When should I have surgery to remove this cyst?

Ok, so a little background first...

DS was born via 'emergency CS'. No other complications apart from a long, slow recovery.

I am 14 weeks pregnant with Bub no 2. At my dating scan, the scanner found a cyst. It measured about 7.5cm on the 12 week scan. All indications (bloods, scans) are that it's non cancerous, and apart from bloating and a little pressure on the bladder, is unlikely to cause problems with Bub or my pregnancy. It will be monitored throughout my pregnancy. All in all, it's a 'nice' cyst!

However, it does need to be removed. There are two options for this:
1. I have a CS and the cyst is removed at the same time.
2. I have a VBAC (which I desperately wanted before I knew about the cyst), then have surgery 6 weeks later to have it removed. Of course, the VBAC is not 'guaranteed', and I may end up with a CS anyway. My ob said the cyst is unlikely to have any impact on my ability to have a successful VBAC.

Logic tells me it'd be easier to just go with the CS and have the cyst removed at the same time. It means less time off for DH, my mum would be able to stay from interstate the whole time (but asking her to stay for 2 months or more might be pushing it), a more stable start for Bub without me being in hossy at 6wks (breast feeding etc), less upheaval for DS, and we'd have a set timeline for what's happening when. DH is also keen for this option.

Still, there's this nagging feeling that I'm having a CS when I don't 'need' one and that I could still have my VBAC.

So, here are my questions...
Do I really need the cyst removed at 6 weeks? I mean, if it could wait 6 or so months, I'd definitely want the VBAC.
What would you do?
Has anyone else had a cyst removed? How did you make your decision about when to have surgery? What happened?

TIA

Hey Hun

I can relate a bit to how you are feeling! I'll share my story and hope it may help :)

When I was pregnant with my second bub, they discovered cysts too. Similar size to yours (even slightly bigger at one point), on both ovaries. My obst wasn't too fussed (as like yours, mine were clearly Simple cysts and fluid filled). So we just had an extra ultrasound or two during my pregnancy just to check them. They caused me no problems and I went on to deliver a big healthy boy.
When he was about 4 months old, I had my cysts drained. That kept them away for a while, but they did come back. Then a bit down the track, I fell pregnant with our 3rd child. The cysts had reformed but again we just watched them during the pregnancy. I went on to deliver a very big boy this time :)
After that last pregnancy, I had ultrasounds every 6 months or so just to check on them. I was just hoping the cysts would disappear by themselves. Anyway, they didn't of course so when my last bub was about 14 months I had the cysts removed fully.
A bit long sorry!... Anyway, if they are sure your cysts aren't nasty and aren't causing you problems, then I wouldn't feel pressured to have a c/s because of them! But if you want to have a c/s because that's the birth you want, then that's your choice and that's OK.
The main risks of leaving your cysts there, are injury to your ovary, torsion etc. That is a very serious thing, but there's no way of predicting that may or may not happen. Obviously, it wasn't a problem for me as I had my cysts for a period of a few years. With no pain, or symptoms at all.

Anyway, I'm sure you will come to the right decision! Some doctors a are bit more forward in treating these things, but my two specialists were happy taking a more hands off approach and observing things until I was ready.

All the best! x

My sister had non cancerous cysts that were causing her grief throughout her pregnancy (pain) but they still left them alone once her pain was managed. This happened twice between 30-40 weeks. She went on to have a VB & over 6 months on the cysts are still there but not causing her any further issues. Is there a specific reason they are in a rush to have them out?

Have you asked your doctor whether you can put off having the cyst removed for 6 months postpartum? And can they do the cystectomy keyhole rather than open? I'd go with the VBAC but that's just me.

Thank you so much for your replies. And support.

After seeing the ob, it seemed logical to have a CS and remove the cysts, but the more I thought about it..... They're causing no hassle, they're simple cysts, and I Want My VBAC! Surgery for surgery's sake seems stupid to me. DH worries that they'll suddenly turn cancerous, or that it'll end up being expensive to manage (with out of pocket expenses), and he worries because I don't react too well to anaesthetic.

But I worry I'll have 6 weeks of pain, won't be able to pick Bub up for weeks after, wont be able to walk properly for weeks, will feel physically drained for months (above and beyond what Avignon a newborn will do) like with my last CS. I know a planned CS is different, but I really want a chance to birth my Bub my way!

After posting last night, DH and I chatted and agreed to talk to the ob again and ask him if there's a reason the cysts need to be removed at or soon after birth.

As for keyhole surgery, the ob said that's what they'd do if I had the op later, and go from there (if they can't remove it all, or if its growing into the ovary, there's always a chance they'll have to do open surgery).

Any other perspectives?

I haven't had personal experience with a cyst, however a friend of mine was pregnant with her 4th and had a pretty big cyst. It was discussed throughout her whole pregnancy that she would need a c-section (and she had had 3 normal vaginal births previously so didn't really want one). She went into labour, and gave birth completely without any issues.

6 weeks later she had to go into hospital and have the cyst taken out because it was causing her pain. It had twisted her ovary or something? So they took it out with keyhole surgery. I don't think her recovery was very long or painful - unlike what a c-section would be.

Its still early days so if it was me in your position, I wouldn't make a decision either way until way into the third trimester :)

Thanks Arimeh. I'm hoping to leave it as long as possible while still allowing time for DH to organise time off work and Mum to get flights over (can get pretty $xxxy around Christmas). Do you know if the surgery caused problems with your friend breast feeding? Was Bub allowed in hospital with her?

Just saw this thread and thought I'd update for anyone who might want some info in the future...

I decided not to make a decision for as long as possible...at least until after my 20 week scan. So, I was feeling quite anxious about my scan. As it turned out, there was absolutely nothing to worry about. The cyst had shrunk right down until it was barely visible. The 'fibroid' they found on the 12 week scan wasn't present at all - the specialist thinks it was a contraction at my 12 week scan as thy can mimic fibroids.

So, at 27.5 weeks, I am confident that there's nothing stopping me from VBACing this Bub! ;)