I am feeling very anxious as one of my daughters has an ovarian cyst which she has the option of having removed by keyhole surgery under general .

It was first discovered a while ago and is about 4cm. On having it checked again it is still the same size and although she does get slight discomfort it is liveable.

I know that most woman have cysts but they usually burst monthly with your cycle.

So has anyone had this done? Is it worth the risk of general anesthesia? If it is left could it cause problems if she wants to have a child later in life?

We are very worried as she does suffer from blood pressure problems and I do not know anyone who has gone through this procedure.

Not me

hmmm it is not such a big cyst, depending on what kind of cyst it is hormonal thepray might be more convenient also depending on your daughter's age...maybe would be OK to discuss this with the OB/GYN?
laparoscopy surgery does not leave much scaring but it is still an intervention...just my two cents

all the best!

Thank you Angela - She is 25 years old and am not sure what kind of cyst it is.

Has your daughter had a second opinion? Just to weigh up all the pros and cons.

When I was a young woman I had an ovarian cyst which burst and I developed pelvic peritonitis. The hospital took out my appendix and only operated on the real reason a few days later. This left me with a life time of tubal inflammations and fertility problems. Over the years, adhesion's and lesions caused lots of pain and discomfort and eventually I had to have a full hysterectomy. Hence no kids.

I'm not suggesting for a moment that this will happen to your daughter and it sounds as if her gyny is keeping a regular check on things. Any change in pain in that area though, she should be at her doctors like a shot.

Hope I haven't made matters worse.

Interesting thread for me as I'm 25 and have PCOS - just curious as to why she's been recommended to have surgery?

A laparoscopy is one of the safest way to operate, and a good anesthetist knows how to deal with blood pressure problems in a patient. Your daughter is still very young, which makes it extremely unlikely that she will have problems with the anesthesia (which is shorter with a laparoscopy).

I understand your concerns. What is the incidence of fertility problems if the cyst is not removed?

I had key-hole surgery under a general anaesthetic to remove an ovary (very painful adhesions due to endrometriosis), it was pretty straight forward and I was on my feet again very quickly. Tiny scars too, which was a plus.

If the cyst is 4 cms that's pretty bit isn't it, a similar size to the ovary itself? Plus if it's causing her pain that it would be better to get it removed, there's only so much they can tell through scans and so on.

A year ago I was in the hospital because a cyst ruptured. They never saw it during my physical and I never felt any pain to indicate something was amiss. Once it ruptured I was in so much pain I kept vomiting, screaming and trying to shred anything I could grab. Pain continued for 3 days, though much less severe than the first day. I was told the cyst was just over 4 cm which was too small for them to consider surgical removal (was in the US, Dr said if it was 4.5 they would have considered it).

My Dr said the surgery was relatively simple but it is still surgery. A good anesthesiologist will be able to safely sedate your daughter. If the Dr thought there was too much risk in the surgery they wouldn't recommend it.

I wish your daughter the best.

I had a similar sized ovarian cyst at that age - it might help you to know what sort of cyst it is - mine was a 'benign dermoid cyst' - basically, the ovaries are prone to this sort of cyst because they are such special cells - capable of producing ever other sort of body cell.

The way the specialist explained it to me, the cyst began during my prenatal development. One cell turned into a 'skin' cell (hence the term 'dermoid') - and it grew in the ovary into a piece of skin - there was hair, oil, fat and even something that looked like a piece of bone or tooth...

Mine was detected around that age. I was in the very early stage of pregnancy with my second baby, and the ovary had moved (did you know the ovaries move around) until I could feel it just to the left of my belly button - when I lay flat on my back you could almost see a bulge in the skin...very strange...It was about the size of a golfball - so the same size as your daughter's cyst, 4-5cm diameter.

They did an ultrasound and measured it, made an 'educated' guess of what it was, and did not think it was a problem for pregnancy, and not urgent to have it removed, so I waited until my son was about 8 months old to have a lapaoscopic procedure and have it removed.

The surgery was very straightforward. Being quite young and still interested in having children, I did speak to the doctor about whether or not it would affect fertility, but he told me two things - firstly, you can still fall pregnant normally with one ovary working, so even if they completely removed one, everything could be expected to function normally as the other ovary would take over the job. Secondly, the egg cells grow on the outer surface of the ovary, and the cyst was inside, so they literally scraped the cyst out and then sewed the ovarian tissue back together again, and left it there...

Either way, when I did try to fall pregnant again, I had no trouble at all.

The laparascopy was in 2002. I chose a surgeon who was a gynaecologist and not an obstetrician - I was lucky in that my surgeon was actually a specialist on this procedure - I agreed to have other doctors there to supervise the operation for 'teaching' purposes and on the day there were about 12 doctors in the theatre... They did introduce themselves very briefly but I was fairly out to it with pre-medication by then so I wasn't too worried.

The surgery was very straighforward, I went home just a few hours later...

The only thing that was really tricky was something they call 'shoulder tip wind pain' - it's common with laparascopy. I was explained as air below the diaphragm, like when you get a 'stitch' when running, but instead of your abdomen hurting, you get referred pain in your shoulder. What worked for me was keeping extra warm and having a heat pack across my stomach... and keeping my feet up...

Your daughter's doctor can explain the risk of leaving it in. For me the 'risk' is that it was not benign, but cancerous, or that it burst - causing the sort of scenario that oldhand spoke about. I have a friend who had one burst in her early 20's and it caused a life-threatening infection...and she was Type 1 diabetic so fairly high risk in that situation anyway, they mucked up her insulin/sugar after the surgery, and she nearly went into a coma from low blood sugar... so I'm certainly more comfortable with planned/routine surgery vs. an emergency situation.

Oh, the scars were tiny too - four tiny little crosses where the laparascope was inserted, and they removed the cyst through my belly button and then stitched it all up again... a little sunshine on the scars was recommended (not sunburn!) - to help it heal - and it really did seem to work...I'd be struggling to even find the scars these days amongst all the stretch marks from having three babies

Hope that helps....

PCOS is something very different.

(Standard) Removal of ovarian cysts by laparascopy is a routine surgery nowadays. The risks are now little to almost insignificant (compared to the number of surgery)n and I would say if your daughter does that in a Swiss hospital she should be in good hands.

The risks of leaving a cyst is much higher.

I wouldn't hesitate - had it last september - nothing at all.

Your daughter can be happy to have such a cautious mom!

What she says.

I know of people who have had larger o-cysts which went away with hormone therapy.

Does that make it 4 cents?

Thanks FMX - my daughter lives in the UK so would have treatment there.

I have just spoken to her on the phone and passed on all the information that everyone has given and warned her that any pain - straight to the hospital - so many thanks for those who shared their experiences.
I fly back to the UK later in the week so will go with her to the Docs.

Many thanks for the informative post - I don't suppose you would mind explaining to me the difference between these kinds of cyst and those that occur from PCOS please? I should know more - I know it's terrible!

True, nevertheless a 4 cm cyst is not an extremely large cyst and they have a tendency to recur so why operate when you can treat with medication. I had an 8cm cyst and it went away with hormones. Also, a routine surgery does not mean there are no risks.

Have a look at www.pcos-uk.org.uk - that might help you understand it a bit better. There seem to be lots of sites if that one is not informative enough.

PCOS is a syndrome characterized by multiple micro or tiny cysts that develop and stay all along the cycle. They are not treatable by surgery but hormonally as they are mainly very tiny and multiple. THey are caused by a hormonal imbalance although the true reason behind it is unknown but it is closely related to insulin resistance and the metabolic syndrome.

Laparoscopy is a very easy recovery

The only thing I would be wary of at her age and wanting kids is the adhesions/scar tissue

I had 3 operations in 5 months on my fallopian tubes, after the first one to unblock my tubes I thought all would be OK. Went back in for another op 4 months later as scans weren't looking good and the scar tissue was so bad they couldn't get in via laparoscopy due to intestine/bowl/etc... stuck to stomach wall and blocking the way - and op was abandoned and re scheduled a week later for a laparotomy (fully cut open)

So - she needs to discuss these concerns - because I have read and heard that any surgery (even appendix) can cause scaring and adhesions around fallopian tubes etc... and cause issues later

The hormone therapy might be worth looking in to

Sorry if the above adds more to your worry

THAT is what would concern me...

Crikey - at first glance it doesn't look like a very comforting website! Will probe it a bit more when I'm more awake.

All the best to your daughter, whatever she decides to do.