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Ovarian Cyst Question
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bwizzle16 posted:
Two days ago I was diagnosed with an ovarian cyst. I started my period yesterday, beginning with very painful menstrual cramps. About 3 this morning I woke up with a horrible stabbing pain in my pelvic region. We rushed to the hospital, and I was told my cyst was the size of a golf ball. When I arrived at the hospital, I weighed 97 pounds. I currently weigh 105 pounds. I was prescribed Lortab for the pain. Has my cyst ruptured? What was the sudden unbearable pain? I couldn't move, and now my abdomen hurts when I walk and move around.
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Jane Harrison Hohner, RN, RNP responded:
Dear bwizzle: There are at least two reasons for sudden onset, extremely severe pain with an ovarian cyst:

1. The cyst can rupture releasing all the fluid inside. This fluid splashes against the lining of the abdomen ("peritoneum) and irritates the lining. This is the same type of pain as when an appendix ruptures. In the case of an ovarian cyst, the body reabsorbs the fluid in several days. Meanwhile, an ultrasound can often see the evidence of a ruptured cyst as fluid that sits at the lowest part of the abdomen ("free fluid in the pelvis").

2. If the cyst is large enough it can twist the ovary and tube--like a heavy flower twisting a more fragile stem. This is called "ovarian torsion". If the twisting persists it can shut off the blood supply to the ovary causing incredible pain and harming the ovary. It is also possible to have a partial torsion, or a brief torsion. These are harder to diagnose, but they do resolve.

Lastly there is a type of ovarian cyst ("hemorrhagic ovarian cyst") where a tiny blood vessel continues to bleed causing prolonged cyst pain.

Hopefully the ER gave you some guidelines about care at home. They should also have given you a diagnosis and instructions about following up with a GYN. If the pain is escalating you should return to the ER, otherwise, with a ruptured cyst, the pain should slowly abate.

Yours,
Jane
 
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clipper1956 responded:
I had one of those in the early 80's and my OB just surgically removed mine it was bleeding and causing severe stabbing pain. I've had 3 children with one ovary so that doesn't stop child birth. I got pregnant within 2 months after that, good luck.
 
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clipper1956 replied to clipper1956's response:
12 months not 2 sorry, because I stayed on the pill. When I got off to get pregnant I did immediately.
 
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REDKAT responded:
Jane is right. When the cyst ruptures, the fluid is caustic to the surrounding tissues, kind of a chemical peritonitits. Some people have said a heating pad helps. Especially if you are young and slender, concern over the torsion exists. An ultrasound will help evaluate this if the pain persists.
 
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LeaKen responded:
Years ago I was experiencing some abdominal pain. After examination the doctor diagnosed a ruptured ovarian cyst. Had surgery which "wedged-out" the cyst, leaving both ovaries in tack. After surgery I did experience servere pain during my periods, which lasted for several months. The pain slowly reduced each month and once I got pregnant (about a year later) most of the pain sudsided. Not sure if this method is still use today, but worked well for me.
 
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Anon_6061 responded:
You can read all about ovarian cysts here -
http://www.ovaryresearch.com/ovarian_cysts.htm.

Most ovarian cysts are benign and will resolve on their own so monitoring may be all that's needed. When surgical removal is necessary, it seems fairly common to remove the ovary versus just the cyst (cystectomy) but according to the excerpt below, cystectomy is possible in most cases. I suspect though that it requires more skill and time but no higher (insurance) reimbursement than ovary removal so that may explain the common practice of ovary removal. Removing the ovary may disrupt hormone production.

"Removing a cyst, called a cystectomy, is like taking a clam out of the shell. The thinned out ovarian tissue is cut open, and the cyst is gently peeled away from inside the ovary. The cyst fluid is then removed with a suction device. The cyst now looks like a deflated balloon and can easily be removed through the small laparoscopy incision. Rarely, if a cyst has destroyed all the normal ovarian tissue, it may be necessary to remove the entire ovary and it is possible to do this, as well, with the laparoscope."
 
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Anon_6061 replied to REDKAT's response:
REDKAT - Why would torsion be more of a concern in a "young and slender" woman?


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