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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest Risk With A Ruptured Ovarian Cyst

I had always had irregular periods and had an endometrial ablation done 7 years ago with no periods since. Two years ago, I was admitted to the ER with severe pelvic pain. Left ovary was enlarged and filled with blood, colon enlarged, bladder enlarged. I had a high white blood cell count. I was told I had possible ruptured ovarian cyst and a resulting infection. Follow up sonogram showed a 2.1 cm endometrial lining and two masses in the cervix as well as a 3 cm hemoraggic ovarian cyst. Re-sonogram a month later showed that the lining and mass was gone even though I had no bleeding. I have had pelvic pain since. Recently I have had a brown watery discharge. Last week I was again in ER. Sonogram showed 3 cm hemoraggic ovarian cyst and 2.1 cm endometrial lining. CT scan the next day showed a 6 cm heterogeneous mass on the the left ovary with inflammation in the region and mild pelvic ascites. Heterogeneous, thickened appearance of the endometerium and two adjacent cystic structures (unclear if they are attached to the endometrium). They did another sonogram and said that the cyst had ruptured and I had a lot of free fluid and blood surrounding the area and now I have a 1 cm cyst on the other ovary. My doctor wants to watch and see some more, I am in pain and want answers.
Thu, 28 Apr 2016
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OBGYN, Maternal and Fetal Medicine,  's  Response
Dear Patient. I would have been great to know your age, weight and body habit.
With the information available I can only tell you that your health care system has created a very complex situation out of a very simple condition. With the available information one can surely assume that you have an Ovulatory Dysfunction secondary to Polycystic Ovaries (irregular periods, thick endometrium, ovarian cysts). You may be experiencing a POS (Polycystic Ovary Syndrome) but I lack necessary information to have the diagnostic criteria.
In any case, if they had offered you Oral Contraceptives (OCs) all your symptoms and findings would have never appeared. Oral contraceptives (the Pill) inhibit the growth of ovarian cysts and avoid endometrial thickening, your periods would have been regular every 28 days.
There is still time to do it, so, in my opinion, if you were my patient I would immediately prescribe OCs and treat other associated conditions such as Obesity, Diabetes and Hypertension if present. Some specific lab tests would help if I wanted to be more precise in the diagnosis.
Consider these lines when talking to your attending MD
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Suggest Risk With A Ruptured Ovarian Cyst

Dear Patient. I would have been great to know your age, weight and body habit. With the information available I can only tell you that your health care system has created a very complex situation out of a very simple condition. With the available information one can surely assume that you have an Ovulatory Dysfunction secondary to Polycystic Ovaries (irregular periods, thick endometrium, ovarian cysts). You may be experiencing a POS (Polycystic Ovary Syndrome) but I lack necessary information to have the diagnostic criteria. In any case, if they had offered you Oral Contraceptives (OCs) all your symptoms and findings would have never appeared. Oral contraceptives (the Pill) inhibit the growth of ovarian cysts and avoid endometrial thickening, your periods would have been regular every 28 days. There is still time to do it, so, in my opinion, if you were my patient I would immediately prescribe OCs and treat other associated conditions such as Obesity, Diabetes and Hypertension if present. Some specific lab tests would help if I wanted to be more precise in the diagnosis. Consider these lines when talking to your attending MD