Ovarian Cysts

What are ovarian cysts?

Ovarian cysts are fluid-filled sacs in the ovary that are commonly picked up on pelvic ultrasounds in women of all ages.

Do ovarian cysts cause symptoms?

Most ovarian cysts don’t cause any symptoms. The main reasons for acute symptoms are:

  • Torsion, or the cyst twisting on its base
  • Cutting off the blood supply to the ovary
  • A rupture of a cyst
  • When the cyst(s) become(s) too big

 

The pain can be sudden and severe, often causing the person to ‘double over’. Some cysts grow slowly to a fair size and can present with bloating,  pressure on bladder or bowels and painful intercourse. 

What are the common types of cysts?

There are many types of cysts affecting the ovaries. 

Follicular

Relates to formation of egg follicle

Corpus Luteum

Relates to ovulation

Dermoid

May contain hair, skin, teeth

Endometrioma

Associated with endometriosis

By far, the most common types are the follicular cyst and corpus luteum cyst.

Cancer and borderline tumours are an uncommon cause of ovarian cysts. Usually, these cysts have a complex appearance on scans.

How can you diagnose the type of ovarian cyst?

Some ovarian cysts have a typical appearance on ultrasound scans. Examples of benign or non-cancerous cysts include dermoid cysts and endometriomas, which usually have a characteristic appearance on an ultrasound scan.

Complex-looking cysts with solid elements are harder to diagnose. It’s difficult to differentiate between benign and cancer on ultrasound, so surgery may be required for a definitive diagnosis. 

How are ovarian cysts treated?

Depending on appearance of the cyst on ultrasound, we may recommend a conservative approach consisting of observation and repeat ultrasound. 

Surgery may be recommended for ovarian cysts if they:

  • cause symptoms
  • are more than 5 cm in size
  • have a complex appearance suspicious of cancer
  • have failed to resolve after a period of conservative approach

Do you need to remove the entire ovary?

This isn’t a decision any gynaecologist would take lightly. If there’s any suspicion that the cyst may have a cancerous change then it’s advisable to remove the entire ovary. Trying to remove the cyst only carries the risk of spilling the contents of the cyst inside the abdomen. 

How is the surgery performed for ovarian cysts?

In most cases, ovarian cysts can be removed laparoscopically, also known as keyhole or minimally invasive surgery, leaving minimal small scars on the belly. 

We may have to do a bigger incision if the cyst is large or suspected to be cancerous or could potentially be a borderline tumour. It’s preferable to remove the cyst intact in cases when cancer is suspected.

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