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Hello. This is my 3rd question regarding adnexal mass / cyst. Please refer to my previous 2 questions for background. Since 12/20 (first appt. with a GYN in 5 years), I have experienced mild discomfort (pressure or fullness, some twinges, some urinary discomfort – increased urge). Some days mild, other days (3 to 5 days per week), enough to take 2 ibuprofen, usually in the p.m. hours. How much discomfort is acceptable during this "watchful waiting" stage? I like to exercise, but other than walking, exercise aggravates this some. So I walk. My next CA125 test is scheduled Feb 2. Next period due Feb 28. Next ultrasound scheduled April 2. What other tests could or should be done? I don't want to jump unneeded to laparoscopy. Even after 2 ultrasounds, the GYN has not said WHAT type of mass this is. GYN has just said “cyst” but does NOT say whether this is 1) purely functional, 2) endometrioma, or 3) other. Shouldn't he have some idea? Thanks.

Optional Information:
Female , Age: 48

Already Tried:
Ibuprofen. Slight curtailing of exercise routines.

Customer (name blocked for privacy)

Hi,
Here is how I look at it....
A cyst with your medical history is likely to be a functional ovarian cyst. However the exact diagnosis can be confirmed only on aspiration/ removal.
I believe that if you have worsening symptoms then an early removal maybe needed since a symptomatic cyst becomes an indication for removal. The amount if discomfort that you are describing is probably acceptable since you do not have significant issues at rest. Curtailing the exercises and more walking as you have done seems appropriate at the present moment.
I would wait for the CA 125 results, and the next ultrasound before taking the next step. The next step could be a cyst aspiration, OR even a removal depending on these reports. No other tests maybe needed before this,
I can understand the frustration due to a lack of definitive diagnosis, but this is a common situation, and your present management seems appropriate and logical.
All the best,

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Regards
Dr. Gupta

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