Overview of an Ovarian Cyst
Each month, during your normal menstrual cycle, a cystic structure known as a follicle forms. The follicles secrete estrogen and progesterone which stimulate the release of a mature egg from your ovary. In some instances, the follicle continues to grow and becomes known as an ovarian cyst.
Ovarian cysts are relatively common in all women who continue to experience menstruation. In many instances, ovarian cysts are completely asymptomatic: a woman will not experience any pain or other signs or symptoms which alert her to the fact that she has a cyst. Most ovarian cysts will resolve, even without treatment, after one or two menstrual cycles.
An ovarian cyst may be simple, or complex. A simple ovarian cyst contains only fluid, however a complex ovarian cyst contains both fluid and solid contents. Follicular cysts and corpus Graafian cysts are both simple, functional cysts. Complex ovarian cysts may be one of several types, namely; dermoid cysts, endometriomas and cystadenomas. Complex ovarian cysts have greater potential to develop into a malignancy, and treatment for complex ovarian cysts is often less conservative for this reason.
In many instances, asymptomatic ovarian cysts will be discovered as part of a routine pelvic examination or an ultrasound that has been ordered for another purpose. It is usual for an ovarian cyst that is small and favorably located to be observed over several menstrual cycles, to see if it resolves on its own. Sometimes, ovarian cysts do cause obvious signs. These include irregular or painful periods, pain during sexual intercourse or when passing a bowel movement, or pain in the abdomen which may radiate to the thighs and buttocks.
Whilst ovarian cysts may at first be diagnosed by a manual pelvic examination, this diagnosis will usually be confirmed by performing an ultrasound. This non-invasive technique will allow your doctor to understand the size, composition and location of your ovarian cyst. It is also likely that you will be asked to undertake a pregnancy test, as your doctor will want to rule out an ectopic pregnancy. A blood test is also likely: your doctor will test for the CA 125 antigen, which is present when a cyst is malignant, but also indicates the presence of pelvic inflammatory disease or endometriosis.
Treatment for your cyst will depend on your age, the type of cyst, its location, size and speed of growth. Sometimes ovarian cysts can cause complications; they may rupture, which in turn may cause internal bleeding, shock or peritonitis. They may also become large enough to cause your ovaries to twist, which causes extreme discomfort.
In certain circumstances, your doctor may believe that the best option is for surgical removal of your ovarian cyst. Laparoscopy is a more conservative, "key hole" surgery, where three small incisions are made in your abdomen. Small surgical instruments are inserted through these incisions. In other cases, your doctor may perform a more traditional surgery, where a larger incision is made in the abdomen and the surgery is "open". It is typical for your doctor to send any removed cystic tissue for biopsy during your laparoscopy or open surgery. If this tissue is deemed to be malignant, your doctor may wish to remove some of your reproductive organs, including your ovaries, fallopian tubes or uterus. The circumstances under which an oopherectomy (removal of ovaries) or hysterectomy (removal of uterus) will occur will be discussed with you prior to the surgery.
Recovery from surgery is usually rapid and complete, however actual recovery times will differ depending on the type of surgery you have experienced. Your ongoing prognosis is likely to be very good, although if you have not had your ovaries removed; it is common for cysts to reoccur.
What are the Symptoms of a Ruptured Ovarian Cyst