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Re: GYNECOLOGIC: Ovarian Cyst, Laparoscopy, and Gynecare Thermachoice
From: William F. von Almen, II, MD, FACOG (anonymous@obgyn.net)
Thu, 29 Mar 2007 20:41:40 -0500 (CDT)
Michelle
Just my 2 cents worth here. With a history of endo, cyst on same ovary
for several years 9and while on ocp therapy), worsening pain, I would
not shy away from having laparoscopy and probably removing ovary. The
ablation also sounds like a good idea here, but be sure you are done
with childbearing.
You do not say what size the cyst is, and if it is cystic or solid or
mixed, but I think it bears surgical evaluation none the less...Dr. von
Almen
At Thu, 29 Mar 2007, Michelle wrote:
>
>I just returned from the doctor and was told that I have a left ovarian
>cyst (seen on ultrasound). My doctor gave me 3 choices: 1)Observe the
>cyst for awhile, 2) start OCPs, or 3)have it removed laparoscopically. I
>have had ultrasounds in 2002, 2004, and now in 2007, all of which have
>shown a cyst on the left ovary. The problem is that these were done
>with 3 different doctors, so my previous ultrasound records are not
>available yet to my current physician (I signed a release of records but
>they had not arrived by my appointment today). I am, therefore, left to
>wonder if this is the same cyst that was seen in 2002 and 2004 or
>whether this is a new cyst. I am inclined to believe that this might be
>the same cyst as I know that I have had increasing pain on that side
>since 2002 (gradually getting worse and worse over the past 5 years)).
>If that is the case, then there does not seem to be any point in
>continuing to observe it. I also know that I have been on OCPs on and
>off for extended periods of time over the last 5 years, so I am also
>inclined to believe that if they haven't done the trick during that
>time, resuming them seems a poor option. I told my doctor I wanted the
>laparoscopy, but then I started to backslide a little as I started to
>think more about it. I have had one laparoscopy in 1997 for
>endometriosis. I started to wonder if I was being too rash in jumping
>to that option right away. I also started to get a little scared when
>he discussed doing the Gynecare Thermachoice procedure at the same time
>because I do also have extremely heavy periods and anemia.
>
>Has anyone had both procedures at once? I guess it makes sense to do it
>while the patient is already under anesthesia, I am just a little
>frightened by the prospect of doing both at once.
>
>I forgot to ask my doctor also if they removed just the cyst itself
>laparoscopically or whether it is the whole ovary. I have read that if
>you are over 40 (I'm 41) that it is better to remove the entire ovary.
>
>My doctor is willing to schedule the procedures based on the current
>ultrasound findings, but I felt like I should probably compare the
>ultrasound with those done in the past. Now I am regretting that. I
>know I am in significant pain and have been for years, so I don't know
>if I am doing myself any favors by waiting.
>
>Does anyone have any suggestions for me? I guess I feel a little guilty
>jumping right to the laparoscopy, like maybe I am not being rational and
>should be considering the conservative options. I guess I am just
>frustrated with feeling so much pain for so long.
--
William F. von Almen, II, MD, FACOG
Private Practice
New Orleans, La.
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