyone's got a lot of good points about pain and being careful with yourself. However, one thing to remember is that in order to be able to navigate around in your body, they pump your belly area full of CO2. After the surgery, the gas slowly disappates through your body and in two of the three surgeries I had a wicked random pain in my armpit area. It felt like nothing I've ever felt before or since...kind of like the pain from really bad stomach issue, but in my arm. I honestly thought it was a heart attack the first time but it's just the gas finding ways out of your body. But other than that, laproscopy is probably the easiest and best form of surgery. Just take care of yourself.
posted by teleri025 at 6:56 AM on April 16, 2012


I had an ovary and fallopian tube removed last year. I had a huge tumor (not a cyst) in the ovary, and the surgery was a laparotomy, which left me with a gnarly scar (but I always scar badly). I had been trying to get pregnant for a few months before discovering the tumor, and my doctor assured me that I would have no problems conceiving with one ovary. The ovaries normally randomly switch ovulation every month, but when one is missing, apparently the other takes up the slack and ovulates each month. I waited the requisite month after surgery, then got pregnant three months later! At first I was really worried that I would have an ectopic pregnancy that would necessitate the removal of my other fallopian tube, but so far the pregnancy's been completely normal.

I was out of work for three weeks, but I had a huge incision on my abdomen, so I would think two weeks would probably be fine for you. My first day back I had a lot of pain moving around, and was pretty tired that whole first week, but was back to my normal self by the next week.
posted by Safiya at 7:36 AM on April 16, 2012


My best friend discovered she had a fifteen POUND dermoid cyst when we were freshmen in college. You couldn't tell she had it just by looking at her, either. She lost the ovary, but has suffered no long-term problems from only having one remaining ovary. She's still fertile and everything's in working order. Her surgery took her about a month to fully recover from, but she was walking around within a few days of the surgery.
posted by zoetrope at 7:52 AM on April 16, 2012


GET A SECOND OPINION!

I would hope that you have had a second opinion. Do NOT rely on only one doctor's opinion. I had the same experience (not with the ovaries but other) and it turned out I could have avoided this.

I had an cyst similiar to this removed some time back. It was a nightmare as the surgeon forgot to turn me on the side after the surgery and water went into my lungs. Nearly died but thankfully there was a nurse who knew what to do and immediately came to my rescue. I was unconsious and suddenly couldnt breathe.

I do not trust the medical establishment much as I believe common sense is very rare and not taught in medical schools.


My advice is

Keep your family close, make sure they have access to you
When they are dressing you up for surgery, make VERY VERY sure that you let them know which ovary (left or right).
Talk to the nurse and the people who are preparing you for surgery. Tell them EXACTLy why you are there, for what, which ovary, what the trouble is.
Ask them what you should expect. The nurses are excellent, usually, and will help you with details.
Do NOT think that the surgeon knows or is on top of things. Talk to her, ask her what exactly she will be doing

I cannot stress how important it is to be very very assertive. This is your body, make sure the surgeion/nurses listen to you.
posted by pakora1 at 11:14 AM on April 16, 2012


Thanks for all the advice, suggestions, kind words and wishes! I truly appreciate it.

The procedure is outpatient, same-day surgery (of all the details to leave out! DUH) and I'm scheduled as the first surgery of the day and hope to be home by lunchtime. My mom is driving me to and from and will be taking care of me, with help from my boyfriend. I will try to take the suggestion of doing NOTHING for a few days after the surgery (I am not so great at that) for MAXIMUM HEALING POTENTIAL. I have a stack of nerdy DVDs and comic books waiting for me.

My diagnosis was based on the opinion of two doctors, external and internal ultrasounds (SUPER FUN), an MRI and three radiologists. I read the MRI and ultrasound reports. I would rather not have surgery but I would even more rather not have the thing torse or end up with a 200lb cyst like the lady in that Discovery Health show. (This thing grew a centimeter in a month -- WHAT IS IT EATING?!??!)

My mom will be an excellent advocate for me. She is extremely tough and is already practicing her Shirley McClaine routine.

Thank you all again, so, SO much.
posted by Aquifer at 8:52 PM on April 17, 2012


Thanks again for all your help and advice, everyone! The surgery was yesterday, it went well, and they WERE able to save my ovary. I went home the same day and have been trying to make myself chill at home. My belly is sore and has some nasty-looking bruises on it and the marks from the I.V.s look like stigmata, but all is well! I feel pretty good, probably a combination of SWEET, SWEET RELIEF that it's over, and some crazy endorphins.
posted by Aquifer at 7:47 PM on April 20, 2012 [6 favorites]


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