Apr 26

Ask Dr R: Painful ovarian cyst after hysterectomy

Preliminary note:  Many people consider surgical removal of the uterus, with ovaries left in the body, to be a “partial hysterectomy”.  Actually, the term hysterectomy refers only to the uterus, not the ovaries.  When surgeons remove the uterus and ovaries it is called a hysterectomy with bilateral (both sides) salpingoophorectomy (tubes and ovaries removed).  To surgeons, the term partial hysterectomy infers removal of the body of the uterus with the cervix left in place, or more accurately, “subtotal” or “supracervical” hysterectomy. 

Read on…

Dr. R, I had a partial Hysterectomy in 2002. I had been having pain on my right side. Find out that it is a cyst. The pain is very intense and is getting worsre. I want my doctor to finish the hysterectomy this time instead of just removing the cyst because he said it could come back. I am 43yrs old. Do you think this is wise to just go ahead and have the full hysterectomy this time? And also do you think that I would go straight into menopause at this age. I don’t want them to keep going in and out.

Thanks Dr. R

If indeed the cyst is the source of pain, something that only your examining physician can determine, then at minimum the cyst must be removed if it does not resolve spontaneously, and some cysts, particularly cysts that occur as a result of ovulation, do resolve spontaneously.  Cysts that are large, twisting (called ovarian torsion), not associated with ovulation, or are suspicious of containing cancer must be surgically removed and sometimes cannot be removed without totally removing the ovary from which they arise.
To remove both ovaries will bring on abrupt surgical menopause to any woman at any age, unless of course she has already gone through natural menopause. The average age of menopause is 51, so the decision to induce this in yourself 8 years earlier than might otherwise occur requires careful counseling from your doctor and consideration from yourself. You may benefit from perusing the patient resources on the North American Menopause Society website: http://www.menopause.org/Consumers.aspx.  As with all other complicated surgical decisions, you may want to obtain other clinical opinions from consultants who review your test reports combined with a physical exam to give you the answers to the issues outlined in this response. Obviously, given the pain involved, such second opinions are to be arranged urgently!  Do not delay. Keep us posted…

Best Regards,

Dr R


  1. Anonymous

    Likewise, I am 43 and going through the same situation. I had a partial hysterectomy in 2008. For the past two months and currently, I am experience right side pain, and it has been diagnosed as ovarian cyst. The pain stopped for about two weeks, but now it is starting again. Does the cyst rupture and reoccur?

    Hello GM:

    The ovarian cyst could be de-compressing, leaking cyst fluid as it does so, and this fluid can cause severe but transient pain that is not a sign of damage. Or it could be twisting (this is called ovarian torsion) which IS dangerous and does require close follow-up and may well require surgical intervention. Or the cyst may be growing larger or may be infected, again both requiring close follow-up and intervention. You must report all these symptoms to your doctor immediately as the develop, as I trust you have done.

    Best Regards,

    Dr R

  2. Anonymous

    Dr. R, I wrote to you about a month ago. I did decide to go ahead and have the Laproscopic Bilateral(other part of hysterectomy) done. I had the partial in 2000. I had it done one week ago today. I am feeling much better. Little pain in the navel area. Some “hot flashes” ocurring in the early hours of the morning for a few minutes and then they go away. My doctor said that the surgery went well and I am to follow-up with him in about 3 weeks. Dr. R, I hear some women say that they lost their drive for sexual intercourse. Does this happen in all women who have total hysterectomies or does it depend on the female. I am a little nervous about this. I have been married 18 1/2 years and my husband is a wonderful man. What advice do you have now that all my plumbing is gone. Thanks for your previous response to my question in April. I really love your website. God Bless R (Alabama)

    Dear R from Alabama,
    We are learning more every day about women’s sexuality, and we have found that a variety of hormones definitely contribute to sex drive. Some of these hormones are produced by the ovary, while others come from the adrenal glands (on top of your kidneys) and others come from your brain. Chances are your sex drive will be just fine, possibly better now that the source of pelvic pain is gone, along with the worry. The love and stability in your relationship trumps all, as this is the sexiest of sex drive factors.
    Thank you for getting back to us and sharing your story.
    Dr. R

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