Brief Answer:
Your ovaries heal very nicely after surgery of this type

Detailed Answer:
Hello, and I hope I can help you today.

A hemmorhagjc ovarian cyst is caused by bleeding under the surface of your ovary from the spot where your egg popped out when you ovulated. So the "cyst" that forms is actually a normal part of your menstrual cycle except in your case the bleeding that took place was excessive and the surgeons had to stop it. Usually the doctors really do not "remove" the cyst, rather they remove the blood and cauterize any bleeding areas. With other types of cysts, which are growths or tumors, sometimes normal ovary tissue can be removed with it, but not with hemmorhagjc cysts.

Because of this, the normal ovary tissue is largely left intact. So your ovary should heal well and your fertility will not be affected.

Even women who lose one ovary can still get pregnant as each ovary has millions of egg cells in each and one ovary can completely take over if the other is lost.

So you really do not need to worry about the rest of your ovary or your fertility potential after hemmorrhagic cyst removal.

I hope I was able to adequately answer your question today and that my advice was reassuring. Feel free to contact me further if you have any other questions or concerns.

Sincerely, Dr. Brown

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Brief Answer:
It has to do with the way the surgery is done

Detailed Answer:
You may want to try looking up benign laparoscopic ovarian cystectomy on you tube so you can see what I am talking about, but I will try to describe surgically how it's done. It is much easier with a visual aid.

All the word "cyst" means is a fluid-filled space. In a hemmorhagjc cyst, the fluid collects in a pocket in the ovary where the egg had grown. The pocket is lined with tissue that normally makes hormones after the egg comes out to support a pregnancy if you conceived.

So removal of the cyst is just peeling away the lining cells of that space after a small incision in the wall of the ovary. The lining cells, or the "wall" of the cyst are what is removed, leaving the normal ovary intact.

Try to picture if you had a small balloon filled with water under your skin. To remove it, you need to make an incision in the skin, shell out the balloon (without breaking it) and then sew the hole left by the balloon shut and control bleeding. If the balloon had burst under your skin, the balloon would still be removed, but deflated. What was sent to the pathologist is the equivalent of the deflated balloon. By testing the inside of the balloon (an analogy... only works with cysts) you can tell what kind of liquid was inside. Not true for a balloon... but it works for an ovarian cyst.

I hope that analogy helps you visualize things it's a hard concept to grasp if you've never seen an ovary. Look on you tube also for "technique of ovarian cystectomy" it may help.

I do want to reassure you that what your doctor told you is accurate. You really do not have to worry about losing ovarian function from a cystectomy for a ruptured hemmorhagjc cyst. Only very rarely do doctors need to remove a whole ovary for a cyst that is not a type of tumor.

Your surgeon may have taken pictures during your surgery as well as may be able to show them to you. Ask him/her at your next appointment.

I hope this information was able to clarify things with you and eases your anxiety a bit.

Take care, and let me know if you need anything further, Dr. Brown

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Brief Answer:
Trust me I am a gynecologic surgeon we remove cysts all the time

Detailed Answer:
I am not sure what you are reading, but benign ovarian cystectomy is a commonly performed procedure. There are other situations where the tube and ovary need to be removed too, but with your type of cyst and situation, that is usually not done. It is better to look in medial texts or videos rather than blogs or patient stories to get the most accurate information.

Try looking at this video:

http://youtu.be/_yslQlN4FV0

This is an illustration of the technique of shelling out a benign cyst from the ovary. I really want to reassure you that on a young woman with a hemmorrhagic cyst that burst the surgeons' priority is to try to preserve the ovary. We do not want to remove any healthy tissue in any operation unless it is medically necessary.

You are also welcome to get a copy of your operative report that the surgeon completed. It will say all the steps performed during your procedure. It would be in your medical records.

I hope this helps!

Dr. Brown

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Brief Answer:
The bruising is just under the skin- it is normal

Detailed Answer:
Hello again,

A bruise you see on your skin cannot be coming from the ovary... there are layers of muscle and fat between your skin and the abdominal cavity where the ovary is. Also a torsion doesn't happen after surgery, because the cyst (which makes the ovary bigger than normal, which is a risk for torsion) is already gone.

Any incision can have some bruising around it and is normal sometimes after any surgery. Your surgeon may have manipulated your ovary through the right port of your cyst was on the left because it is technically easier that way. In addition, a torsion cannot be missed during surgery; your doctor was just saying that torsion was suspected because your pain before the surgery was similar to someone with a torsion.

I understand it is normal to be afraid after an experience of having emergency surgery that you were not prepared for. But I want to reassure that nothing you are concerned about is abnormal or gives me any reason to suspect your surgery was complicated or that your doctor was incorrect in his or her findings.

I hope you can try to relax a little and concentrate on healing.

Take care, Dr. Brown

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Brief Answer:
Any medication that helps stop ovulation will help prevent ovulatory cysts

Detailed Answer:
Hello again,

A ruptured cyst of the type you had, a follicular cyst, is literally just excessive bleeding that takes place after normal ovulation. Please go to the link below to look at a visual schematic of the menstrual cycle:

https://www.google.com/url?sa=i&rct=j&q=&esrc=s&source=images&cd=&cad=rja&uact=8&ved=0ahUKEwiA6-Pn87XJAhXIRSYKHX1GD8EQjRwIBw&url=https%3A%2F%2Fwww.utahfertility.com%2Finfertility-diagnosis-treatment%2Ffertiliy-your-health%2Fphases-of-menstrual-cycle-utah-county%2F&bvm=bv.0000,d.eWE&psig=AFQjCNFwhj80fo0K55x8VyiZ4ubzTdWV2A&ust=0000

Literally, your egg grows in liquid, just like a chicken egg... and this liquid-filled space is called a follicle or follicular cyst and forms every month in a healthy, menstruating woman. Your egg pops out of your ovarian capsule at ovulation, and in your case, bleeding at the spot where your ovary burst to release the egg caused the hemorrhagic cyst.

So technically, yes- this was caused by something hormonal, but it was just a chance thing that happened as a complication of a normal ovulation.

The reason that your right ovary was not easily seen on the ultrasound before the operation is that your pelvis was full of blood before the surgery. The blood clots look solid on ultrasound and can be confused with normal organs or obscure the view of your normal ovary, because a normal ovary that is not ovulating is quite small (only 2-3 cm in size)

In any case, any medication that prevents ovulation will help prevent the development of cysts caused by hormones. Birth control pills are the most popular option, though any form of hormonal birth control (there are also patches, injections, and vaginal rings) will also work. In terms of a "good" pill
they all will work to suppress ovulation, so the only was to know what pill works best for you is to try one and see how you feel.

It is important to realize that side effects of the birth control pill will be the worst in the first month of use. Typical side effects can include nausea, bloating, breast tenderness, mood changes, or spotting when you're not supposed to have your menstrual period. If you experience these side effects in the beginning, really try to stick it out until you have been on that particular brand for three months. If at that time you were still experiencing bothersome side effects, you can switch to a different brand of birth control pills.

I would suggest that you tell your doctor what brands of pills you have previously disliked so you may try another. There were over 75 types of birth control pills on the market worldwide, and your local doctor will know what is available in your area and what you have not tried yet.

However, having an ovarian cyst rupture is a chance event that may never repeat itself. Women obviously ovulate frequently, but the chance of having a ruptured ovarian cyst that requires surgery is extraordinarily small. Therefore you really do not have to use birth control pills to prevent another ruptured cyst unless you want to; but it does reduce the chance of this happening again if you are on hormonal contraception.

So I suggest that you discuss the brands of pills available with your local doctor and I'm sure that through trial and error you will be able to find a brand that works well for you if you so desire.

I hope this information was helpful to you, and I suggest you repeat these questions as well with your local doctor or the doctor who performed your surgery, as they will be able to come up with the best regimen for you to be treated in the future.

In the meantime, try to concentrate on healing from your surgery and in a few weeks when you see your doctor for a follow-up appointment you will be able to fully discuss your options.

Best wishes again,

Dr. Brown

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Brief Answer:
The stress of surgery can make your period abnormal

Detailed Answer:
You are welcome. The stress of the surgery on your body made you spot- this was not likely your real period, but is common when women are very sick or have a major stress on the body. You are likely to get your real period in two to three weeks after the surgery. The "hot flash" feeling you are getting may again be due to stress, or the blood still left in your abdomen causing a mild on-and-off fever. This is also common after surgery of any type.

Again, just try to get some rest and recover from the surgery and all these unusual feelings will go away in time. It takes a total of 6 weeks for your body to feel completely normal again, but most people feel well enough to do normal activities after two weeks.

Take care, Dr. Brown

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