2 laps, 3 months apart....

[anna2525]

After seeing a consultant twice and having an internal/external ultrasound, I have been booked for a laparoscopy 25th May. This is the first of 2 operations, so I was just wondering if anyone else had a similar experience?

The consultant said we need to take a 2 stage approach because of the endometrioma/cyst size is large (14cm x 10cm). He said it is most likely an endometrioma, although there is slight chance it could be a 'mucous filled' cyst, but unlikely. Because I haven't had children yet (I'm 33), but would like to (and would like to start trying soon!), he said he will do his best to save the ovary, hence the approach. 

So in lap 1 surgery, he will drain the cyst and attend to any adhesions, as it looks like my other ovary is stuck to my uterus

Then for 3 months I’ll have hormone injections (zoladex I think) so the cyst can shrink further and not be agitated by having periods. 

And then another lap to remove the cyst. The consultant aims to protect my ovarian reserve as possible, however, he did warn me the ovary might already be damaged (which was difficult to hear). He said he will also do a dye test for my Fallopian tubes. 

Honestly, I don’t know what to be more nervous of, the surgeries (I've never had an operation before!) the hormone injections and side effects, or the possibility that my chances of conceiving might be significantly reduced! So worried about all of it but aiming to stay positive and optimistic.

The annoying thing is, I have normal periods and no pain, yet I looks like (from reading this amazing forum) I might have stage 3 or 4 endo. It is so strange to think there is so much going on inside.

Has anyone else followed this approach for a large cyst? Do you think the hormone injections may damage my eggs at all (sorry, such a strange question), and will it further affect my chances of conceiving? From reading this forum and other research, it sounds like hubby and I should start trying for a baby soon after lap 2? 

Thanks again for taking time to read this and I hope everyone is well and having a nice weekend xxx

[JeanOsborne]

Hi Anna, are you having surgery with a BSGE specialist? If you are that's great but if not I would recommend you seek a referral to one as stage 3-4 should only be treated by one and not a general gynaecologist. This is nhs guidelines,so there is protocol to follow. Having surgery to remove (with excision not ablation) would give you the best chance of conceiving. 

With regards to Zoladex , I had these injections for six months and it did prevent my 11cm endometrioma from growing and also helped with pain. I also had more energy. Hot flushes were horrible ,I took evening primrose oil and sage leaf tablets , one of each twice a day which helped. 

 Have a look on the BSGE website to see if you surgeon is on the list. If he's not then you can find one on there that is near to you. Good luck.

[anna2525 in reply to JeanOsborne]

Hi Jean, Luckily, I was referred to a BSGE specialist centre, and I found out that my gynecologist has undertaken advanced lap training, and he runs the endo clinics. My hubby did asked him though if he had worked on such large cysts before (he had!).

Thanks for the advice re supplements. The side effects of hot flushes and moodiness don't sound great, so hopefully these will help! Will take a look at Holland and Barrett asap

[JeanOsborne in reply to anna2525]

Hi Anna if you have any questions about the Zoladex don't hesitate to ask . Always happy to try and help. Hope the surgeries go ok. 

[anna2525 in reply to JeanOsborne]

Thank you Jean. This is much appreciated. 

[anna2525]

Hi Lindle. 

Thanks for the links - I can see the centre on there, and the lead clinician's name. However, my actual consultant is not on that list, I think maybe because he is newly qualified (in his mid 40s)? But I have seen he recently completed advanced training in lap for endo. To be honest, no one has said to me the stage of endo, this is my best guess from all the readings and what I've been told from the ultra sounds. He was still uncertain to diagnose until I've had the first surgery, but I will definitely would like a follow-up meeting after the surgery so he can tell me exactly what was found and what to expect next. As you say, surgery number 2 needs to remove all the endo tissue. As I have no bladder/bowl pains I can't even say how far it has spread...this is all so scary.