OVARIAN CYSTS

Facts

  • N Ovarian cysts are fluid-filled sacs that form within the ovary or on its surface.
  • N The size of an ovarian cyst varies. It can be as small as 2 cm to more than 20 cm in diameter.
  • N Cysts that are smaller than 3 cm in diameter are functional cysts and will resolve with time.
  • N Surgery is considered in cases where the cyst is causing symptoms, larger than 5 cm or whereby cancer cannot be ruled out.

Who are at risk

Your likelihood of developing ovarian cysts is heightened by:

  • N Women of reproductive age. A woman has the tendency to develop a cyst If she is still menstruating and her body is still producing estrogen.
  • N Hormonal problems. This is particularly common in those who are taking fertility medications to address hormonal problems.
  • N Pregnancy. The cyst the forms during ovulations may stay on the ovary throughout the pregnancy.
  • N Endometriosis. This condition causes uterine endometrial cells to grow outside of the uterus. Some of these tissues can attach to the ovary and form a growth.
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  • N Family history. There are some women who are genetically predisposed to develop ovarian cysts. 
  • N A previous ovarian cyst. If you experienced developing ovarian cysts, there is a good chance that it may also form again in the future. .

Symptoms

  • N Lower abdominal or pelvic pain
  • N Pain or pressure upon urination or bowel movement
  • N Infertility
  • N Bloating or increased abdominal girth
  • N Fullness or heaviness in the lower abdomen
  • N Chronic pelvic pain or low back pain
  • N Irregular menstrual periods

In instances where the ovarian cyst ruptures, bleeds or twists (torsion), it can cause sudden severe pain. This usually occurs in the mid-menstrual cycle or after strenuous activities.

Diagnosis

  • N Pelvic ultrasound. In a transvaginal approach, a thin covered wand is placed into the vagina to visualize the uterus and the ovaries. This produces clearer images than a scan that is done through the abdominal wall (reserved for sexually naive patients) because the wand/probe can be positioned closer to the ovaries.
  • N Blood test for tumor makers. A blood test may be ordered if there is a suspicion for ovarian cancer. CA-125 is often elevated with ovarian cancer.
  • N Laparoscopy surgery. Through a small incision, a thin scope called a laparoscope can be passed into the abdomen. This allows the surgeon to identify the cyst at close proximity and allows removal (cystectomy) at the same setting.
  • N Pregnancy Test. The pregnancy test may be done in order to rule out ectopic pregnancy since it often has similar signs and symptoms.  

In certain circumstances, a CT or MRI scan may be necessary to make an accurate diagnosis.

Treatment

  • N Ovarian Cystectomy – This is a surgical removal of the cyst from your ovary with the preservation of normal ovarian tissue. It is an appropriate treatment for pre-menopausal women to conserve ovarian tissue for reproductive and hormonal function.
  • N Laparoscopy (keyhole surgery) – This approach is associated with less post-operative pain and faster recovery. It is an appropriate treatment if the risk of malignancy is low.
  • N Laparotomy (open surgery) – This is a surgical approach that is recommended if you had a previous surgery, if the cyst is large, or if the cyst has suspicious features for cancer.  
  • N Oophorectomy – This is a surgical procedure to remove one or both ovaries. It can be done alone or together with another procedure, such as a hysterectomy.

At the Dr. Pamela Tan Clinic, we provide advice and intervention for women with ovarian cysts. Contact us today for proper advice and treatment.