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Have enlarged ovary with functional cyst, painful heavy periods, constipation and diarrhea. Surgery needed?

Mar 2016
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Answered by

Practicing since : 2011
Answered : 4047 Questions
Hello. I'm a 44yr old woman who has suffered from IBS in the past (was awful in high school, but generally susided as i aged). I am currently dealing with a host of reproductive issues, and have an ovary cyst that previously ruptured and is causing me nonstop pain. At the same time, I have strong stomach rumbling around that right ovary (almost sounds/feels like it's cooking in there!) and have been experiencing more bouts of constipation and diarrhea during same timeframe of increased right pelvic pain, as well as severe bloating, fatigue, and some difficulty urinating (thats gone on for years, as I also have a prolapsed uterus),. Within the oast few weeks, my sciatic nerve directly behind my right ovary was also causing severe pain, but an MRI ruled out a herniated disk and a chiropractor has been helping to alleviate the "angry muscles" in that area, as well as a very twisted pelvis. (Not too surprisingly, sciatic nerve symptoms have improved, but my "ovarian" pain has worsened.)

In addition, I have very severe, debilitating cramps with my period (8 months - year now) with heavy bleeding. An ultra sound showed some signs of endometriosis or andomyosis, an enlarged right ovary with a functional cyst, a uteran fibroid, as well as uteran polyps. The 24/7 pain, especially surrounding that right, gurgling ovary (usually only gurgles like that while I'm laying in my back) has disrupted my life to the point that I finally scheduled exploratory laparoscopy to have my ovary checked out, and also have the polyps removed and a D&C. The GYN wants to also do ablation to relieve the heavy bleeding--but the bleeding i can live with. its the pain that has become intolerable. She also wants to take that right ovary regardless of finding cancer or not -- although she says my ultrasound did not reveal cancer, and she's convinced (or at least tried to convince me) that it probably isn't cancer (although my maternal grandmother did die of ovarian cancer; my mother had a complete hysterectomy at 50 for a large fibroid).

A) Does this sound like a good plan of action to you?

B) Would an underlying gastrointestinal issue possibly be causing severe pain just behind that ovary, and should I have a colonoscopy?

C) Any thoughts on ovary removal prior to having such gastrointestinal testing done? (I'm scheduled for surgery at 7:30 am pacific time today).

Thank you for your thoughts and input!!!
Posted Sat, 13 Apr 2013 in Women's Health
Answered by Dr. S Patra 1 hour later

Thanks for writing to us. I am trying to solve your problem.

1) In this stage, best treatment option is surgical removal of uterus with both side of ovaries by the means of total abdominal hysterectomy (TAH + BSO) or vaginal hysterectomy (VH + PFR) in case of 3rd degree uterine prolapse.

After that, you can take HRT) for few years along with some measures to maintain healthy life style.

Only histopathological examination of ovarian/ uterine tissue can confirm the cancerous changes.

2) Underlying gastrointestinal issue and pelvic pathology (like endometriosis/ fibroid etc) with co-existence of herniated disk & compressed sciatic nerve can cause this type of pain.

Here, you may need to undergo colonoscopy to rule out other pathology if any after consulting with gastroenterologist.

In addition, you can consult with orthopedic surgeon/ physiotherapist to alleviate low back pain.

3) As you are suffering from IBS or altered bowel habit for long time, you can undergo colonoscopy or other gastrointestinal testing to rule out underlying pathology for proceeding next line of management.

On the other hand, only removing of ovary may not alleviate your problem but total hysterectomy can do that. You can consult with your gynecologist regarding this to make a concrete decision prior to surgery.

Hope I have answered your query. If you have any further questions I will be happy to help.

For any future query, you can directly ask me by viewing this page WWW.WWWW.WW
Wish your good health & take care yourself.

Dr Soumen
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