Pap Smear Is Not Always Enough: How Ultrasound Helped Detect..

✨Translated by AI

Thinking a Pap smear was enough.

But in reality… it wasn’t a complete check.

It was only when I had an ultrasound that they found an ovarian cyst.

In the end, I had to make the decision to have one ovary removed.

How would you feel if you found out you had to have an ovary surgically removed?

For Ms. Mam – Podjana Rattanapracha, who recently underwent surgery to remove an ovarian cyst, her first reaction upon learning that she needed surgery was neither fear nor worry. Perhaps it was because this was not her first surgery. Another reason might be that this procedure was performed using laparoscopic (minimally invasive) surgery, which is known for smaller incisions, less pain, and faster recovery.

She also felt confident in her medical team. But there were several other important reasons that helped her undergo this surgery with peace of mind.

And Ms. Mam’s experience may change the way many people think about healthcare and surgical treatment altogether.

Getting an annual health check-up helps you understand your body better.

At the age of 48, Ms. Mam is a working woman who spends most of her time in front of a computer. Her life, which once included running for exercise during free evenings and weekends, had to slow down due to joint inflammation. As a result, she can now only do light exercise occasionally. Still, she remains attentive to her health and attends an annual health check-up every year.

“Three years ago, when I reached the age where brain, heart, and lung screenings are recommended, I decided to get checked to see if I had any risk of a stroke. The doctor also examined my thyroid and found a lump. They performed a biopsy. It wasn’t cancerous, but I’ve been taking medication ever since, almost as if it were a chronic condition. I also have high cholesterol, so I need to take medication regularly.”

Learning about the limitations of her own body encouraged Ms. Mam to pay more attention to her diet, which has helped with weight control. She admits that as she gets older, a slower metabolism combined with her health conditions makes it much easier to gain weight than before.

Ms. Mam had not yet reached menopause and had never experienced any gynaecological problems. She had always believed that a pelvic exam and a Pap smear were sufficient, and she had them done every year without fail. She had also never experienced any symptoms related to her reproductive system.

Until the day she decided to undergo an additional test beyond her usual check-up following a recommendation—an ultrasound of the uterus and ovaries two years ago.

That was when an ovarian cyst was finally discovered.

…No symptoms.

…No warning signs.

…No indication of how long it had been there.

…Even though I thought I had been taking good care of my health all along.

From being a healthy person, she suddenly became a patient who needed surgery—and had to lose one ovary, at an age close to menopause.

That was when she realised that a Pap Smear only screens for cervical cancer. It cannot detect problems deep inside the uterus or ovaries. An ultrasound is needed to see those internal details.

Because the female reproductive system is complex, it requires more careful and thorough screening.

If she could turn back time, she believes she would have chosen to get a more complete check-up much earlier.

Don’t assume that you’re “still fine” just because you have no symptoms. By the time you finally find out, it may already be too late to have a choice.

“With an ultrasound of the uterus and ovaries, the doctor found a small mass, about 1 cm in size, near my right fallopian tube. At first, I was shocked, but the doctor said it was probably nothing to worry about because I was already older and approaching menopause. Once menopause starts, it might shrink on its own.

So I didn’t do anything special and continued exercising as usual. The doctor scheduled follow-ups every three months. During the first year, it didn’t grow. However, in the second year, it increased to about 2 cm. Then, in the last six months of the third year, the small mass started growing rapidly—from 2 cm to 3 cm, and eventually to 4 cm.

At the same time, the tumour marker test came back positive. The doctor then suggested two options: taking a tissue sample for staining to check for abnormalities, or undergoing surgery to remove the mass for a proper diagnosis and for safety.

This was because the tumour had grown quickly within just a few months, and there were also a lot of adhesions in the abdominal cavity.”

A surgery without fear or concern

Before deciding to proceed with surgery, Dr. Sai – Dr. Pattraporn Udompornthanakit, her attending gynaecologist at the Women’s Health Centre, BNH Hospital, recommended that she undergo surgery because the ovarian cyst had increased in size and the tumour marker levels were rising. Removing the tissue for examination would provide a clearer and more definitive diagnosis.

The doctor also recommended removing both the ovary and the fallopian tube, since Ms. Mam did not plan to have any more children.

“At first, I was worried about whether my hormones would be affected after the surgery. But the doctor explained that women have two ovaries. If one is removed, the other can still function and compensate. That reassured me that it wouldn’t make me age faster, and it made the decision much easier.”

Dr. Pattraporn therefore recommended that Ms. Mam undergo laparoscopic surgery, which results in smaller incisions, less pain, and faster recovery. The procedure was performed by Dr. Ming – Dr. Sitthanan Thanintranon, a gynaecologist specialising in gynaecologic laparoscopic surgery at BNH Hospital.

“I didn’t feel afraid at all. I’ve had open abdominal surgeries before—both an appendectomy and a cesarean section. But this surgery seemed better than the previous ones because it was done laparoscopically. So I wasn’t worried. After it was done, the wound didn’t hurt at all,” Ms. Mam said.

The only side effects from the surgery were a sore throat that lasted about a week, caused by the breathing tube used during general anaesthesia, and a feeling of abdominal bloating due to the gas introduced into the abdomen so the doctor could clearly see the internal organs during the laparoscopic procedure. This discomfort lasted for about two weeks until the body naturally released all the gas.

“Compared to open abdominal surgery, the first step getting out of bed was extremely painful. When walking, you had to bend forward because the wound hurt so much. With laparoscopic surgery, however, within 24 hours I could already walk slowly and felt quite normal without pain. Within two weeks, I was able to walk at my normal speed again.”

At the time of this interview, it has been three weeks since Ms. Mam’s surgery. Her body has almost returned to 100% normal. She can walk normally, do light exercise, and no longer feels bloated from the gas used during the procedure.

The only precautions remaining are general ones, such as avoiding heavy lifting or intense exercise, which she needs to wait about six months before resuming.

During the first 24 hours after the surgery, before Ms. Mam was able to get up and walk on her own, the nursing team took care of her hygiene and personal needs, while checking her blood pressure every two hours. If there were any issues, the nurses quickly stepped in to assist, provided the necessary medication, massaged her, monitored her condition, and explained possible side effects, such as the discomfort caused by the gas used during the procedure. This support helped her get through the period when she was unable to take care of herself.

“The nurses didn’t just come to check my temperature and blood pressure and then leave. They would ask how I was feeling that day and whether my wound hurt. If I felt uncomfortable at any point, they responded right away.”

The only concern she had about this surgery was the biopsy result from the removed tissue. Just one day later, the test result was ready, and Dr. Sai quickly came to provide an update. It turned out to be a chocolate cyst, which is not cancerous and posed no serious problem. This news greatly relieved Ms. Mam’s worries.

“Once it was removed, I felt relieved. I no longer had to keep wondering whether it would grow in the next three months, or if it might become large enough to press against other organs. Those thoughts had actually made life more difficult. Before, whenever I had abdominal pain or unusual urination, I would wonder if it was because of the cyst. From now on, if I experience any other health issues, I can be confident that it’s likely due to something else—not this tumour anymore.”

Ensure your health checks match your age.

Although Ms. Mam was able to detect the problem early through her annual health check-ups, she hadn’t undergone every possible test. She chose only the screenings that seemed necessary based on her age and existing health conditions—areas where doctors at the Women’s Health Centre at BNH Hospital can provide appropriate guidance for women at each stage of life.

“I’d like to encourage everyone to pay more attention to their health by having an annual check-up and making sure the tests are complete for your age. That way, you can understand how your body is changing. If a problem is found early, it can be treated before it becomes more serious. And if the results show nothing wrong, you gain peace of mind as well.”

For Ms. Mam, she believes that every baht spent on health check-ups is worth it, because her ovarian cyst showed no symptoms. If it had been discovered too late, the treatment might not have been as simple, and the recovery might not have been this quick.

“When I decided to go ahead with the surgery, I also tried to stay optimistic. I thought that if it turned out to be cancerous, treating it early from the beginning would still be better than waiting until it might require chemotherapy or radiotherapy. Fortunately, that wasn’t the case.”

An Interview with Ms. Podjana Rattanapracha

February 2026

Women’s Health Centre, BNH Hospital

Doctor Profile

PATTRAPORN UDOMPORNTHANAKIJ, M.D.

Obstetrics and Gynaecology,Maternal and Fetal Medicine

Women Health Centre

SITTHANAN THANINTRANON, M.D.

OBSTETRICS AND GYNAECOLOGY, REPRODUCTIVE MEDICINE

Women Health Centre

Related Women’s Health Packages

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Cervical Cancer Screening Package (Pap Smear & HPV DNA)

The Pap Smear test combined with the HPV DNA test (Co-test), offers higher accuracy in detecting early-stage cervical cancer. This combination significantly reduces the risk of cervical cancer, with a sensitivity of nearly 100% in detection.

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