Ovarian Cysts

What are ovarian cysts? What is the most appropriate treatment?

Ovarian cysts are fluid-filled sacs located in an ovary.

Women have two ovaries on one side of the uterus and each one is about a size of an almond.

Ovaries of reproductive-age women produce and release mature oocytes (eggs) during each menstrual cycle.

Many women have ovarian cysts at some time during their lives.

 

How is the diagnosis made?

The diagnosis is made by transvaginal ultrasound or Magnetic Resonance Imaging (MRI) of the lower abdomen.

 

What are the symptoms?

  • Pain before or during the menstrual period or during sexual intercourse
  • Bowel pain or pressure
  • Nausea, vomiting and heaviness in the abdomen
  • Difficulty urinating
  • Bladder pressure that causes frequent urination or urinary retention
  • Abnormal menstrual periods (deviations in terms of frequency and volume of menses)

 

Which are the types of ovarian cysts?

There are various types of ovarian cyst.

The majority of ovarian cysts are benign, in other words they are not cancerous. 

The most common types of ovarian cysts are the following:

  • Functional ovarian cysts

Ovaries produce oocytes (eggs) each month. Sometimes, an oocyte may continue to grow and turn into a cyst. Functional cysts are usually harmless, painless and they go away on their own during the next menstrual cycles.

  • Dermoid ovarian cysts

This type of cysts can contain tissue like hair, skin or teeth. Most of them are non- cancerous; however, they can cause ovarian torsion.

  • Cystadenomas ovarian cysts

Cystadenomas consist of ovarian tissue and may be filled with mucus and other fluids. Also, they can turn into malignancy.

  • Endometriomas ovarian cysts

They are cysts developing as a result of endometriosis (a condition in which endometrial cells grow outside of the uterus). The most common symptoms are the painful periods and the infertility problems.

 

What is the relationship between ovarian cysts and ovarian cancer?

As time goes by, a benign cyst can turn into cancer.

Unfortunately, it is not known how long the process of transformation takes or the factors that might increase this risk.

There is no doubt that the women who have family history of ovarian cancer need immediate treatment.

Of course, in some cases, ovarian cysts have features of malignant tumors from the initial screen examination.

 

When ovarian cysts should be removed?

  • If you have family history of ovarian cancer
  • If the features of the ovarian cyst are suspicious for malignancy
  • If the cyst causes pain, pressure, trouble with bowel movements or urination
  • If you have abnormal periods associated with infertility
  • If you have a functional ovarian cyst that it does not go away on its own and it is getting bigger

 

Which is the treatment of choice?

The ovarian cyst resection is usually performed laparoscopically.

 

What are the complications of an ovarian cyst if left untreated?

If the management of an ovarian mass is conservative, the risk of possible complications should be assessed. For example:

  • An ovarian torsion. The presence of an enlarge cyst makes the ovary prone to torsion (twisting of the ovary) which can lead to necrosis of the ovary
  • A rupture ovarian cyst. It can cause acute pain leading internal hemorrhage
  • A progress of cyst to malignancy

 

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