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When symptoms do occur, they may include: Pelvic pain or a dull ache in the lower abdomen Bloating or abdominal swelling Pain during intercourse Changes in menstrual patterns Difficulty emptying the bladder completely Complications are uncommon but can include cyst rupture (causing sudden, sharp pain), ovarian torsion (twisting of the ovary, which is a surgical emergency), or, rarely, malignant transformation

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Coordinating multiple injections requires practical planning

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