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Ultrasound Result Showed Trace Of Free Fluid And Bilateral Hemorrhagic Ovarian Cyst. Should I Be Worried?

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Posted on Tue, 25 Jun 2013
Question: I did an ultrasound and result came back with trace of free fluid at the upper limits of normal physiology and right ovarian cyst. Bilateral hemorrhagic ovarian cyst superimposed 3.9 cm! Should I be concerned ?


Thanks , XXXXXX
doctor
Answered by Dr. Aarti Abraham (27 minutes later)
Hello XXXXXX
Thanks for your query.

A fluid filled area of the ovary is called an ovarian cyst. These can be large or small, benign or cancerous, worrisome or part of the normal function of the ovary.
If the cyst is smooth and completely filled with clear fluid, chances are it is not too XXXXXXX If it is smaller than 2 inches (5 cm) in diameter it may very well go away on its own. This scenario accounts for the vast majority of ovarian cysts. Most women will have some sort of functional ovarian cyst at one time or another in her lifetime.
If it is closer to 10 cm or 4 inches it is less likely to go away on its own. And if the cyst is not completely clear, but has a more “complex” appearance it may either be a hemorrhagic cyst, a cyst caused by bleeding into the ovary with ovulation, or an endometrioma, a cyst from endometriosis of the ovary. Both of these conditions are benign. A hemorrhagic or ovulatory cyst will heal on its own, an endometrioma will not.

After menopause it is less likely to have ovulation related cysts. Still, benign cysts are more common than cancer of the ovary even in older patients. The likelihood of getting ovarian cancer in our lifetime is 1.7%. At age 60 this is only 1 of every 1500 women.

There are other cysts that may form in the ovary. Among the most confusing and interesting is the Dermoid Cyst. This is where an ovarian “egg” cell forms a cyst containing hair and possibly a tooth or other bodily tissues. These are almost always benign with a cancer rate of 1/1000. Dermoid cysts are fairly typical in appearance on ultrasound or X-Ray and easily removed by minimally invasive means with a laparoscope.

Most ovarian cysts are treated laparoscopically. This allows the doctor to be very conservative, leaving all normal tissue and removing only the cyst tissue. Since these are usually benign, they can be drained inside and removed through a half-inch opening. This is out patient surgery and most patients are back to work in 1 – 2 weeks. Only on rare occasion is it necessary to remove the entire ovary, even when the cyst occupies most of the ovary, the tissue left behind can reconstitute itself back into an ovary and ovulate. Conserving ovarian tissue is imperative for future fertility as well as for the manufacture of estrogen, progesterone, and testosterone, which have been shown to have health benefits throughout life. The complete ovary might need to be removed if it is twisted around itself, a torsion, which can block off the blood supply (although the ovary may be saved if this is diagnosed early enough in the process). Or the ovary may be completely destroyed by the disease process undergoing treatment.

Some cysts are bilateral, present on both sides, so both ovaries need to be carefully examined.

Some cysts may be suspicious for cancer. If they are small enough to be sequestered in a surgical bag, they can be removed laparoscopically, placed in the bag, drained in the bag and removed piecemeal from within this bag. If cancer is found, the remainder of the surgery, a staging surgery to evaluate the extent of the disease may be done either laparoscopically or through an incision, depending on the circumstances.

Again, the good news is that most ovarian cysts will heal on their own, most are benign, and most that require removal can be removed in a minimally invasive, outpatient surgery.

Please consult your gynecologist for fuller details.
All the best !
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Aarti Abraham (14 minutes later)
Thank u for ur answer! Another issue that i have in the ultrasound is i have a partially distended urinary bladder! Should I be concerned?

Thanks again!
XXXXXX
doctor
Answered by Dr. Aarti Abraham (41 minutes later)
Hi again.
A partially distended urinary bladder means a partially full bladder, which means there was some amount of urine in it, which is to be expected :)
Please ignore that line.
It is a routine statement, it means nothing that you should be worrying about.
Take care XXXXXX.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Dr. Aarti Abraham

OBGYN

Practicing since :1998

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Ultrasound Result Showed Trace Of Free Fluid And Bilateral Hemorrhagic Ovarian Cyst. Should I Be Worried?

Hello XXXXXX
Thanks for your query.

A fluid filled area of the ovary is called an ovarian cyst. These can be large or small, benign or cancerous, worrisome or part of the normal function of the ovary.
If the cyst is smooth and completely filled with clear fluid, chances are it is not too XXXXXXX If it is smaller than 2 inches (5 cm) in diameter it may very well go away on its own. This scenario accounts for the vast majority of ovarian cysts. Most women will have some sort of functional ovarian cyst at one time or another in her lifetime.
If it is closer to 10 cm or 4 inches it is less likely to go away on its own. And if the cyst is not completely clear, but has a more “complex” appearance it may either be a hemorrhagic cyst, a cyst caused by bleeding into the ovary with ovulation, or an endometrioma, a cyst from endometriosis of the ovary. Both of these conditions are benign. A hemorrhagic or ovulatory cyst will heal on its own, an endometrioma will not.

After menopause it is less likely to have ovulation related cysts. Still, benign cysts are more common than cancer of the ovary even in older patients. The likelihood of getting ovarian cancer in our lifetime is 1.7%. At age 60 this is only 1 of every 1500 women.

There are other cysts that may form in the ovary. Among the most confusing and interesting is the Dermoid Cyst. This is where an ovarian “egg” cell forms a cyst containing hair and possibly a tooth or other bodily tissues. These are almost always benign with a cancer rate of 1/1000. Dermoid cysts are fairly typical in appearance on ultrasound or X-Ray and easily removed by minimally invasive means with a laparoscope.

Most ovarian cysts are treated laparoscopically. This allows the doctor to be very conservative, leaving all normal tissue and removing only the cyst tissue. Since these are usually benign, they can be drained inside and removed through a half-inch opening. This is out patient surgery and most patients are back to work in 1 – 2 weeks. Only on rare occasion is it necessary to remove the entire ovary, even when the cyst occupies most of the ovary, the tissue left behind can reconstitute itself back into an ovary and ovulate. Conserving ovarian tissue is imperative for future fertility as well as for the manufacture of estrogen, progesterone, and testosterone, which have been shown to have health benefits throughout life. The complete ovary might need to be removed if it is twisted around itself, a torsion, which can block off the blood supply (although the ovary may be saved if this is diagnosed early enough in the process). Or the ovary may be completely destroyed by the disease process undergoing treatment.

Some cysts are bilateral, present on both sides, so both ovaries need to be carefully examined.

Some cysts may be suspicious for cancer. If they are small enough to be sequestered in a surgical bag, they can be removed laparoscopically, placed in the bag, drained in the bag and removed piecemeal from within this bag. If cancer is found, the remainder of the surgery, a staging surgery to evaluate the extent of the disease may be done either laparoscopically or through an incision, depending on the circumstances.

Again, the good news is that most ovarian cysts will heal on their own, most are benign, and most that require removal can be removed in a minimally invasive, outpatient surgery.

Please consult your gynecologist for fuller details.
All the best !