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Is it necessary to remove the uterus for treating ovarian cyst?

Q: I am a 50 years old woman having a cyst of size 8 cm x 5.7 cm in one ovary. The doctor has suggested removal of the uterus. However, another doctor has told that there is nothing wrong with the uterus and only the cyst needs to be removed, which can be done by laparoscopic surgery. The first doctor told me that I cannot go for laparoscopic surgery as I have asthma. Should I get the cyst or the uterus removed? Can I go for laparoscopic surgery? I am suffering from asthma for the last 18 years and have been twice admitted to the ICU for its treatment in the last six years. Please advise.

A:At 50 years of age, when an ovarian cyst is detected, the prime thing is to rule out anything sinister. Before you plan any surgery, it would be good to do some blood tests (tumour markers) such as CA125, CA19-9 and CEA. If they are within normal range, it is reassuring. They can be elevated in many conditions including benign ovarian cysts, so increased levels do not carry great significance. There is no point removing the cyst and leaving the ovary behind i.e. removing the ovary is preferable to avoid any recurrence of ovarian cysts in future. This is because you are likely to undergo menopause in a year or so and the ovaries do not serve any purpose following menopause. I would even advise removing the other ovary even if it appears normal for the above reason. This operation can be done laparoscopically, even if you have asthma. Asthma is not a contraindication for laparoscopic surgery.

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