Ovarian Cysts

What are ovarian cysts?

Cysts are fluid filled sacs in the ovaries that can be benign (non-cancerous), borderline (risk to become malignant is present) or cancerous.

Causes

Risk factors for cyst formation include early menstruation, irregular menstrual cycles, PCOS, excessive upper body fat distribution, and hormonal treatments like ovulation induction or IVF. 
The likely cause depends on the age of the woman, time of her menstrual cycle and ultrasound appearance of the cyst. Cysts sometimes are formed when the follicle that contains an egg fails to break and release the egg out of the ovary, resulting in accumulation of fluid and sometimes blood in the follicle. Endometriosis can also cause cysts, known as endometriomas of 'chocolate cysts'.

Symptoms

Ovarian cysts usually do not cause any symptoms, but you must be investigated if you observe swelling or bloating of the abdomen, experience significant pelvic pain, severe pain leading to nausea and vomiting pain or in the pelvis region not related to menstruation.

Diagnosis

Cysts are confirmed on ultrasound. MRI is occasionally used for assessment of the severity of endometriosis.Very rarely, if malignancy is suspected CT scan will be requested.

Treatment

Some cysts will disappear by themselves and some cysts that are large will require treatment.

Treatment options include non-surgical and surgical treatment. The non-surgical treatment includes:

• The oral Contraceptive pill help to decrease formation of new cysts and prevent the formation of eggs that will become cysts.
• Non-steroidal anti-inflammatory drugs such as ibuprofen and acetaminophen help to relieve pain.

Surgery is usually recommended to remove the cyst if its size exceeds 5 cm, if the cyst is causing pain and discomfort, or even to remove the whole ovary if they are highly suspicious to be malignant. Laparoscopic surgery (key-hole surgery)  is usually performed, sometimes laparotomy (open abdominal cut) is necessary.