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Ask Dr. Norm S. Your Own Question
Dr. Norm S.
Dr. Norm S., Board Certified OB/GYN
Category: OB GYN
Satisfied Customers: 11231
Experience:  Over 30 years of experience in OB/GYN practice, including teaching students. Fellow of American Board of Obstetrics and Gynecology.
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My daughter aged 12 years old, she was feeling pain in

Customer Question

My daughter aged 12 years old, she was feeling pain in abdominal area right side then we done ultrasonography of her whole abdomen and a cyst in her right ovary sized 5.00 centimetre by 4.8 centimetre shown
Now what we have to do
Submitted: 10 months ago.
Category: OB GYN
Customer: replied 10 months ago.
She is feeling pain and her temperature is 104 Fahrenheit
Customer: replied 10 months ago.
Please advise me is it possible to remove without sergery
Expert:  Dr. Norm S. replied 10 months ago.

Do you know whether it was a simple cyst of the ovary (one fluid filled sac) or was it complex (a number of sacs with things inside them)?

What did the doctor think was causing the fever?

Has your daughter started her periods? Thank you.

Customer: replied 10 months ago.
it's one fluid filled sac then what's your suggestion
Customer: replied 10 months ago.
Period started from two months ago but it's not regular
Customer: replied 10 months ago.
Cause of fever is unknown
Expert:  Dr. Norm S. replied 10 months ago.

A simple cyst 5 x 5 cm in a young girl who has started her periods is likely to be a functional benign cyst. That means it's one that will most likely go away on its own. We would treat it with pain pills and rest, and hope that the pain and the cyst would go away within a few days to a week or so.

However, the fever is worrisome. If it's related to the cyst, that suggests a possible infection, although ovarian cysts don't generally get infections, since they're inside where there are no bacteria.

It's possible that the cyst has twisted on it's blood supply (torsion), in which case surgery would be necessary to untwist it. Sometimes if the blood supply was cut off too long, the ovary dies and needs to be removed.

So her doctors will have to figure out why she has the fever. It may or may not be related to the ovarian cyst. If it is, I think that she'll likely need surgery, at least a laparoscopy (scope through a small hole in the abdomen) to learn what's really going on with the ovarian cyst. Best wishes.

Customer: replied 10 months ago.
I just want to know is it normal curable without surgery ? But she is feeling pain in abdominal right side area and fever
Expert:  Dr. Norm S. replied 10 months ago.

A simple ovarian cyst will usually cure itself without surgery.

If it's complicated by twisting or infection, then she would probably need surgery.

It's up to her doctors to figure out whether it's twisting or infected. That will require exam, blood tests, and perhaps a different scan, such at MRI.

Customer: replied 10 months ago.
Sir I am sending herewith report copy
Expert:  Dr. Norm S. replied 10 months ago.

Thank you. The ultrasound report shows that everything else appears normal, and it appears to be a simple right ovarian cyst.

If it weren't for the fever, that report would be reassuring, and no surgery would be needed. However, the ultrasound doesn't explain the fever. Your daughter's doctor need to search for the cause. If a cause is not found other than the ovary, then I think surgery is needed.

Customer: replied 10 months ago.
But she is feeling pain and continue fever so please advise what type of blood test need
Expert:  Dr. Norm S. replied 10 months ago.

If a blood test showed high white cell count or low hemoglobin, that would be worrisome. Otherwise, blood tests probably won't help much.

A specialized ultrasound called Doppler can show blood flow in the ovary, and could be helpful.

The degree of pain could help. If the pain is severe, surgery may be needed.

Customer: replied 10 months ago.
Her hemoglobin is 14.8
Expert:  Dr. Norm S. replied 10 months ago.

That's normal.

Dr. Norm S. and other OB GYN Specialists are ready to help you
Customer: replied 10 months ago.
Sir
I am now going to next ultrasound and I will send you report and white blood cell report
Customer: replied 10 months ago.
Sir just now I have done further ultrasonography with dopler and please see the report and advise ms
Customer: replied 10 months ago.
y with dopler and please see the report and advise ms
Expert:  Dr. Norm S. replied 10 months ago.

I don't see the report yet.

Thank you for your payment and rating.

Customer: replied 10 months ago.
Sir here is report
Expert:  Dr. Norm S. replied 10 months ago.

It appears from the report that the right ovary is normal, but the cyst is close to the ovary but not in it. There is no blood flow in the cyst.

It's hard to know just what to make of this. Most cysts like this are arising from inside the ovary and are part of the ovary. I suspect that's still true, but I can't be sure from the report.

A CT or MRI scan may help to give further information.

Customer: replied 10 months ago.
Sir have you prescribe any medicine/drug in just based on these report which medicine will shrink or destroy the cyst
Expert:  Dr. Norm S. replied 10 months ago.

No, there is no medicine that will shrink or destroy the cyst. If it's a benign functional cyst, it will go away on its own over a few weeks (unless it's twisted).

Customer: replied 10 months ago.
Sir
How I will be sure that the cyst has twisted , can you say what physical visible sign/symptom/ complication will arise
Expert:  Dr. Norm S. replied 10 months ago.

If the cyst has twisted, your daughter's pain will continue and get worse.

A CT or MRI may be able to tell.

Customer: replied 10 months ago.
Sir here is last report please see it and comments
Customer: replied 10 months ago.
Sir this is last report please see it
Expert:  Dr. Norm S. replied 10 months ago.

There is nothing new in this report.

Customer: replied 10 months ago.
Sir
Here a specialist advised me to remove that cyst of my daughter by laparoscopy please advise me
Expert:  Dr. Norm S. replied 10 months ago.

If a specialist has advised you to have the cyst removed, then I would do it. The specialist is able to see and examine your daughter, and can tell more about the cyst than I can without seeing her.

Customer: replied 10 months ago.
Sir
My question is if the cyst stay and didn't twist or the size didn't increase during some wreaks then what problem in her body can arise
Expert:  Dr. Norm S. replied 10 months ago.

If your daughter is still having very much pain, that's a problem.

If she's not having much pain, then I'm not sure why the specialist would want to remove the cyst.

Customer: replied 10 months ago.
Sir
Bad news for me from today morning my Daughter felled very much pain and then taken she pain killer then gone pain, at noon she again feel pain and then suppository pain killer given then pain gone , at night again come pain and given pain killer then gone now what can I do please help me
Expert:  Dr. Norm S. replied 10 months ago.

What pain killer is your daughter taking?

Customer: replied 10 months ago.
That is clofenac 50 mg , Algen tablet, at noon Voltarin suppository, then at night Napa suppository
Customer: replied 10 months ago.
Sir please help me by giving advise me
Expert:  Dr. Norm S. replied 10 months ago.

As long as the pain is well relieved by Voltarin and Napa (paracetamol), that's a good sign. If these medications don't continue to give your daughter good relief, then she probably needs surger.

Please click the rating stars so that I may receive credit for my time and answers. Thank you.

Customer: replied 10 months ago.
Actually it's relieving pain for sometime when using pain killer but it's coming again and now she has no fever or vomiting
Expert:  Dr. Norm S. replied 10 months ago.

Would you say that the pain is getting worse?

Customer: replied 10 months ago.
Sometime pain is worse but sometime she didn't feel pain it's coming and going
Sometime it's worse but after sometime it's no pain
Expert:  Dr. Norm S. replied 10 months ago.

Again, I would say to go along with the advice of the specialist and have the cyst removed by laparoscopy.

Customer: replied 10 months ago.
we asked it to our doctor that why sometime pain coming and going then they told us that her cyst sometime twisting and after sometime it's clearing
Can you tell me is it nature of the cyst
Expert:  Dr. Norm S. replied 10 months ago.

If it's twisting, I think that means the cyst should be removed. If it twists and stays twisted, it cuts off the blood supply and the ovary dies.

Customer: replied 10 months ago.
but if it's twisting it will come in report ? Which report will help us that about twisting history
Expert:  Dr. Norm S. replied 10 months ago.

I think that the only way to be sure if it's twisting is by looking at it with laparoscopy.

Doppler ultrasound, MRI, and CT can all suggest that it's twisting, but it may not be possible to be sure without looking at it.

Customer: replied 10 months ago.
But in Doppler ultrasound yesterday does not come
Tomorrow morning doctor advised to do ultrasound again but my question is if in ultrasound does not come twisting side by side her pain is also coming and going then is it should for us to go in laparoscopic decision ?
Customer: replied 10 months ago.
Sir please advise me
Expert:  Dr. Norm S. replied 10 months ago.

I have advised you, and I'm afraid I have nothing more to offer. I will opt out. Best wishes to you and to your daughter.

Customer: replied 10 months ago.
Just advise me if I wait for two or three days for the laparoscopy ?
Customer: replied 10 months ago.
Sir here is today ultrasound report
Please advise me