OVARIAN CYSTS
What are the common names for ovarian cysts?
Ovarian cysts are also called cystic ovarian mass.
What is the percentage of population affected by ovarian cysts?
It is estimated that 8 to 18% of women suffer from ovarian cysts.
How do ovarian cysts affect you?
Most ovarian cysts are harmless and cause little or no discomfort. However, large cysts can cause pain.
Which part of the body is affected?
The ovaries are paired organs that are a part of the female reproductive system. Situated on either side of the uterus, their main function is to produce ova and release sex hormones. Each month, one ovum matures, is released and picked up by the fallopian tubes for reproduction.
The ovaries develop cyst-like structures every month called follicles. Each follicle has an egg surrounded by fluid, which provides protection as it develops. When the egg matures, the follicle bursts open, releasing the egg and the fluid.
What are the types of ovarian cysts?
There are two types of ovarian cysts:
- Functional ovarian cysts are the most common. They do not cause any harm, are non-cancerous and short-lived.
- Pathological cysts may be benign or cancerous (malignant).
What are the causes of ovarian cysts?
The causes of ovarian cysts depend on the type.
Functional ovarian cysts
The causes of ovarian cysts depend on the type.
These cysts are associated with the monthly menstrual cycle. They form when.
- fluid inside a follicle is not released at the time of egg release (corpus luteum cyst).
- the follicle swells up but doesn`t release the egg (follicular cyst).
What are the signs and symptoms of ovarian cysts?
Some cysts do not show any signs or symptoms. If symptoms present, the most common is pain, which may be characterised as follows:
- Pelvic pain before your period starts or before it ends.
- Dull pelvic ache that radiates down your lower back and thighs.
- Pain during intercourse.
- Pain with bowel movements.
- Nausea, vomiting or tenderness in your breast like that experienced during pregnancy.
- Abdominal fullness or heaviness.
- Urination problems due to pressure on your bladder.
- Sudden extreme pelvic or abdominal pain.
- Fever or vomiting that accompanies pain.
- Shock.
- Rapid breathing.
- Weakness or light-headedness.
- Ovarian torsion: painful twisting of the ovary when they grow large and move out of their usual position.
- Rupture of a cyst, causing severe pain and internal bleeding.
Other symptoms may include
The symptoms that indicate an emergency include:
Cysts are common during pregnancy and can lead to complications such as torsion or rupture. Ovarian cysts present during pregnancy are closely monitored.
Pathological cysts
These cysts form as a result of abnormal cell growth of either the cells that form the egg or those that cover the ovary. They are not related to the menstrual cycle. Pathological cysts may include:
- Dermoid cysts: develop from cells that form the egg and can contain tissues such as skin, hair or teeth. These are usually benign.
- Cystadenomas: develop from cells that cover the ovary and are usually filled with liquid or mucous.
- Endometriomas: develop when tissue lining the uterus, called endometrium, begins to grow outside the uterus and on the ovaries.
Dermoid cysts and cystadenomas can grow big and shift the ovary from its normal position. This increases the chance of painful twisting of your ovary, a condition called ovarian torsion.
Can an ovarian cyst become cancerous?
Ovarian cysts are mostly benign, but some can become cancerous. The risk increases with age as post-menopausal women are at a higher risk for ovarian cancer.
Can ovarian cysts affect your chances of getting pregnant?
Ideally, ovarian cysts do not interfere with your fertility, but certain conditions associated with the cysts, such as endometriosis and polycystic ovarian syndrome (PCOS) can influence your chances of getting pregnant.
How are ovarian cysts diagnosed?
Ovarian cysts are usually detected during a pelvic exam. Other tests that could help in the diagnosis of cysts include a pregnancy test (for corpus luteum cysts), blood test to detect cancer protein, ultrasound and laparoscopy.
Ovarian cyst treatment - OVARIAN CYSTECTOMY
Most of cysts on the ovary can go away by themselves – these cysts will resolve after a few weeks and do not need any treatment.
However, some cysts are pathological – they do no resolve spontaneously. These cysts need to be removed with surgery.
Cysts need to be removed when:
- they do not go away after several weeks.
- they are large or continue to grow.
- they cause severe pain.
- cancer is suspected.
Removing the cysts can prevent complications of the cysts in the future. These complications include rupture, infection, internal bleeding, or ovarian torsion. When complication occurs, women may have severe acute pain and an emergency surgery will be needed.
Additionally, once the cysts are removed, they can be sent for pathology to make sure that there is no cancerous tissue.
Laparoscopic cystectomy
Ovarian cysts are removed with a surgery called cystectomy. In cystectomy, only the cyst is removed, preserving the healthy ovarian tissues. Most of cystectomy are performed using minimally invasive techniques – laparoscopic ovarian cystectomy.
In laparoscopic surgery, a few tiny incisions (typically 0.5-1cm) are made on abdominal skin. Through these tiny incisions, our surgeon put in a slender, high-definition telescope (laparoscope) to confirm the presence of ovarian cyst. At the same time, its important to carefully check the condition of other pelvic organs, including the other ovary.
Next, laparoscopic instruments are introduced to remove the cyst from the ovary. These fine, special devices will enable the surgeon to perform precise minimally invasive surgery. Finally, the cyst will be taken out of the body with dedicated techniques, such as using a specially designed bag.
Compared to traditional open abdominal surgery, minimally invasive surgery causes less trauma to the body. Recovery is much faster. Patients can often get up within a few hours of surgery, and move around without major difficulty on the next day. Hospital day is reduced. Most of our patients go come on the next one or two days, some even on the same day of surgery, depending on the complexity and extent of the surgery. Normal activities can be resumed much earlier than open surgery, usually in one to two weeks’ time.
Removal of ovaries - Laparoscopic oophorectomy
In some cases, the entire ovary may need to be removed, for example, when the cyst is very large and has destroyed the ovary. Because of new advances in laparoscopic instruments and techniques, the entire ovary can be removed with minimally invasive surgery as well. Surgical removal of the ovary is called oophorectomy.
Women are normally born with two ovaries. If the other ovary is healthy and preserved, it will still function to maintain normal hormone cycles and ovulation for potential conception and pregnancies in the future, even after the diseased ovary is removed.
For women after menopause, its recommended to remove both ovaries in the same operation. This will completely eliminate the risk of re-growth of the cysts or ovarian cancer in the future.