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Ovarian Cysts

Ovarian cysts are closed, sac-like structures within the ovary that are filled with a liquid or semisolid substance. Ovarian cysts may not cause signs or symptoms.

Larger cysts are more likely to cause signs and symptoms such as:

  • Pain in the abdomen, pelvis, sometimes radiating to the lower back.
  • Bloating or indigestion
  • Increased abdominal girth.
  • Feeling an urge to have a bowel movement or having difficult, painful bowel movements.
  • Urgency or frequency of urination
  • Dyspareunia-pain during intercourse

There are many types of cysts affecting the ovaries:

Physiological due to ovulation: which should resolve after 1-3 months

Benign cysts: Like Dermoids (benign teratoma). This is a cyst that may contain hair, skin, teeth, cartilage and virtually any type of cell within the body.

Endometriomas: associated with endometriosis

Cystadenomas (Serous, Mucinous): benign simple cysts that are the most common type

Low malignant Potential tumours (Borderline tumours): somewhere in between benign and malignant

Cancers: most commonly serous adenocarcinoma

Metastatic: spread from another cancer to the ovaries e.g. Breast or Bowel

Most ovarian cysts are not cancerous. The majority of ovarian cysts are diagnosed with a transvaginal ultrasound or physical examination. A tumour marker (blood test) may be helpful in predicting if the cyst is cancerous to some extent. The treatment of an ovarian cyst depends upon the type of cyst, its size, whether it is causing any symptoms, and the risk that it may be a borderline tumour or a cancer. Treatment varies from observation and monitoring to surgical treatment.

Depending on history and examination, if a cyst appears small (less than 5 cm) and is simple on imaging (i.e. there are no solid areas, no increased vascularity or internal complex features) then observation with a repeat ultrasound in 8-12 weeks may be all that is necessary.

Most other cysts if they are low risk can be dealt with conservatively (i.e. by just removing the cyst with cyst wall and conserving the ovary) by laparoscopy.

High-risk cysts, particularly in the older age group, may still be dealt with in consultation with a gynaecological oncologist laparoscopically if appropriate but are generally removed along with the ovary and tube. Frozen section (a pathologist looks at the removed tissue while you are still asleep) is available for intraoperative assessment of these or any suspicious cysts or lumps so that any treatment that is necessary procedure can be performed at the time of surgery.

Whatever the type of cyst, Dr Desai will take appropriate steps to ensure that you are offered the most appropriate treatment for you.