Thursday, March 11, 2010
Cystectomy For Grapefruit Size Dermoid Cyst On Ovary
Hello, I'm writing from Nevada. I went in for an appointment with my MD a few weeks ago after trying to conceive for 1 year. While I was there he did a pap and routine exam as well. In the exam he found my uterus was small or off to the side a bit and wanted me to have an ultra-sound done. When we did this they found a grapefruit-sized dermoid cyst in my left ovary. We're planning on having it surgically removed but I have a few questions.
1. With the size of the cyst is there any chance of keeping a portion of my ovary?
2. If it MUST be removed, is there any possibility of saving my eggs?
3. With a cyst of this size is it wise to do the procedure laparoscopically or should it be done with one large incision?
I have no issue with work and recovery time, I just want it done in the safest way to keep my ovary if possible. I do have another appointment with my MD to discuss this information, just looking for some suggestions or input. Thank you.
Hello K. from Nevada,
A skilled gynecologist will usually remove the Dermoid cyst without sacrificing the ovary. Make sure that your's will do that. The procedure is called a cystectomy. There is no reason the ovary should be removed.
The technology for preserving eggs certainly exists, although the pregnancy rates are not as good. However, we do recommend this in women that have cancer since they would otherwise lose the option of getting pregnant with their own eggs. This will have to be done in an IVF center, and must be done BEFORE the surgery, not during or after. The ovary has to be stimulated to grow the eggs so that they can be removed and frozen.
The cystectomy procedure should also be done by a method called laparoscopy, using a scope and small incisions. I do this procedure all the time. If your doc can't do it laparoscopically, then find one that can. This is the best method to preserve your ovary and cause minimal damage so that your fertility is not compromised. Try not to have an open (laparotomy) procedure if you can.
I hope this helps,
Edward J. Ramirez, M.D., FACOG
Executive Medical Director
The Fertility and Gynecology Center
Monterey Bay IVF Program