What is ovarian cyst?
Each month during your menstrual cycle, a follicle grows on your ovary. A follicle is where an egg is developing. Most months, an egg is released from this follicle. This is called ovulation. If the follicle fails to break open and release an egg, the fluid stays in the follicle and forms a cyst. This is called a follicular cyst.
Another type of cyst occurs after an egg has been released from a follicle. This is called a corpus luteum cyst. Such cysts often contain a small amount of blood.
Ovarian cysts are more common from puberty to menopause. This period of time is known as the childbearing years. Ovarian cysts are less common after menopause. Many of the cysts usually do not need treatment, as they normally go away on their own within a few months.
Most common types of cysts
- Dermoid cysts: Dermoid cysts tend to occur in younger women. These cysts can grow quite large – up to 15 cm across. These cysts often contain odd contents such as hair, parts of teeth or bone, fatty tissue, etc.
- Cystadenomas: These develop from cells which cover the outer part of the ovary. These types of cysts are often attached to an ovary by a stalk rather than growing within the ovary itself.
- Endometriomas: Many women who have endometriosis develop one or more cysts on their ovaries. Endometriosis is a condition where endometrial tissue (the tissue that lines the uterus) is found outside the uterus. It sometimes forms cysts which fill with blood.
- Polycystic ovary syndrome (PCOS): Polycystic means many cysts. If you have PCOS you develop many tiny benign cysts in your ovaries. The cysts develop due to a problem with ovulation, caused by a hormonal imbalance. PCOS is associated with period problems, reduced fertility, hair growth, obesity, and acne.
Causes of ovarian cysts
It’s not yet known why some women develop ovarian cysts. Some women are at an increased risk of getting functional cysts after using progestogen contraception -for example, the progestogen- only pill, the intrauterine system (Mirena) or the contraceptive implant (Implanon). Some hormones used for the treatment of infertility can trigger functional cysts developing in your ovaries. Also, if you’re being treated with the medicine tamoxifen for breast cancer, you may be more likely to develop cysts, but they usually go away when you finish treatment.
Ovarian cysts often cause no symptoms. When symptoms occur, they are typically pain or a late period. An ovarian cyst is more likely to cause pain if it:
- Becomes large
- Breaks open
- Interferes with the blood supply to the ovary
- Is bumped during sexual intercourse
- Is twisted or causes twisting (torsion) of the Fallopian tube
Symptoms of ovarian cysts can include:
- Bloating or swelling in the abdomen
- Pain during bowel movements
- Pain in the pelvis shortly before or after beginning a menstrual period
- Pain with intercourse or pelvic pain during movement
- Pelvic pain – constant, dull aching
- Sudden and severe pelvic pain, often with nausea and vomiting, may be a sign of torsion or twisting of the ovary on its blood supply, or rupture of a cyst with internal bleeding
Changes in menstrual periods are not common with follicular cysts, and are more common with corpus luteum cysts. Spotting or bleeding may occur with some cysts.
Surgery to remove the cyst or ovary may be needed to make sure it isn’t ovarian cancer. Surgery is more likely to be needed for:
- Complex ovarian cysts that don’t go away
- Cysts that are causing symptoms and do not go away
- Simple ovarian cysts that are larger than 5 – 10 centimeters
- Women who are menopausal or near menopause
Types of surgery for ovarian cysts include:
- Exploratory laparotomy
- Pelvic laparoscopy to remove the cyst or the ovary
Laparoscopic ovarian cysts surgery
The doctor will make a small incision just below the navel. Next, the doctor will insert a laparoscope. This is a thin tube with a camera on the end. To allow the doctor to better view the organs, carbon dioxide gas will be pumped into the abdomen. The laparoscope will be used to locate the cyst. Once found, the doctor will make one or two more incisions. Surgical tools will be inserted to remove the cyst. The doctor may remove tissue for testing. If cancer is found, both ovaries may need to be removed. Once the cyst is removed, the doctor will remove the tools. The incision area will be closed with stitches or staples.
After the procedure, you will be given IV fluids and medicines while recovering. The whole procedure will take about 1 hours. There will be pain after the surgery. Your doctor will give you pain medicine. You may stay overnight, or you may be able to leave the hospital the same day as your surgery.