Ovarian cysts are fluid-filled sacs in the ovary that are commonly picked up on pelvic ultrasounds in women of all ages.
Most ovarian cysts don’t cause any symptoms. The main reasons for acute symptoms are:
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.
There are many types of cysts affecting the ovaries.
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.
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.
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:
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.
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.