Treatment Options for Ruptured Ovarian Cysts
The treatment you receive for a ruptured ovarian cyst will depend on the severity of your condition when you presented to hospital, the extent of damage caused by the rupture and upon whether or not there were any complications associated with the cystic rupture.
Primary treatment of your condition will be to stabilize your condition, if you have presented in an emergency situation. Doctors will need to assess your airway, breathing and circulation, and may need to start you on intravenous treatment. For very unstable patients, your first diagnostic treatment will include a culdocentesis, to determine the type and extent of fluid in your abdominal cavity.
In most cases of ovarian cyst rupture, whether there have been complications or not, you will be started on antibiotics. In the short term, you may be treated with stronger antibiotics such as Gentamycin or its variants. This drug has a narrow therapeutic window and treatment with this drug will not be extended. You will likely also receive a broad-spectrum penicillin variant as well as a drug such as Metronidazole, which acts against anaerobic bacteria and protozoa. Treatment may also include a cephalosporin drug, such as Cefotetan, which targets gram-positive cocci bacteria and gram-negative rod bacteria.
In pre-menopausal women, your doctor is likely to want to induce an anovulatory state – that is, to prevent ovulation. This will be achieved using oral contraceptive medication. It is important to use this medication to reduce stimulation of the ovaries, which also reduces the risk of further cysts. Treatment with oral contraceptives is not likely to be permanent, and you can discuss your options for falling pregnant with your doctor.
Of course, since ruptured ovarian cysts are often quite painful, your doctor will want to help you manage your pain. The type of analgesic medication you are given will depend on the other medications you are being given. Acutely, preventing infection is the primary concern, so doctors may change your pain medication as your antibiotic load changes. Typically, you may be started on a higher dose analgesic such as Fentanyl or a barbiturate such as Vicodin. A lower dose codeine derivative, such as Tylenol, will be recommended for mild to moderate pain. Newer analgesics, such as Ketorolac may also be useful therapeutic agents in certain situations.
Once your condition has been stabilized, your doctor may want to continue running tests to understand your condition more fully. You are likely to have regular abdominal examinations, both manual and by ultrasound. Your doctor may need to undertake a laparoscopic or surgical exploration to either diagnose or treat your ruptured ovarian cyst. Surgical management of a hemorrhagic cyst will probably be necessary.
If your treatment has included a surgery, your doctor will speak to you about your post-operative care. There will be things that you will need to do, such as regular foot and leg exercises to prevent blood clots if you are bed bound. You will also be advised not to undertake certain activities, such as use of tampons and sexual intercourse, until your medical team is satisfied with the way that your body has healed following surgery.
After you leave hospital, it is likely that your condition will continue to be monitored over a series of outpatient appointments. These consultations may involve further ultrasonography. You may also need to consult your gynecologist to rule out any underlying malignancy or to talk about how your condition may have impacted on your fertility.