What are Ovarian Cysts?
Cysts are fluid-filled sacs that develop on the ovaries. Cysts are quite a common finding on a pelvic ultrasound scan. Majority are harmless, don’t cause any symptoms, and resolve without any treatment within a few months.
Can cysts cause symptoms?
Cysts can cause symptoms if the following occur:
• Cyst Rupture: This is where the cyst splits (releasing its contents into the abdomen)
• Cyst enlargement: If cysts get very large, they can press on neighbouring structures
• Cyst Torsion: This is when the cyst twists around the tissue it is connected to. When this occurs, it blocks the blood supply to the ovary
• Cyst Haemorrhage: This is when there is bleeding into the cyst
The most common complaint is pelvic pain or pressure. Other symptoms may include a sudden onset of severe pain, bloating, painful sex, passing urine frequently, change in bowel habit, abnormal bleeding pattern, or feeling full after eating small amounts of food, so speak to your doctor if you develop any of these symptoms.
What types of cysts are there?
Cysts can be broadly divided into TWO types: PHYSIOLOGICAL and PATHOLOGICAL
These are cysts that can develop during the normal menstrual cycle. They are often harmless, rarely cause any symptoms, and usually resolve on their own.
These are cysts that are not related to your menstrual cycle and contain abnormal cells. There are many different types.
These cysts are not cancers however, it’s important to remember that pathological cysts have the potential to undergo changes and these changes over time can lead to more serious conditions such as ovarian cancer.
They found a cyst on my ovary… now what?
The way cysts are managed depends on several factors: size, symptoms, appearances on ultrasound, the level of a marker called a Ca125 (if available) and whether the patient has gone through the menopause.
As a rule of thumb, women who have not gone through the menopause (premenopausal) and have small (less than 5cm in diameter) simple ovarian cysts generally do not require follow-up, as these cysts are very likely to be physiological and almost always resolve within three menstrual cycles. If a woman has gone through the menopause, (postmenopausal) these cysts will require further monitoring, as cancerous cysts develop more commonly in postmenopausal women.
Premenopausal women with simple ovarian cysts between 5-7mm in diameter should have yearly ultrasound follow-up and those with larger simple cysts should be referred to a Gynaecologist for further investigation. Postmenopausal women with simple cysts larger than 5mm should be referred to a Gynaecologist.
Any cysts with worrying or suspicious features should be referred urgently to a Gynaecologist
How are cysts treated?
Physiological cysts do not require treatment as they often go away on their own. If cysts need to be removed, the procedure is usually either a laparoscopy (where a device with a camera is placed through small incisions in the abdomen), or a laparotomy where a larger incision may need to be made in the abdomen.