Conditions

Ovarian cysts occur frequently and generally they are physiological (normally occurring).

Many ovarian cysts are asymptomatic and symptoms of ovarian cysts can include:

• Pain (on one side only or both sides of the pelvis)
• Abdominal swelling and bloating (if the cyst is particularly large)
• Urinary frequency
• Constipation

Diagnosis of an ovarian cyst involves:

• Taking a history of symptoms
• A physical examination  
• Ultrasound scan
• CA125 blood test if an ovarian cyst is found on ultrasound

Types of ovarian cysts:

• The great majority are physiological (normally occurring)
• Dermoid cysts – can contain hair and sebaceous fluid from the skin and very rarely teeth
• Serous and mucinous cyst adenomas – these are benign cysts
• Endometriomas – these are cysts that are found in association with endometriosis containing old blood, these are also known as chocolate cysts
• Borderline ovarian cysts – They have the potential to become malignant
• Malignant or cancerous ovarian cysts. These cases are referred to a Gynaecological Cancer Specialist

Management of ovarian cysts

If there are few symptoms and the cyst is less than 5cm in diameter then:

• CA125 blood test is required
• If this is normal a follow-up ultrasound scan in 6-8 weeks
• If the ovarian cyst is persisting at follow-up scan then Laparoscopic removal may be indicated

If there is significant pain associated with ovarian cysts then Laparoscopic surgery is recommended for their removal.

Laparoscopic cyst removal involves;

• Insertion of a laparoscope or telescope through the umbilicus (tummy button)
• Distending the abdomen with gas to obtain a good view
• Three small incisions in the lower abdomen
• Removal of the cyst from the ovary
• It is rare to have to remove an ovary unless it is malignant (cancerous) or the women is post-menopausal

The surgery takes 1-1½ hours, requires 2 days in hospital and 7-10 days to recover.