Gynecologic Surgery
OVARIAN CYST

OVARIAN CYST

Ovarian cyst

Ovarian cysts are ball like masses that can affect the ovary. Ovarian cysts can occur in one or both ovaries. Ovarian cysts may contain fluid, solid or mixed contents. They may be cancerous, mildly cancerous or non cancerous. Dr Mayur Pai is well trained in the diagnosis and treatment of ovarian cyst. He often performs laparoscopic surgeries and other non surgical treatments related to ovarian cyst.

This page will highlight various aspects of ovarian cyst like:

What are the warning symptoms of ovarian cyst?

Can ovarian cyst affect my fertility?

Why is it important to diagnose and treat ovarian cyst?

Can ultrasound help in diagnosis of ovarian cyst?

What is the role of laparoscopy in the treatment of ovarian cyst?

What are the chances of recurrence of ovarian cyst in the future?

What are the advantages of laparoscopic surgery over open surgery?

What is medical or non surgical management of ovarian cyst?

Keep reading till the end of the page in order for better and near complete understanding of ovarian cyst and the treatment of ovarian cyst. This will help you understand whether surgery or other non surgical treatments are best suited for you.

 

What are the warning symptoms of ovarian cyst?

Ovarian cysts are mostly non symptomatic. This means that in most patients they do not cause any discomfort to the patient like pain or heaviness. These cysts are often diagnosed on ultrasound examination of the pelvis.

Some large cysts may cause pressure symptoms due to their weight or cause a twist (torsion of ovary) and become painful. Swelling of the abdomen may occur in neglected cases of large ovarian tumors. This may also occur in cases of ovarian cancer. Fever is an extremely rare symptom but may occur due to infection.

Can ovarian cyst affect my fertility?

An ovarian cyst if sufficiently large can disturb the normal anatomic relation of the ovary and the fallopian tube. This may prevent the meeting of the eggs and sperms.

Chocolate cysts of the ovary are frequently linked with infertility.

In cases affected with cancer at a young age, the ovary has to be removed and this may causes infertility.

Why is it important to diagnose and treat ovarian cyst?

Ovarian cysts are of different types. Fortunately, most ovarian cysts are non cancerous. Some ovarian cysts may cause harm to the woman if neglected.

Torsion of the ovary or twist of the ovary occurs in about 10% of the cases. The enlarged ovary twists and the ovarian blood supply first decreases and then stops. Torsion of ovary happens to heavier tumors of the ovary and the lady may complain of sharp or dull aching pain in the lower abdomen. If left untreated, the ovary may become gangrenous and may need to be removed.

Rupture of the ovarian cyst may occur in delicate cysts and the content can be spilled in the abdomen. This is not mostly a problem but if the ovarian cyst is cancerous then the cancer may spread. Occasionally a condition called pseudomyxoma of the peritoneum may occur which has very bad prognosis.

Some non cancerous tumours can develop in to cancers over a long period of time. Fortunately there is only 1 to 2% chance that this happens.

How does the doctor do diagnosis of ovarian cyst?

Ovarian cysts are best diagnosed by ultrasound examination. Ultrasound examination can clearly reveal the size, number and location of the ovarian tumors. Ultrasound also gives an idea about the contents of the tumour like- clear fluid, thick fluid, solid or mixed contents and this tells us the probable type of ovarian tumour.

Ultrasound may also help in measuring the septations in the ovaries. This measurement helps us in diagnosing the possibility of cancer.

Doppler ultrasound can help in improving the diagnosis of cancerous ovarian tumors.

CT and MRI scan may occasionally be used to more accurately give an idea of the type of ovarian tumor.

Blood tests called tumor markers are done to give us an understanding of the tumor’s cancer status. These tests are also helpful for follow up of a patient who has been treated for ovarian cancer.

Most ovarian tumors can be diagnosed with relative accuracy using these tests but in some complex ovarian masses, the final diagnosis is revealed only after surgery.

What is the role of laparoscopy in the treatment of ovarian cyst?

Ovarian tumours can be operated by laparoscopic surgery. Laparoscopy gives us an opportunity to examine and take biopsies from the entire abdomen.

Most non cancerous ovarian tumors are best treated laparoscopically and the lady benefits from a better cosmetic result, lesser pain and blood loss.

Laparoscopic surgery is also good for the surgical staging of ovarian tumors and for removal of small to medium size cancerous ovarian tumors. Large ovarian tumors may require open surgery or a combination of laparoscopy and open surgery for safe removal of the tumor without rupture.

The treatment of choice depends on several factors like patient’s history, imaging and blood markers and other relevant tests. Medical treatment can be easily done for commonly occurring benign follicular cysts. Surgery by laparoscopy or laparotomy also needs to be discussed with the patient with respect to the advantages and disadvantages of the surgery and the patient’s goals with respect to her fertility.

What are the chances of recurrence of ovarian cyst in the future?


The chances of recurrence in benign (non-cancerous) ovarian cysts is very low. However new cysts from a different area may appear. This happens in cases of long term diseases like endometriosis in which ovarian chocolate cysts are common. Chocolate cysts of the ovary often recur and the patient may need continued treatment for several months and years.

Borderline ovarian cancers and ovarian cancers have a high chance of recurrence. If these ovarian cancers are removed, then the recurrence chances depends on the ovarian cancer type and the amount of spread that has occurred. Early diagnosis and treatment of ovarian cancer may help in better chances of a permanent solution.

What are the advantages of laparoscopic surgery over open surgery?

Laparoscopic surgery is a type of gynaecologic surgery done through small incisions called key holes. These surgical incisions are the size of 5mm to 10 mm and heal rapidly with less pain and scarring.

Laparoscopic surgery can be used for the diagnosis and treatment of ovarian cysts and ovarian cancers.

Laparoscopic surgeries have a advantages like better cosmetic outcome, lesser pain and blood loss. In case of some cancers, Laparoscopic surgeries may need to be combines with open surgeries for better tumor removal with less chances of tumor ruptures.

What is medical or non surgical management of ovarian cyst?

Some types of ovarian cysts are treated non surgically using tablets and injectables but others strictly need surgical intervention. The best type of treatment is decided by the different investigations like imaging and blood tests. Sometimes the patient’s general condition and future fertility needs are also taken in to account while making the optimum decision.

It is best that the patient consults a well-qualified gynaecologist who has good experience in treating ovarian cysts.

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