Ovarian Cysts post WLS

I'm 5 months post-op (RNY) and have lost 99lbs. I started having really bad pelvic pain a few weeks ago. Got in to see my dr. and got an ultrasound and they found 2 ovarian cysts - 1 on each side, about 3cm each. I used to get painful cysts but the last ones were about 4 years ago - before my periods stopped due to PCOS. Now my OBGYN is telling me that he doesn't want to do surgery to remove them because my gastric bypass was so recent. Has anyone heard of this?? I just want these cysts gone - especially since they are septated and also likely hemorrhagic. Should I be pushing for surgery or is it precautionary to wait and if so, how long should I wait?

Appreciate any advice!

I agree with your doc as I was told the same thing by my doc ( but for a fallopian tube issue). They still consider that area to be healing even 5 mos out and most docs you find do not want want to rescar the area for some time. Actually, I'm 4 yrs out and my doc didnt want to retouch my surgery area unless it was a high health risk being posed to me. I had some cysts reappear too, but I had also started to carb up while that happened. So I had to eliminate my carbs again and I went back on metformin  for 3-4 months to rid myself of my cysts. Not sure if you're able to do the same at this point, but if you have reintroduced carbs back into your diet, possibly consider eliminating them again. My doc says thats what was most likely making mine resurface after having them gone for 3+yrs. Hope Ive helped some.

August 13th made me a year out  august 15 is when the sever pain kicked in on my lower half in "that area" it was so horrible i was in the bed untill my room mate made me get up and he took me to the e.r here in durham, nc. the pain was sever like someone had heated up an ice pick and was stabbing me down there. well after two er visits. ( that is a whole long story in its self)  they did an ultra sound, two cysts. one on each ovary 3cm apart. the paper work i was given stated that even if they did surgery they would more than likely come back. any way. so here is my dilema. I am 30 years old. never married never had any kids. im scared to death. i go back for an ultra sound sept 30th of this year. so they can check on the size of the cysts and go on from there. if they were to do surgery and the cycst come back there goes the horrid pain as well. I dont know if there is any other way to deal with these things. the past few weeks from the er trip till now. my uterus has been hurting like crazy. i have to keep my self jacked up on pain meds and lots of them. not the addictive kind, ibpropheren ( or how ever u spell it) OVER THE COUNTER stuff. in order to even work, if i drive a cross a speed bump im damn near crying,  a rail road track i made that mistake ONCE. now i go no more than 2 miles per hour over them because any jarring of my body my uterus feels it the worse. and it lets my whole body and mind know.. ( that was not the thing to do). I appreciate any advice also. i am documenting this as well for my gyn when i go back to him the end of this month. i also am very tired alot no energry some days. i go to work and i come home around 5pm by 930 i am falling asleep where i sit.

Hi Soft..pls see my response to the OP if you haven't already. Also, please know it's not ok to continue in the type of pain you describe by taking ibuprofin (sp?) and NSAIDS are not allowed to post RNY patients in any event so you are quite possibly risking a healthy pouch in the process. I will probably never know how long I "carried" my cyst (left ovarian) or how fast it originally grew because except for the fatigue/LETHARGY which was generally attributed to obesity I had no symptoms/pain until post RNY.

As I understand it the ultrasound provides for the most reliable diagnosis but torsion (twisting and cutting off blood supply) can still be difficult to detect w/out surgery. Because my cyst was so large and cancer could not be 100% ruled out it initially looked like I would need open abdominal surgery to remove it which obviously would have been harder to endure than the LAP ultimately performed. But after a CA125 test and endometrial biopsy and the sample recieved from the original aspiration were benign, it was determined the probability of metastisizing was much smaller than the risk of open surgery.

I feel very fortunate/appreciative that my WLS surgical team was in close consultation w/the OBGYN surgical team so everyone could see/consider the BIG picture. Yet I am dissapointed my complaints of lethargy/fatigue/generalized pain/weight gain were so readily attributed to obesity that a CT scan/ultrasound wasn't done two years pre-RNY when I started seeking relief from the medical professionals. So again, research research research, connect the experts and be your own best advocate. Best Wishes.

I would push for the surgery. I am in a similar situation my doctor doesn't want to pursue surgery either. I think its because he thinks it should all be resolved as I lose weight. But what he doesn't understand its just gotten worse as the weight has come off.  My symptoms were not bad when I was fat. Now that I'm 50 pounds lighter they are more obvious and getting worse. I never had facial hair, body hair or even bad cramps. My periods were a little irregular started 28-32 days but have been like that forever. Now my periods no longer exist even with bc. Had breakthrough bleeding every month. Then my periods wouldn't start when I would stop the pill. I haven't had a normal period in about 4 months! I have facial hair, loss of hair on head, back hair, even the hair on my pubic region has thinned out! I have severe pain in my ovaries even when I'm not on my period or ovulating (I never had that before).  I have ovarian cysts (never had before) also read that if a women does not have a period that they are more susceptible to getting endometrial cancer. That happens when a women does not shed the lining of their uterus at least 4 times a yr. So I have actually been pushing my doctor for a hysterectomy. He doesn't feel the need but I feel its my body and can't have kids anymore and think its best for me. I haven't had a normal period in months and all symptoms are worse. Cancer runs in my family history so why shouldn't he do this for me. I have insisted on it and think he should respect my wishes. I am going to pursue it and push for it even if I have to have another Gyno do this. I have 3 kids that I need to think of and don't want to end up with a bad situation later. I have lost 50 pounds and still have all the symptoms for PCOS. I am taking metformin, spiro and acupril. These are all med that I am taking due to PCOS otherwise I wouldn't have to take anything. I know the hysterectomy will resolve some issues but atleast I will have peace of mind. Its your body and you need to do what is right for you.

I am 5yrs out (RNY) have lost 100lbs. I had a partial hysterectomy only keeping my ovaries 6 yrs ago. 2 yrs ago I had a small cyst on my left ovary I was being watched for. I the developed neurological symptoms March 2008 have been hospitalized several times, tests, etc. turns out to be early stages of MS. I didn't go last yr to gyno due to all of this. Early this year I started with weird symptoms of bloatedness after eating, constipation, frequent & urgent urination, pain in pelvic region. I got an e/mail from someone about ovarian cancer signs which scared me and went right away to get checked. The small cyst has grown over 2yrs into a large mass the size of a grapefruit and now the other one has 3 small ones on it. I had ultrasounds, MRI, & Catscan which all are leading towards a malignancy now, although the CA-125 bloodwork was ok, my orig. gyno was just going to put me on the pill to try to shrink them & wait and see. He was so afraid to touch me surgically due to all my prior surgeries and the MS. All he talked about was adhesions & scar tissue. I have breast cancer that runs in my family and did not want to take the pill. I went to get another opinion and switched to that dr. he said he would never put me on the pill with my grandmother dieing of cancer, also the mass is too large to shrink and he doesn't trust the CA-125 test, I am having the ovaries & tubes out on 10/12, the will be tested on the spot & sent out for testing as well. If it is cancer it would be very early, the only fear is having chemo & getting sick with my small pouch!! Seek a 2nd opinion like I did!!!!   

I had a massive (12-14cm) ovarian? cyst incidentally discovered 1 week post RNY when I presented to ER with excruciating upper abdominal pain that appeared to be eminating from one of the lower RNY trocar sites. They ran a CT and found the "fluid collection" pretty much filled my pelvic floor but because of the size it was impossible to discern it's source and rule out secondary fluid collection due to the RNY. They were able to determine from the ultrasound and other indications it was not septic and most likely benign. Anyway because it was pushing my organs around and pressuring my incision site(s) and because I was just one week out of major surgery my WLS surgical team consulted w/an OBGYN surgical team and elected to do a CT guided aspiration which almost certainly saved me from developing a hernia and the downward sprial related to complications therein if not my life and allowed me time to heal from the RNY. I went back to the OBGYN 3 months later for followup and it appeared the cyst had resealed and filled itself cuz it was now 14cm again. The OBGYN was fabulous in her explanation, diagnosis and recommendation reasoning and removed the cyst lap two weeks later. The healing was actually more painful than the RNY I think because it involved lower ab muscles this time but two weeks out from that I felt FABULOUS. Get a second opinion, research, research, research, and be your own best advocate.

Aside from the cysts that they found they also diagnosed me with dysplasia. Which they did the leep procedure and now I am having to go every 3 months for routine pap. Which I hate I can no longer have kids because I had tubal 6 yrs ago and have continuously requested a hysterectomy. My OBGYN has declined to do it each time. Which I don't really understand why. But have decided to go to a different Dr. to get a second opinion. I am no longer having my periods at all and know that it could result in endometrial cancer and do not need that. I have done extensive research on my condition which is pcos related and feel that the hysterectomy is my best option.