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04.01.2016, admin
Dermoid cysts are formed from eggs which despite not being fertilized by sperm, begin to pathologically divide and develop into masses which may possess characteristic human tissues such as fat, bone and hair.
Most ovarian cysts are asymptomatic, however they may cause pain and other symptoms if they are particularly large, rupture, undergo torsion or become infected and hence may need surgical removal.
Since the ovaries are responsible for producing the ovum (egg), by removing the ovaries, permanent infertility occurs and patients will never be able to conceive. A variety of deleterious effects on a woman’s long term health including an increased risk of: premature death, cardiovascular disease, cognitive impairment or dementia, Parkinson’s disease, osteoporosis and bone fractures, a decline in psychological well-being and a decline in sexual function. In order to try and mitigate some of these deleterious effects of a bilateral oophorectomy, Hormone Replacement Therapy (HRT) is usually prescribed, especially in young patients. It quickly became apparent that all I had heard about you from some of your patients, and peers is correct. It has been my first day back at work and I have been inundated with people telling me how much happier I look. Our family is now complete, and neither child would be here if it wasn’t for your skill as a surgeon. Once again I would like to thank you for your expert care and attention and to let you know that everything is well with me.
I have seen many doctors over the past 15 years many of them have shown limited compassion, empathy and understanding for endometriosis. I would like to express our sincere thanks and gratitude for the treatment we received under your care. We have been trying for 3 Years and this is the first possible month after my operation that it was possible to fall pregnant and I did.
I would like to thank you for the genuine concern, commitment and dedicated care you always gave me. Mr Trehan is the only doctor who has ever listened to me and understood the cause of my symptoms. My quality of life has improved drastically and I can only thank you once more for what you have done for me. Despite all the awards you have won for being such an outstanding and innovative surgeon, the biggest thing for me is that you have never lost sight of your patients! I am so thankful that I was able to be treated by my consultant of choice & In my opinion the best gynae surgeon in the country! Thank you so much for everything you did for me in performing the incredible operation earlier this year. After the follicle ruptures and releases the egg (ovum), a corpus luteum forms which releases hormones.
They may be either “serous” (containing a clear water like fluid) or “mucinous” (containing a thick, viscous fluid).
During this procedure, the cyst is specifically separated from the ovary and then removed from the pelvic cavity. Trehan has demonstrated that no matter how large the ovarian cyst, the ovarian cyst itself can always be removed whilst leaving the ovaries themselves in tact. Further, even after natural menopause, the ovaries produce significant quantities of the male hormones androstenedione and testosterone which are converted to oestrogen in the female body, and these hormones are important for a woman’s health. Unlike natural menopause, these changes caused by a bilateral oophorectomy are abrupt and dramatic due to the sudden loss in ovarian hormones. However, studies have shown that long term HRT use significantly increases the risk of cardiovascular disease, strokes, deep vein thrombosis (DVT – clots in the legs) resulting in pulmonary embolism (potentially fatal clots which migrate to the lungs) and breast cancer.

Trehan’s opinion, under no circumstances should a woman’s ovaries be removed in order to treat ovarian cysts; even if a cyst is present only on one ovary, future problems with the remaining ovary can result in the above problems. Trehan during the laparoscopic removal of large (greater than 10cm in diameter) dermoid cysts on both ovaries in the same patient (ie. Trehan which described a case in which he removed of a large ovarian cyst during pregnancy can also be viewed by clicking here.
Trehan performs all benign gynaecological procedures, including cystectomies via laparoscopic (keyhole) surgery as it is associated with less post-operative pain and complications, a quicker recovery and a far superior cosmetic appearance when compared to laparotomy (open surgery). You have that rare combination of expertise and genuine concern for your patient’s well being. Me and my fiancee will always remember you fondly as the man who gave us the best wedding present imaginable. I have been feeling so much better and my quality of life has improved with my ability to work every day throughout the month.
After suffering for so many years, I am now looking forward to being pain free and can get on with my life. I know it is early days yet, but I wanted to say a huge thank you for you to have made it possible. I always had complete confidence in you and never ever felt like just another number or statistic. I am now managing to work 30 hours per week which would have been unthinkable only a short time ago.
You are a true star & will always be a special person to have had an impact on my life. You understand what it’s like to live with the condition, you are always there for your patients and you have our best interests at heart.
My husband and I again thank you sincerely for your expertise and skill operating and advising us about my endometriosis. These cysts are fluid filled and what is inside these cysts are various in composition—depending on the type of cysts that develop. However, in some instances, the follicle may fail to rupture and continues growing, thereby forming a follicular cyst. In some instances, fluid may abnormally accumulate within the corpus luteum, forming a cyst. During the removal of a dermoid cyst, particular care must be taken in order to prevent material leaking into the pelvic cavity and they are hence placed into a bag prior to removal from the pelvic cavity. By completely separating the cyst from the ovarian tissue and reconstructing the ovarian tissue, the cyst can be completely removed whilst normal ovarian hormone and egg production can be retained.
Your understanding, knowledge and genuine belief in me and my symptoms gave me reassurance finally. Sometimes, it only contains nothing but fluid, oftentimes, it may contain oil, and a lot of other things too.But then cysts do not develop all the time in obvious areas which are palpable by our palms and areas obvious to our naked eyes.
Many couples, especially the women exhibit a multitude of reactions and responses upon discovering they are pregnant. Trehan has demonstrated that all ovarian cysts can be successfully removed via laparoscopic (keyhole) surgery no matter how large they are, even if the patient is pregnant. Trehan’s patients can be confident that their operation will be completed by keyhole means as Mr. Oftentimes, these cysts may develop inside our body cavities and for females, cysts do develop especially in the ovaries and structures adjacent to it.How Ovarian Cysts Develop?Most ovarian cysts occur due to hormonal problems.

Pregnancy is something which many couples look into because it can further strengthen one’s family bond and relationships.
Trehan’s conversion to laparotomy rate is amongst the lowest in the medical literature, as are his major complication rates, reoperation rates and readmission rates. Furthermore, it will add joy to the couples once this pregnancy has been carried out healthily.However, pregnancy is not an easy thing for all women. Further, over 90% of Mr Trehan’s patients are able to leave the hospital after just an overnight stay in hospital.
However, with some hormonal changes some of these ovarian follicles do not progress to ovulate and burst—this leads to an “impacted” form of ovum. Although pregnancy is not a disease, it can be accompanied by many other complications and side-effects. While this may sound very threatening, a woman should not freak out and be overly anxious about this condition.In majority of cases, ovarian cysts are harmless and do not pose threats to a woman’s life and the baby inside her womb. This may also be accompanied with a cramping pain in the pelvic area like that of dysmenorrheal. Most women with ovarian cysts in pregnancy carry their pregnancy out well… the cysts do disappear on its own. To further explain how ovarian cysts in pregnancy happen and how these can be treated, read on…What Are Ovarian Cysts In Pregnancy?Ovarian cysts in pregnancy are usually benign and contain harmless and non-toxic fluid.
Also, the ovaries may experience torsion due to the twisted formation of the ovarian follicles which may lead to infertility. Many cases of ovarian cysts in pregnancy resolve on their own, even without the woman knowing its existence. This is attributed to an impaired blood supply to the ovarian tissues leading to cell and tissue death.Treatment of Rupturing Ovarian CystsOvarian cysts may pose life threatening complications therefore, immediate hospitalization may be necessary. However, there are instances that ovarian cysts may grow large and cause pressure to neighboring organs.
Since ovarian cysts in pregnancy often produce limited to no symptoms at all, many diagnoses ovarian cysts are accidental. Sometimes, during pelvic examinations and pregnancy related procedures like abdominal ultrasound, a cyst may be diagnosed. A large cyst, on the other hand may cause signs and symptoms like pressure on the site, stomach pain, nausea and vomiting, and the likes. However, simple presence of these symptoms does not automatically point out to ovarian cysts since these symptoms are also common in pregnancy per se.When Ovarian Cysts in Pregnancy Become ComplicatedThere is a small number of ovarian cysts which may be a source of complication during pregnancy most especially if these are large enough to cause pain and pressure to the uterine walls. When the pain due to the pressure of these cysts become unbearable and acute, miscarriage can happen. Thus, it is important to immediately respond to pain especially when a woman is pregnant and diagnosed with ovarian cysts.Treatments for Ovarian Cysts in PregnancyNormally, a physician will run an imaging study to determine the size of the ovarian cysts and subsequently rule out any malignancy.
For non-pregnant women, surgery may be performed if the patient prefers removal of the cysts, however the said procedure is not indicated for women who are pregnant due to possible complications.

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