OVARIAN CYST

Ovarian cyst is a fluid filled sac, surrounded by a very thin wall, within an ovary. Most (about95%) are harmless and occurs during the reproductive years at any age.

Ovarian cyst size varies from small 2-3 cm like almond to big as watermelon

Types of ovarian cysts

• Functional cysts, most common and form the part of normal menstrual type and short-lived examples are follicular cyst and corpus luteal cyst
• Complex ovarian cyst (Pathological cysts)-these are cysts that grow in the ovaries, they may be harmless (benign) or cancerous (Malignant) examples are Dermoid cyst, endometriotic cyst, cystadenomas.
• Malignant cyst (cancerous)

Risk factors

• Hormonal problems. These are usually functional cysts and disappear without treatment. They may be caused by hormonal problems or by drugs used to help you ovulate.
• This condition causes uterine endometrial cells to grow outside your uterus. They can grow in the ovary to form cyst Severe pelvic infections.
• Infections can spread to the ovaries and fallopian tubes and cause cysts.
• An ovarian cyst normally develops in early pregnancy to help support the pregnancy until the placenta forms. Sometimes, the cyst stays on the ovary until later in the pregnancy.
• History of previous cyst in the ovary.

Ovarian cyst symptoms

• Ovarian cyst pain can be mild to severe in the lower abdomen
• Fullness in the abdomen
• Pain during or after menstrual periods
• Irregular periods and Infertility
• Urinary or Bowel disturbance

Diagnosis of ovarian cysts

• Ovarian cysts are usually diagnosed by either ultrasound or CT scan
• Blood test- blood tests like CA 125 will be elevated in certain types of ovarian cancer

Ovarian cyst treatment

Ovarian cyst treatment depends on the type of the cyst, age of the patient, she has completed her family or not, size of the cyst and symptoms.

• Observation, this is recommended, especially if the cysts are simple, small and if she in reproductive age, repeat scans are done to assess further.
• Ovarian cyst removal.

Laparoscopic ovarian cystectomy

In this cyst can be removed through small incision. Even large cysts can also be removed by this depending on the type of the cyst. In most of the patients will be discharges on the same day. This type of the surgery does not usually affect a women fertility and recovery time is much faster.

Open surgery

Here big cut is made on the abdomen and recommended if the cyst is cancerous. A longer cut is made giving the surgeon better access to the cyst. Cysts are removed and sent to the lab.

Complications

An ovarian cyst often causes no problems, but sometimes it can lead to complications.

• Ovarian cyst torsion: Here ovary will rotate called torsion especially in dermoid and cystadenomas. It can block the blood supply to the cyst and cause abdomen pain, vomiting, sometime if left alone can cause ovarian tissue death.
• Ovarian cyst Burst (Ovarian cyst rupture): Cyst can rarely rupture because of vigorous activity and sex causing severe pain and internal bleeding.
• Cancer: In rare cases, a cyst may be an early form of ovarian cancer.

Ovarian cysts during pregnancy

Ovarian cysts occasionally develop during pregnancy. In most cases, they are simple cyst and does not need intervention. Surgery may be indicated if there is torsion, rupture, if suspicious of cancer or if the size of the cyst is likely to present problems with the pregnancy.

Can Surgery Be Performed On Pregnant Women?

The risks of surgery and having anesthesia are higher for pregnant women, surgery is only usually performed when the cyst has grown huge which is causing symptoms like pain, for torsion or if any suspicious of malignancy. The procedure can be carried out by laparoscopy and ideally should be done in the second trimester of pregnancy. When the pregnancy is advanced, we will not have much space to perform laparoscopically. There is slightly increased risk of bleeding, abortion and anesthesia in first three months of pregnancy.