Ovarian Cyst 

An ovarian cyst is a fluid-filled sac [more than 3cm in diameter] that develops on a woman’s ovary.

There are two main types of ovarian cyst - functional and pathological.

Functional ovarian cysts are the cysts which develop as part of the way the normal ovary works. They are extremely common. They are harmless and usually disappear without treatment. They are always benign and often go unnoticed.

Pathological ovarian cysts are cysts which are not part of the way the ovary normally works. There are several different types of pathological cyst including dermoid cysts and cystademomas. These cysts can grow and become quite large. The majority of these cysts are benign but very rarely they can be cancerous.  Up to 1 in 10 women may need surgery for an ovarian cyst at some point in their lives.

Symptoms
An ovarian cyst is not symptomatic but will cause symptoms if it ruptures, is very large, or it twists [torsion] and blocks its blood supply to the ovary. The symptoms of ovarian cyst includes: 

  • Pelvic pain which may be a sudden, sharp and severe pain to a dull, heavy sensation.
  • Dyspareunia [pain during sex]
  • Difficulty emptying your bowels
  • Frequency of micturition
  • Menorrhagia [heavy periods]
  • Irregular periods
  • Bloating and a swollen tummy

Any sudden, sharp or persistent pain could be a sign that the ovarian cyst has ruptured or twisted. This can be serious and medical attention may be needed immediately.

Investigations

  • A blood test for CA 125 level may help to rule out ovarian cancer. 
  • Pelvic ultrasound scan will provide information on the side, size, appearance of the cyst[s].  This information is vital to help provide a treatment plan. 
  • MRI of the abdomen and pelvis is sometimes necessary for more detailed assessment of the ovarian cyst and surrounding structures. 

Treatments
Depends on severity of symptoms, nature, appearance and size of cyst and the CA125 level.  It may involve conservative or surgical management.   Ovarian cysts maybe removed by laparoscopic or laparotomy approach.