Ovarian Cyst Treatment
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Frequently Asked Questions – Ovarian Cyst
Fluid-filled sacs often develop on your ovaries as a result of your menstrual cycle. These ovarian cysts usually don't produce symptoms and don't last long, so treatment isn't necessary in most cases. However, a cyst on your ovary may also develop due to abnormal cell growth, though most of these are benign. If you have a large cyst, a cyst that ruptures or one that stops the flow of blood to your ovaries, symptoms are likely and you may require surgical intervention.
What Causes Ovarian Cysts?
Ovarian cysts that form during your menstrual cycle are either follicular or luteal cysts. Eggs form inside fluid-filled follicles in your ovaries, but if a follicle doesn't release its egg or if it doesn't shrink after releasing the egg, the follicle grows in size to form a follicular cyst. Typically, these cysts only last a few weeks. Alternatively, luteal cysts develop if the remaining tissue after an egg's release fills up with blood. Luteal cysts are less common and take longer to disappear, though occasionally they may burst, causing bleeding and pain.
If you are not yet 40, you may develop a dermoid cyst, which forms from the cells that would usually develop into an egg. These ovarian cysts have the potential to reach 15cm in size. Meanwhile, cystadenomas usually develop in the over 40s from the cells covering the outside of your ovary. There are two types of cystadenoma you can develop, either small serous cystadenomas that have the potential to rupture or large mucinous cystadenomas that can sometimes fill your whole abdomen. Rarely are any of these ovarian cysts cancerous.
What Are the Symptoms of Ovarian Cysts?
Although symptoms aren't always present with a cyst on your ovary, the most common signs of ovarian cysts are as follows:
Pain in your pelvis, which may be dull or sharp, and can occur during intercourse
Your periods may become lighter, heavier or irregular
Indigestion, feeling full quickly or bloating
Urinating more frequently
How Are Ovarian Cysts Diagnosed?
Although the majority of ovarian cysts are never diagnosed, as there are no symptoms, if you have symptoms suggestive of an ovarian cyst referral to a gynaecologist is recommended.
An ultrasound scan confirms whether or not you have a cyst on your ovary and if so, its size. This scan uses sound waves to form an image of your ovaries when a probe passes over your abdomen; you may also have a probe placed inside your vagina to allow scanning from more than one angle. As the scan is also able to detect whether the cyst is made from largely fluid or solid material, this can identify solid cysts that may possibly be cancerous.
When this is the case, a blood test that measures levels of a protein raised in ovarian cancer is advisable, though further investigations are still needed for confirmation of ovarian cancer, as the results of this test are sometimes elevated in other conditions as well.
How Are Ovarian Cysts Treated?
Even if an ultrasound scan reveals you have ovarian cysts, you won't always need treatment. This decision depends on the size and characteristics of the cyst, whether you are symptomatic or not and whether you are pre or post-menopausal. The latter relates to the fact that after the menopause women have a slightly greater risk of developing cancerous growths on their ovaries. If you are pre-menopausal, immediate treatment isn't usually recommended, as most cysts clear of their own accord in a matter of weeks, though you will receive a follow-up scan to confirm this has happened.
Large or symptomatic ovarian cysts normally require surgical removal. However, you may still be advised to have surgery, even when this is not applicable, if further investigation of the cyst is needed. Surgery on an ovarian cyst usually needs a general anaesthetic, but there are two surgical options, known as laparoscopy and paparotomy.
What Does Surgery to Remove Ovarian Cysts Involve?
If you have smaller cysts, you may be able to have a laparoscopy, which is keyhole surgery. A small incision in your lower abdomen allows insertion of a laparoscope. This small tube serves as a microscope to allow your organs to be seen and the cyst is removed through another small skin cut. The procedure usually takes just an hour and the small cuts are closed using stitches. You can usually return home no later than the next day.
When a cancerous ovarian cyst is a possibility, a laparotomy is necessary. This requires a larger cut to provide easier access to your cyst, which is typically around the bikini line or the midline of the stomach. During this procedure, the cyst and ovary are taken out and sent for laboratory testing, before stitches and staples are used to close the surgical site. You may require a few days hospital stay after this operation.