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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Teenager. History Of Surgically Removed Ovarian Cysts. On And Off Pain In Stomach, Nausea. Possible One More Cyst In Ovary?

Hello, so I'm 17 years old and I've had two 4cm ovarian cysts surgically removed in the past year and a half. Once on February 8, 2012 and the second on February 8, 2013. They both were on my right ovary and I think I have another one. I've been having bad pain on and off in that area for the past 2 weeks and felt very nauseous yesterday. I'm thinking if I do have another oversized cyst, should I just get that ovary removed?.. My parents talked about but I just am not sure..
Mon, 16 Sep 2013
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OBGYN 's  Response
Thank you for your question. I think this is a difficult situation for you and your parents to have to decide. The important information is whether or not these ovarian cysts have any abnormal pathology involved. I would like to know what your menstrual history is prior to making such a definitive decision about whether or not to remove your right ovary. If there is an ovulation problem, that can frequently be treated to avoid further abnormal cyst formation. Also, I would like to know if there has been any medical suppression treatment used to avoid cyst formation after the initial two surgeries.
It is reasonable to remove an ovary that continues to form cysts if medical therapy has failed and cysts reform causing this amount of discomfort. However, if the underlying cause for abnormal cyst formation is not determined and treated, the cyst formation may begin on the remaining ovary leading to further surgery. I have seen patients who have undergone surgery for pelvic pain once a year leading to removal of the structure causing difficulty, until no pelvic organs are left. In one instance, despite sequential removal of the pelvic organs, the pelvic pain persisted.
I would think long and hard about removing an ovary at the age of 17 without trying every medical treatment available first. The strongest ovary suppression medication available in the US is Depo Provera administration, which could be given until pregnancy is desired. Ovarian suppression with Depo Provera is extremely powerful and may avoid further surgery.
I hope this answer helps and if you have further questions, I am available for consultation.
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Teenager. History Of Surgically Removed Ovarian Cysts. On And Off Pain In Stomach, Nausea. Possible One More Cyst In Ovary?

Thank you for your question. I think this is a difficult situation for you and your parents to have to decide. The important information is whether or not these ovarian cysts have any abnormal pathology involved. I would like to know what your menstrual history is prior to making such a definitive decision about whether or not to remove your right ovary. If there is an ovulation problem, that can frequently be treated to avoid further abnormal cyst formation. Also, I would like to know if there has been any medical suppression treatment used to avoid cyst formation after the initial two surgeries. It is reasonable to remove an ovary that continues to form cysts if medical therapy has failed and cysts reform causing this amount of discomfort. However, if the underlying cause for abnormal cyst formation is not determined and treated, the cyst formation may begin on the remaining ovary leading to further surgery. I have seen patients who have undergone surgery for pelvic pain once a year leading to removal of the structure causing difficulty, until no pelvic organs are left. In one instance, despite sequential removal of the pelvic organs, the pelvic pain persisted. I would think long and hard about removing an ovary at the age of 17 without trying every medical treatment available first. The strongest ovary suppression medication available in the US is Depo Provera administration, which could be given until pregnancy is desired. Ovarian suppression with Depo Provera is extremely powerful and may avoid further surgery. I hope this answer helps and if you have further questions, I am available for consultation.