Friday, June 24, 2011

Recurrent ovarian cyst causing left ureteric obstruction



A 40 year old lady presented with history of left flank pain of 15 days duration.There was recent exaggeration of the pain intensity.There was no history of fever,dysuria and lower urinary tract symptoms.She gave history of having been operated for ovarian cyst 3 months back.The histopathological report of the cyst was benign.

The biochemical and hematological parameters were normal.CA-125 antigen assay was also normal.The urine analysis didnot reveal any abnormality.The USG abdomen showed left hydroureteronephrosis with cyst in pelvis.The ureter could be traced only to the cyst region.She was subjected to Contrast Enhance CT scan which showed cyst compressing the ureter causing hydroureteronephrosis.

She underwent RGP and DJ stenting followed by aspiration of the cyst under USG guidance.The cytology of the aspirated cyst was essentially normal.Two weeks post-operatively the patient is doing well.We have planned a repeat CT scan after a period of 6 weeks and decide further management.Any recurrence of the cyst would then need laparotomy with cyst removal.

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