What are ovarian cysts ?
An ovarian cyst is a fluid-filled sac in the ovary. Cysts on the ovary are very common. The vast majority of ovarian cysts are benign (non-cancerous) but some are cancerous, or may become cancerous over time. Ovarian cysts can vary in size - from less than the size of a pea to the size of a large melon (occasionally even larger). Cysts can be physiological or pathological .
Physiological or Functional ovarian cysts are the most common type. They form in some women of childbearing age (women who still have periods) when there is a functional fault with ovulation. They are very common. There are two types of functional cyst:
- Follicular cysts. A follicle can sometimes enlarge and fill with fluid. They can occur commonly in women who are receiving infertility treatment.
- Corpus luteum cysts. These occur when the corpus luteum fills with fluid or blood to form a cyst. A blood-filled cyst is sometimes called an haemorrhagic cyst.They usually do not need treatment, as they normally go away on their own within a few months.
Pathological cysts are of different types like Dermoid cyst, cystadenomas ,Endometriomas( chocolate cyst) etc. Depending on the history and ultrasound picture one can judge the nature of the cyst. The exact diagnosis of a nature of the pathological cyst is made on removing it and on Histopathlogical examination.
Another form of cysts are those seen in PCOS. In PCOS one develops many tiny benign cysts in the ovaries giving it a neclace like appearance. 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 and family history of diabetes.
What are the symptoms, problems and possible complications of ovarian cyst?
Most ovarian cysts are small, benign (non-cancerous), and cause no symptoms. Some ovarian cysts cause problems which may include one or more of the following:
- Pain or discomfort in the lower abdomen. The pain may be constant or intermittent. Pain may only occur when you have sex.
- Periods sometimes become irregular, or may become heavier or lighter than usual.
- Sometimes a cyst may bleed into itself, or burst. This can cause a sudden severe pain in the lower abdomen.
- Occasionally, a cyst which is growing on a stalk from an ovary may twist the stalk on itself (a torsion). This stops the blood flowing through the stalk to the cyst and causes the cyst to lose its blood supply. This can cause sudden severe pain in the lower abdomen.
- Large cysts can cause your abdomen to swell, or press on nearby structures. For example, they may press on the bladder or rectum, which may cause urinary symptoms or constipation.
- Although most cysts are benign, some types have a risk of becoming cancerous.
- Rarely, some ovarian cysts make abnormal amounts of female (or male) hormones which can cause unusual symptoms.
This depends on factors such as the appearance and size of the cyst from the ultrasound scan. observation if the size is less than 8cm , patient has no symptoms and the features on ultrasound match with a physiological cyst.
Many small ovarian cysts will resolve and disappear over a few months. You may be advised to have a repeat ultrasound scan after a month or so. If the cyst goes away then no further action is needed.
Removal of an ovarian cyst may be advised, especially if you have symptoms or if the cyst is large or if it shows features suggestive of pathological cyst. Sometimes it might be necessary to remove it to determine exactly which type of cyst it is and to make sure there are no cancer cells in it. Most smaller benign cysts can be removed by a laparoscopic surgery (keyhole surgery).