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Suggest Treatment For Ovarian Cyst
Question: Hello Ma'am,
I have consulted you in the past online and have found your answers very helpful.
I want to consult you regarding my sister. She is 26 years old and unmarried.
1. She was diagnosed with ovarian cyst in both ovaries at the age of 20. She was operated on both the ovaries subsequently.
2. Again in 6 months, she was operated on her right ovary for another cyst. Doctors told she has chocolate cysts which will recur. Thus, they started giving her Zoladex 3.6 injection.
3. After 3 doses, the cysts recurred and she was prescribed Lupride Depo 3.75 injection. She was given 4 injections every 28 days. The last injection was on 31/05/2010.
4. Again in 2012, the cyst recurred and she was given Lupride Depo 11.5 injection two times. The second was administered on 13/02/13.
5. Her USG on 15/1/14 was normal.
6. However, again a USG on 2/9/14 revealed a 6 cm cyst in left ovary. Doctor conducted some blood tests and her SERUM CA 125 is 67.5 U/mL.
What is her exact condition. I wanted a second opinion from you. She is yet to be married.
Please let me know.
Thanks in advance.
I have consulted you in the past online and have found your answers very helpful.
I want to consult you regarding my sister. She is 26 years old and unmarried.
1. She was diagnosed with ovarian cyst in both ovaries at the age of 20. She was operated on both the ovaries subsequently.
2. Again in 6 months, she was operated on her right ovary for another cyst. Doctors told she has chocolate cysts which will recur. Thus, they started giving her Zoladex 3.6 injection.
3. After 3 doses, the cysts recurred and she was prescribed Lupride Depo 3.75 injection. She was given 4 injections every 28 days. The last injection was on 31/05/2010.
4. Again in 2012, the cyst recurred and she was given Lupride Depo 11.5 injection two times. The second was administered on 13/02/13.
5. Her USG on 15/1/14 was normal.
6. However, again a USG on 2/9/14 revealed a 6 cm cyst in left ovary. Doctor conducted some blood tests and her SERUM CA 125 is 67.5 U/mL.
What is her exact condition. I wanted a second opinion from you. She is yet to be married.
Please let me know.
Thanks in advance.
Brief Answer:
Recurrent endometriosis.
Detailed Answer:
Hi Ms. XXXX,
Thanks for posting your query.
I am happy to hear from you after a long time. Hope you are keeping good health. I have gone through the detailed medical history provided by you. Here are my points:
---Your sister is suffering from recurrent endometriosis.
---recurrences often occur subsequent to the expiry of the so-called memory period, often after some medical or surgical procedure. This so-called memory period varies with each individual and also from time-to-time.
--Oral contraceptives have been shown to have some control on the disease process, especially after surgical procedures.
---There are other biomarkers available, like COX, to test for the disease process. CA 125 is mostly used to test for ovarian malignancy. The normal values are below 35 U/ml. Elevated levels are also seen in several other conditions apart from ovarian malignancy and IN ENDOMETRIOSIS. So, please do not worry.
--Pregnancy has often been considered to provide dramatic relief in the condition, though it has to be kept in mind that the disease itself can cause decreased fertility. So, before embarking on any surgical procedure, it is advisable to go for the AMH levels and if there is any abnormality, go for conservative procedures.
--Use of NSAIDs is of use in patients with positive COX titres.
Her current condition of a cyst larger in size warrants surgical management. Laparoscopic aspiration or cystectomy usually helps. Follow-up medical management is usually advised.
Hope I have answered your query. Please feel free to contact for further clarifications. I will be happy to help.
regards,
Shanti.V.
Recurrent endometriosis.
Detailed Answer:
Hi Ms. XXXX,
Thanks for posting your query.
I am happy to hear from you after a long time. Hope you are keeping good health. I have gone through the detailed medical history provided by you. Here are my points:
---Your sister is suffering from recurrent endometriosis.
---recurrences often occur subsequent to the expiry of the so-called memory period, often after some medical or surgical procedure. This so-called memory period varies with each individual and also from time-to-time.
--Oral contraceptives have been shown to have some control on the disease process, especially after surgical procedures.
---There are other biomarkers available, like COX, to test for the disease process. CA 125 is mostly used to test for ovarian malignancy. The normal values are below 35 U/ml. Elevated levels are also seen in several other conditions apart from ovarian malignancy and IN ENDOMETRIOSIS. So, please do not worry.
--Pregnancy has often been considered to provide dramatic relief in the condition, though it has to be kept in mind that the disease itself can cause decreased fertility. So, before embarking on any surgical procedure, it is advisable to go for the AMH levels and if there is any abnormality, go for conservative procedures.
--Use of NSAIDs is of use in patients with positive COX titres.
Her current condition of a cyst larger in size warrants surgical management. Laparoscopic aspiration or cystectomy usually helps. Follow-up medical management is usually advised.
Hope I have answered your query. Please feel free to contact for further clarifications. I will be happy to help.
regards,
Shanti.V.
Above answer was peer-reviewed by :
Dr. Yogesh D
Answered by
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