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Feeling Discomfort In The Lower Quadrant Of Pelvis. Ultrasound Showed Slightly Complex Cyst On The Ovary. What To Do?

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Posted on Sat, 24 Nov 2012
Question: I have just had a gynaecoloical ultrasonography - results have shown uterus ok; right ovary ok - but on left overy there is a bilocular cystic lesion measuring 38x32x22mm each locule measures 19x21x16mm and 24x24x23mm respectively - colour doppler demoinstrated no abnormal vascularity. I have a blood test tomorrow - but I also have a flight from Sydney to the UK for work for 3 weeks - I just don't know what to do - doctor has advised I reschedule flight and get test results and check with a gynaecologist - have a call into the airlines about rescheduling or trying to....or maybe I have the blood test, fly to UK, and call for results and see a gynaecologist in uk if I need to - just don't know what to do! Can you advise and give a view - by the way I'm 49 years old - no bloating, all functions are normal but had dull groin pain on right which I thought was muscular to start with and after it wasn't really going that's when I went to the GP...can you advise at all on flying with this condition - thanks so much - and if I do fly whether I take a sleeping tablet - have Temaze perscription for flights - although never taken one - but maybe this will allow me to sleep and rest ? So hard to make a call - it does seem people do fly with cysts and this is ok - in fact I think on my flight from London to Sydney I may have in fact already had this cyst as the dull ache started around August time - love your opinion - pretty hard to reschedule now but do have a call into the airline - thanks
doctor
Answered by Dr. Timothy Raichle (1 hour later)
Hello, I would be happy to help you with your question.

So from what you are saying, you have had a persistent / worsening discomfort in the left lower quadrant of your pelvis since August (so now for about 3 months) and a recent ultrasound showing a 4cm, slightly complex, cyst on the left ovary. Based on your symptoms, the assumption is that this has been there since August. You are otherwise healthy.

Based on what you are saying, the typical course of action would be to schedule you for a blood test called a CA125. Depending on the results, here are possible scenarios:

1. The lab is normal, pain is tolerable - followup ultrasound in 6 weeks
2. The lab is normal, pain is intolerable - cancel trip and consider surgery
3. The lab is abnormal, pain is not an issue - consider surgery, but not urgent

So given that this has been an issue since August, I do not think that the ultrasound all of a sudden necessarily makes this an urgent issue. I would get the labs done before your trip and call from the UK for the results and decide then if you need to cut your trip short or not. If your pain is a significant issue, then this should be the driving factor as to whether you travel or not.

I hope this helps!
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Timothy Raichle (5 hours later)
Thank you so much XXXXXXX This really helps
Do you have any advice at all about how to manage the cyst whilst flying long haul or are there no real concerns - just walk and stretch as per usual? Can I take a sleeping tablet? My GP was worried about it rupturing?
Strange really as the discomfort is felt more on my right side than left - and it's the left ovary where the cyst is! Almost a trapped nerve type feeling on the right - but feel well enough to fly and work at the other end - and as you say see what the results are and make assessments then.
Appreciate the way you presented the information
Thanks again
XXXXXXX
I will have my blood test tomorrow before flying
doctor
Answered by Dr. Timothy Raichle (11 hours later)
I still stand by my prior answer. If your primary is seriously concerned about travel then that concern should trump what I am saying as this is not exactly medical advice, but rather an educated way to look at the situation.

Also, pain in the pelvis can be confusing as far as the actual source of the pain!

I hope this helps and good luck!
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Timothy Raichle (1 hour later)
Thanks again XXXXXXX - understand completely.
Cheers
XXXXXXX
doctor
Answered by Dr. Timothy Raichle (1 hour later)
Good luck and remember to provide feedback!
Note: Revert back with your gynae reports to get a clear medical analysis by our expert Gynecologic Oncologist. Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Dr. Timothy Raichle

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Feeling Discomfort In The Lower Quadrant Of Pelvis. Ultrasound Showed Slightly Complex Cyst On The Ovary. What To Do?

Hello, I would be happy to help you with your question.

So from what you are saying, you have had a persistent / worsening discomfort in the left lower quadrant of your pelvis since August (so now for about 3 months) and a recent ultrasound showing a 4cm, slightly complex, cyst on the left ovary. Based on your symptoms, the assumption is that this has been there since August. You are otherwise healthy.

Based on what you are saying, the typical course of action would be to schedule you for a blood test called a CA125. Depending on the results, here are possible scenarios:

1. The lab is normal, pain is tolerable - followup ultrasound in 6 weeks
2. The lab is normal, pain is intolerable - cancel trip and consider surgery
3. The lab is abnormal, pain is not an issue - consider surgery, but not urgent

So given that this has been an issue since August, I do not think that the ultrasound all of a sudden necessarily makes this an urgent issue. I would get the labs done before your trip and call from the UK for the results and decide then if you need to cut your trip short or not. If your pain is a significant issue, then this should be the driving factor as to whether you travel or not.

I hope this helps!