Cysts of ovaries - OVARIAN CYSTS

An ovarian cyst is a collection of fluid in the ovary. The vast majority of ovarian cysts are not cancerous. There are two types of cysts – simple cysts and complex cysts.

Ovarian cysts are very common in women at reproductive age. When an egg is developing and released from the ovary, i.e. during ovulation, it is normal to have fluid accumulated in the ovary and form a follicle. This follicle forms a simple cyst, or so-called physiological cysts. When this follicle expands, some women may experience some pressure or pain in the pelvic area, while most women do not feel the cyst at all. Such cysts may only be discovered incidentally during a routine gynaecological checkup or ultrasound scan. They are harmless and will go away by themselves as the fluid is absorbed back into the body.

On the other hand, some cysts do not resolve spontaneously. These are complex cysts, also called pathological cysts. Surgery would be needed to remove the cyst.

Why do complex cysts need to be removed?

Complex (pathological) cysts do not go away by themselves and may cause complications.

• At an unpredictable point in time, the cyst may rupture, causes internal bleeding or infection. They will lead to severe abdominal pain.
• Occasionally, the cyst causes the ovary to twist around, cutting the blood flow to the ovary and causing severe pain – the scenario of ovarian torsion. Emergency surgery will be needed to untwist the ovary and remove the cyst. If the blood flow has stopped for too long, the ovary may not be salvageable. In this case, the whole ovary will need to be removed.

When pathological cysts are diagnosed, it would be better to remove them in a well-prepared elective surgery by your gynaecologist, rather than treating the cysts with an emergency surgery when acute complications occur.

Besides, although ovarian cancer is uncommon, removal of the cysts for pathology diagnosis is an important step to rule out cancer.

Ovarian cysts treatment

Minimally invasive laparoscopic techniques can be used to remove complex cysts (laparoscopic cystectomy). The health of the ovary can be preserved. The cyst will be sent to pathology to confirm absence of cancer.

Compared to traditional open surgery, minimally invasive technique surgery carries advantages of less pain, minimized scarring, reduced infection, a quicker recovery and earlier return to normal activities.

Know more about laparoscopic cystectomy

In women after menopause, the ovaries are no longer needed for fertility purpose. The doctor can remove the diseased ovary together with the healthy ovary on the other side in the same surgery. Removing both ovaries can completely eliminate the risk of ovarian cancer or re-growth of any ovarian cysts in the future.

How can a gynaecologist help when I have an ovarian cyst?

If you have an ovarian cyst, our gynaecologist will help you:

• to differentiate whether it is a normal physiological cyst or a pathological cyst;
• to determine the likelihood that the cyst will go away by itself;
• to develop an observation plan with follow-up pelvic scans to make sure the cyst resolves; or
• to remove the cyst - most likely with our specialized minimally invasive surgery techniques.

Our gynaecologist is also knowledgeable about warning features on ultrasound scan that are associated with the risk of cancer. For these rare cases, we will work together with a cancer expert (oncologist) to develop the best treatment plan.

Each woman is individual and her situation requires an individual plan of management. If you think these issues relate to you, please contact us to arrange a personal consultation and discussion of your case.