Should I have the lap surgery?

[ExpatErica]

I found out at my regular annual OB/GYN appointment that I have three large cysts on my ovaries. After an MRI it was confirmed that I likely have endometriosis on both of my ovaries as well as multiple other places including the Douglas cul-de-sac and the peritoneum surface of the pelvis. The thing is, I really haven't had any symptoms or pain prior to finding this out. I have always had heavy periods, but aside from that I occassionaly will have a sharp pain around the area of my ovaries, but nothing major at all. So I feel very lucky that at least at this point I don't have any significant pain. My doctor recommends that I have the lap surgery done to remove the 3 cysts and any other lesions he might find. My question for all of you is should I have the surgery now if I'm not having any pain or symptoms? For additional information, I'm 33 years old and single. So I have no plans to have children any time soon. I feel like having the surgery now seems drastic since I'm not having pain, but I worry that waiting will make it worse and potentially do more damage to my ovaries. So any advice you might have would be greatly appreciated!

[caliburn]

Hi there! I just want to give my opinion here. I think you should consider to hold your surgery since the cysts did not give any trouble to you. But maybe one day you plan to get pregnant it might gives you some problem later on. Then i suggest you can remove it if its still large cysts and may cause infertility. For the time being, i suggest you to try something else to help reduce the size of the cyst or if you are lucky maybe the cysts will gone. Just try other method maybe acupuncture, traditional medicine, miracle drugs or whatever did you believe can help this problem other then SURGERY. Because trust me, surgery is not fun at all. I've been through it and sadly i have to go through the process again since the cyst is keep coming back even after you remove it. Besides, after surgery it can cause some scars and any other problem which might reduce your chance to get pregnant. Good luck dear

[Hope23]

I personally think you should have key hole to have the cysts sorted and endometriosis burnt away yes! The cysts could get bigger and I've heard on this site of them bursting if left untreated which is very painful. Sadly if you have cysts and Endom your ovaries will already be damaged to some extent due to adhesions/scarring on them from all the problems inside.

The Endom will continue to develop too. Like you, I never had any of the excruciating pain some ladies on here discuss, but just had awful heavy painful periods every month. But in my youth I just thought oh my mum suffered too, I'm just unlucky. Endom wasn't really in the forefront of doctor's minds years ago. And I was never sent to see a Gyne or sent for a scan. So unfortunately when I finally started trying for a baby at 38 (I married late!) All the awful problems reared their head. I was fobbed off with IBS initially. After another few months I put my foot down (should have done this in my 20s!) And was finally sent for a scan where it was found I had severe endometriosis everywhere including my bowel. My First lap they couldn't do anything as the surgeon wasn't specialist enough, so I had to have another lap with an Endom specialist and a bowel surgeon present and it was all a bit scary. But I got through it fine!

I'm not trying to scare you or bore you with my troubles! I just want you to hear about other people's experiences which may help you. My surgeon said you've had this growing and developing inside for years, and that's why your periods were so painful and heavy. He said if you had had a lap in your 20s or 30s (41 when I had it) it wouldn't have been such a long op now and your fertility may have been 'saved'

I hear what you're saying about not looking to have a baby in the immediate future but I think you would be wise to have the cysts and Endom treated now, to try and help and maintain for future fertility. Women are having babies later in life now, but many are having problems conceiving. Years ago people didn't talk/know about endometriosis and IVF and I think it's because women had their families a lot younger so infertility wasn't a major issue like it is now.

Ovarian reserve declines rapidly in our 30s sadly. And by 35 we become in the age group where it's considered more tricky to conceive and our eggs aren't considered as plentiful or as healthy. Indeed when ladies want to donate eggs the cut off point is 35.

Please don't think I'm trying to scare you but because of my problems I really wish someone had told me this stuff when I was your age or younger! I knew it was getting late for me to have a baby but I married late and kept thinking 'ok it will be alright when we start trying. One ovary is completely mushed up under my bowel from the Endom and is not functioning and the other is badly damaged too. My AMH levels are low (egg count) and I was advised there seems no point having IVF using my own eggs because of my low ovarian reserve and the quality of the eggs. So I'm now going through IVF having a donor egg

I know you're probably thinking I only asked if I should have the op for gods sake!!! But because of my long and emotionally charged experience I just want you to be aware of the potential future problems you may encounter. Don't get me wrong, whilst harder - it IS possible to conceive when you have Endom, but whether you have the lap or not I think you should have your ovarian reserve checked out. Don't wait till yr in yr late 30s to start trying and be in the same position as me. If it comes back as low you can always freeze some of your eggs whilst they are still of a good quality. Just a thought

Sorry for the long post. there's always so much to say on this subject!

I hope you can make the right decision for you. Incidentally most people get over a lap in 2 -3 weeks so it's not bad at all. The pain subsides quite quickly.

If you have any other questions don't hesitate to ask

Take care and good luck

Xx

[ExpatErica in reply to Hope23]

Thank you Hope23! Hearing about your experience is very helpful. I decided to go and see another OB/GYN next week to get a second opinion and ask some questions regarding a lot of the points that you have mentioned here. At this point, I am leaning toward doing the surgery mostly because I just want to get it out so it doesn't do any further damage. We will see what the second doctor says, but I really appreciate your advice and good luck with your IVF!

[Hope23]

No probs. Good luck. Don't be fobbed off. And if something is unclear during discussion don't be afraid to say please explain further! It's your body and your right! X

[givemeananswer]

ExpatErica, I'm just curious, why did you have the MRI if your not experiencing any discomfort? Usually and anyone feel free to correct me here if I'm mistaken, but doctors don't usually send patients for MRI's unless the cysts have been shown to not clear up on their own for an extended period of time. Even then it's usually a transvaginal ultrasound in my experience. Or they will try you on medications to see if that will correct their function.You say it was a regular appointment so I assume you go once every year? Had you been told at your last visit about ovarian cysts as well? I would want to know why he's recommending the lap. You are very fortunate to not have pain, I'm a little jealous. But if your gyno thinks you should the procedure, I would want to know why from him.

[ExpatErica in reply to givemeananswer]

Hi there, so it was my regular annual appointment, but I hadn't been for 2 years. I'm actually American but living in Brussels so I kept putting off finding a doctor in Belgium. So, I think because I hadn't been in so long he did the transvaginal ultrasound. The transvaginal ultrasound showed some fibroids in my uterus and 3 cysts (3 cm, 4 cm, and 5 cm) on my ovaries. He told me that he wanted me to get the MRI because he was pretty sure that it was endometriosis and with cysts of that size he wanted to have a better look with the MRI. The MRI likely shows that it is endometriosis. Also, MRI's are extremely cheap here so I don't think they hesitate requesting them like they do in the US. I asked my doctor why he thinks I should have the surgery now and not wait, since I'm not having any pain. He said that he thinks I should do it now because I will definitely have to have surgery before I try to get pregnant. So instead of waiting and doing it when I want to start having kids he thinks it would be better to do it within the next year because if I wait until I want to start having kids then it will just postpone my ability to try to conceive even longer.... to go through the surgery and recovery, etc. before I can start trying. I have scheduled an appointment with a British doctor here in Brussels for next week so I can get a second opinion. But I will definitely ask my doctor if it is worth waiting and monitoring it for the next year to see if anything changes. Hopefully the second doctor will be able to give me more information or just reassure me that the steps my doctor wants to take are the right ones.

[givemeananswer]

Dear ExpatErica,

I think you just made me want to move to Belgium!

All the best to you on your success in finding your man and conceiving somewhere down the road.

I would also inquire with your Gyno as to following the surgery, how he recommends keeping these issues at bay, because they do tend to pop up again.

[ExpatErica]

Hi Ladies, I wanted to give you an update! I met with the a different doctor yesterday to get a second opinion on whether or not I should proceed with the lap surgery even though I'm not having really any symptoms. After talking it over with this doctor he also agreed that surgery is the right course of action for me. Apparently because I still want to have the option to have children and the cysts are fairly large it is better to remove them now to try to preserve as much of my ovarian structure as they can, than to wait and do it later when the cysts will be bigger and potentially do more damage to my ovaries. So, I will be having my first lap surgery in December. Hopefully they will be able to get it all and there won't be any complications. Thank you all so much for your input! It was really helpful!

Erica

[Hope23 in reply to ExpatErica]

Hi again

I won't write an epic post this time!

I'm glad you got a second opinion and I do really feel it's the right thing to do as this damn endom and cysts really are dangerous to our fertility. And yr cysts are pretty big!

I wish you all the success with the lap. And as they say with belching.... better out than in!!! Lol x