Ovarian cysts are fluid-filled sacs that form within the ovary or on its surface. The size of an ovarian cyst varies. It can be as small as 2 cm to more than 20 cm in diameter. Most cysts that are smaller than 3 cm in diameter are functional cysts and will resolve with time. 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:
- Women of reproductive age. A woman is more likely to develop a cyst If she is still menstruating and her body is still producing estrogen.
- Hormonal problems. This is particularly common in those who are taking fertility medications to address hormonal problems.
- Pregnancy. The cyst the forms during ovulations may stay on the ovary throughout the pregnancy.
- 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.
- Family history.
- A previous ovarian cyst. If you have had one, you are more likely to develop more.
Lower abdominal or pelvic pain Pain or pressure upon urination or bowel movement Infertility Bloating or increased abdominal girth Fullness or heaviness in the lower abdomen Chronic pelvic pain or low back pain Irregular menstrual periods
In instances where the ovarian cyst ruptures, bleeds or twists (torsion), it can cause severe pain that comes on suddenly. This usually occurs in the mid-menstrual cycle or after strenuous activities.
- Pelvic ultrasound. In a transvaginal approach, a thin covered wand is placed into the vagina to visualize the uterus and the ovaries. This produces better 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.
- Blood test for tumor makers. A blood test may be ordered if there is a suspicion for ovarian cancer especially CA-125 which is often elevated with ovarian cancer.
- 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 removal (cystectomy) at the same setting.
- Pregnancy Test. The pregnancy test may be done in order to rule out ectopic pregnancy since many of the signs and symptoms of an ovarian cyst are also observed in an ectopic pregnancy.
In certain circumstances, a CT or MRI scan may be necessary to arrive at a diagnosis.
- 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.
- 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.
- Laparotomy (open surgery) – This is a surgical approach is recommended if you had a previous surgery, if the cyst is large, or if the cyst has suspicious features for cancer.
- 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 to get more information about ovarian treatment and removal.