Ovarian Cyst

What are ovarian cysts?

Ovarian cysts are common in women, especially of childbearing age. An ovarian cyst is a fluid filled sac on the ovary. Ovarian cysts, in most cases are benign and resolve on their own. If they are persistent, they may need investigation or medical intervention, to rule out the possibility that they are cancerous.

What are the symptoms?

Ovarian cysts have no symptoms in most cases but can sometimes cause variable abdominal or pelvic pain, or pain during intercourse. If a cyst is large, it may cause twisting of the ovary that leads to pain, and occasionally loss of the ovary.

How are ovarian cysts investigated?

A vaginal ultrasound is often the first investigation to elicit the characteristics of the ovarian cyst. A repeat ultrasound is often required 6 weeks after the first scan to see if the cyst has resolved by itself with time. Sometimes additional tests such as blood tests of tumour markers (blood substances produced by certain ovarian tumours), CT or MRI scan.

What are the treatment options?

Most ovarian cysts will resolve on their own without any treatment. Hormonal treatments may be prescribed to reduce the formation of new ovarian cysts. Surgery is the option of choice for persistent or symptomatic cysts, as it’s the most direct way to get a definitive diagnosis of what type of ovarian cyst it is and in most cases is the definitive treatment as well.

What is involved in surgical treatment of ovarian cysts?

Most surgical treatments for ovarian cysts are performed during a laparoscopy. This is minimally invasive endoscopic surgery where two to four small incisions are made on the abdomen, where a camera is inserted through one of the incisions and instruments for excision of the cysts are inserted through the other incisions. Carbon dioxide gas is then introduced into the abdominal cavity to create space for surgical excision of the cyst. Laparoscopies are day procedures under general anaesthesia.

Some larger or more complicated ovarian cysts may require an open surgery approach. This involves a larger incision on the abdomen and will require one to two days overnight stay in hospital after the operation.

The aim of either surgical approach when treating ovarian cysts is to only remove the cyst, leaving the ovaries intact. However, if the cyst is too large or connected to ovarian tissue, part or all of the ovary may need to be removed.