Posted by: Julie-Anne | 2004/10/07

Cystic Mass adherent to bowel/ureter

I have posted a question on the Cyberdoc as I did not realise that there was a Gynaedoc as well.

In July I had a check-up with a gastroenterologist as I was getting severe colic pains after having a Nissen procedure, cholecystectomy and hernia repair in December 2003. I had a scan and a complicated ovarian cyst was found on the (R) side. I went to my gynae the same month and had another sonar and he put me on a course of anti-inflammatories and progesterone treatment. I had just finished the treatment when I woke up on 17/08/04 unable to walk properly. I was rushed to hospital with terrible pain in my kidney area (R) side and going down into my right side where my ovarian used to be). I would just like to point out that I had a subtotal hysterectomy in 1992 and a subsequent (L) oophorectomy four weeks later due to septicaemia. In 1999, I had my remaining (R) ovary and cyst removed as I was getting a lot of cysts. Since this last op, I have on Livifem as a HRT as I had bad reactions to normal oestrogen implants, patches, tablets, etc.

My gynae immediately booked me in to hospital and removed what he could of this mass which was adherent to the back of my bowel and ureter - it was not malignant and was reported as a complex cyst. My wound went septic as well as the drip site and I was readmitted a second time. I had dressings and on 02/09/04 the wound was debrided and re-stitched. The cyst has recurred and is on sonar reported as a residual complex cyst in the right pelvis with thin internal septations. The gynae did not want to cut it out originally as it would have meant having a colostomy as the follicle cysts are growing on the bowel. As a result I am back on progesterone and anti-inflammatories as well as changing my HRT to Angeliq (a combined oestrogen/progesterone hormone). I have had a subsequent bladder/kidney infection(E.coli which was what caused my wound to go septic) and I am going back on 14/10/04 for a follow-up scan to see if this cystic mass has shrunk. If not, the gynae suggested that I have some injection(all I know is that it is very expensive (R3.700-00) which he says will sort out my problem. I am on Medical Aid thank goodness. What I would like to know is, is this the correct way to handle this problem? I would also like to know what would happen if I just stopped all hormone treatment, as could this be stimulating these follicle cysts to grow on my bowel. I am living on painkillers and tired of having these problems for the past four months. Do you agree with the treatment that I am having as I am thinking of having a second opinion as well, just in case. I am also very bloated and my facial skin is pimply (I have never had a bad skin).

Would you recommend the alternative route of HRT, i.e. soya. Please advise.
I would also like to know whether there is a specialist gynaecologist in JHB who deals with my kind of problems.

Thank you. Please let me know what you think.


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Our expert says:
Expert ImageGynaeDoc

Your case sounds like severe endometriosis with bowel involvement. Difficult to treat and the treatment so far sounds okay. If you have to use hormones it has to have progesterone as well and preferably stay away from hormones and use other alternatives

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