Jun 1, 2009 9:40 am US/Eastern
Dr. Mallika's Files: Case Of Pelvic Pain
Each week Dr. Mallika Marshall shares cases based on true stories from a local urgent care clinic, exclusively on wbztv.com. Names and identifiable characteristics of patients have been omitted or changed to protect patient privacy.
This Week's Case:
A 24 year old woman comes to clinic complaining of right pelvic pain for one month. She says she feels constant pressure in that area but it bothers her more when she's walking or lying down. She has not had any vomiting, diarrhea, fever, pain with urination, or vaginal symptoms. She is sexually active with one partner and has never had a sexually transmitted disease. Her menstrual period has just ended.
On exam, the patient appears comfortable. She has mild tenderness in her right lower abdomen and mild tenderness on that side during the pelvic exam. Pelvic cultures are negative. An ultrasound reveals a 3 x 3 cm right ovarian cyst.
Discussion
Ovarian cysts are fluid-filled sacs that form in or on the ovary. The most common cause is the menstrual cycle. Prior to ovulation, the ovary forms a protective sac, called a follicle, around an egg. If the follicle fails to release the egg during ovulation, it may persist as a cyst.
Many women don't even know they have an ovarian cyst because they often don't cause symptoms. When they do, most women report pain or bloating in the lower abdomen, abnormal bleeding, or pain during sexual intercourse.
Most ovarian cysts don't need treatment and resolve on their own in a few months. Birth control pills can reduce symptoms and help prevent further cysts from forming. Very large cysts or ones that don't go away can be surgically removed.
Follow Up
The patient was advised to take ibuprofen for pain. She was re-examined six weeks later and her symptoms had completely resolved.
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