Looking for gynecologist/hospital for 2nd opinion. (due to cysts)

[Missflurry]

Hi everyone,

To sum it up.

Beginning thus week i found out i was pregnant. But with a checkup later this week the hcg levels dropped and pregnancy is already over. Which is fine.

However my gynecologist (private hospital) did found cysts on my ovaries on both sides. 5 cm and 2 cm.

She recommand surgery to remove it.

As i didnt know much about it back then i thought it was a good solution and necesarry in case of breaking.

But after speaking with other people and reading more about it. Maybe surgery isnt necesarly.

My doctor didnt mentioned what type of cysts it is. Also she didnt say anything about having a follow-up appointment first or other possible treatments.

I will talk to her again.

But I am also looking for second opinion.

I got recommandations for sirijai hospital, chulakorn, and phayathai.

Or these hospitals better than private hospitals in the area of ovarian issues?

Or good hospitals in terms of costs / service?

In my case. I have a good health insurance which doesnt restrict me in choosing a hospital.

But now I am wondering if because of this they give me an expensive solution because my insurance will cover it so they earn more money... Instead of giving me other solution.

In short. What is your experience with gynecologist and are there good ones (maybe better than the ones working in private hospitals) Who would you recommand?

Thanks in advance!!!

[lopburi3]

Phayathai is a group of private hospitals (of moderate cost I believe) rather than government. Believe all would have good doctors available on payment basis. They appear to have provided inexpensive hospital recommendations but you would need specific doctors names for best choice. Others can better address that question.

[Sheryl]

I recommend you consult Dr. Panon at Samitivej. US-trained (Mayo Clinic!) and very good in my experience.

Before going get copies of your medical record if you can.

Below 5 cm the usual management is conservative, not surgical; 5 cm is right on the cusp. It would be important to do a blood test called CA125 if not already done. Also, a repeat ultrasound immediately after your next period may help with the differential diagnosis as these could just be what are called "functional cysts" in which case they will gradually shrink on their own. Diminishing size is a sure sign of no need to worry.

I think most doctors would not recommend surgery assuming these cysts are asymptomatic and that the CA125 is normal, but rather just monitor with periodic ultrasounds. If the CA 125 is elevated that would be different. But see what Dr. Panon thinks, I have great confidence in him.

https://www.samitivejhospitals.com/en/doctors/panon-kasemsarn/

[Sheryl]

P.S. Thai doctors - especially but not only Gyns - often recommend surgery when the option is periodic follow up because they assume the patient will not be compliant about coming back or be able to understand the need for it. This is turn is based on their experience with Thai patients who are indeed on average very poorly informed (especially in matter gynecologiocal). Doctors who trained in the west are used to dealing with better informed patients and will quickly figure out if a woman is able to make an informed choice about conservative management and understand and comply with scheduled follow up.

I just mention this as the advice you got, while probably not correct unless there is more we don't know about (such as abnormal CA125), was not necessarily so for monetary reasons. She may have been concerned that you'd get lost to follow up and the cyst increase in size (the larger a cyst becomes the more danger of rupture or torsion), or about the very small risk of it being maglinant (unlikely but not impossible, periodic CA125 levels and ultrasounds usually would suffice to monitor that possibility).

[Missflurry]

Thank you for the quick responses. I actually had also the ca 125 test done. But I think everything is all good as the doctor didnt say anything about it.

Sheryl I will send you a pm

[fletchsmile]

Phayathai is a group of private hospitals (of moderate cost I believe) rather than government. Believe all would have good doctors available on payment basis. They appear to have provided inexpensive hospital recommendations but you would need specific doctors names for best choice. Others can better address that question.

Phayathai is a reasonable hospital and value for money. The other two are comparable in level and sound like probably recommended by Thai friends or people on a budget.

Our company uses them for annual medical checkups.

The level of English at Phayathai is probably passable but unless someone is fluent in the Thai vernacular of their suthee naripaet I'd rather pick someone with fluent English that's studied overseas so it's 100% clear what you say to them and what they say to you. It's a horrible feeling to have coming away from a doctor for something serious and you're not 100% sure what they meant.

For something serious or important to me or my family - and I'd put OPs pregnancy and possible complications right up there on that score - I'd pick a first tier hospital like Bumrungrad or Samitivej.

Would also add we had possible complications with our first child. After being disatisfied with BNH and a doctor who didn't like being questioned we went to Bumrungrad. One thing that particularly impressed us was the the doctor we saw first saying I'm not an expert in that field for one possible complication and putting us on to a doctor who was to check that out first. Dr.Nopadol Saropala was our gyno. Spoke excellent English - UK educated - very nice and modest guy, open to questions and would always be our first choice as a port of call. No idea if this is his area of expertise, but I'd trust the guy to tell me if it wasn't and get someone else who was