22 Jan What does Ovarian Cyst Treatment entail?
Ovarian cysts are fluid-filled sacs that develop on or inside the ovaries. While many ovarian cysts do not cause any symptoms and are incidentally found during radiological imaging, they can sometimes cause discomfort and pain. Most ovarian cysts revolve spontaneously, however, in some cases ovarian cyst treatment is required. There are a few options available for treating and removing ovarian cysts. Ovarian cysts that lead to discomfort or pain may require pain medication. Some ovarian cysts will require surgical removal.
For further advice and information about ovarian cyst, please see your local doctor or seek a referral to a Gynaecologist Melbourne.
Diagnosis
There are many different types of ovarian cysts. Ovarian cysts are usually diagnosed through radiological imaging, most commonly in the form of pelvic ultrasound or MRI.
To understand some of the common types of cysts, it is helpful to explain what normally happens in the ovary from month to month. Ovarian follicles are fluid filled sacs containing the precursors to an egg. From puberty until menopause, follicles develop in the first half of every menstrual cycle in the ovary in preparation for ovulation. Ovulation is the release of an egg (ovum) from a ruptured follicle, usually occurring from just the dominant (largest) follicle. If no pregnancy occurs, the follicles regress. This cycle repeats itself the next month, and the next.
Common types of ovarian cysts include:
- Functional cysts – develop monthly as part of the normal function of the ovary, essentially a very large follicle. These will resolve on their own.
- Haemorrhagic cysts – are follicles that have bleeding inside, often occurring at the time of ovulation. They may cause pain and lead to an ultrasound. These will resolve on their own, usually over 1-2 months.
- Dermoid cysts – benign tumours of the ovary commonly filled with tissue such as hair, fat and teeth
- Cystadenomas – benign tumours that contains either mucous material (mucinous) or clear fluid (serous)
- Endometriomas (chocolate cysts) – develop due to endometriosis in the ovary, they are cysts filled with blood
Less common cysts are:
- Borderline ovarian cysts
- Ovarian carcinoma (cancer)
Working out what type of ovarian cyst has been found depends on:
- Your medical history, symptoms
- Imaging features, often including a repeat ultrasound to monitor
- Blood tests such as tumour markers
Once an ovarian cyst is diagnosed, treatment or surgical removal of the cyst may be recommended depending on the type of cyst.
Ovarian Cyst Treatment
Conservative Monitoring
Many ovarian cysts resolve on their own without any treatment. This is usually the case when your doctor or gynaecologist determine that the cyst is not harmful or cancerous. However, ovarian cysts will still be monitored closely until they disappear through regular checkups.
However, your specialist gynaecologist will recommend surgical removal of the ovarian cyst if it is:
- persistent – does not resolve spontaneouly
- large in size (usually more than 4-6cm)
- causing symptoms
- suspicious of cancer
A hemorrhagic cyst (ruptured cyst) will usually improve without any treatment after a few days. Pain medication can be used to manage the pain. If the pain is severe, stronger pain medication and monitoring in a hospital might be needed.
Ovarian Cystectomy
Ovarian cystectomy refers to the process of surgically removing an ovarian cyst. This is done while preserving the ovary, particularly prior to menopause. In cases where a cancerous process is suspected or if there is no normal ovarian tissue detected, the entire ovary does need to be removed (oophorectomy). In a pre-menopausal woman, the menstrual cycle and fertility won’t be affected as the other ovary will still function normally. Laparoscopic surgery is the most common way of performing an ovarian cystectomy.
Laparoscopic Surgery For Ovarian Cyst Treatment
A laparoscopic surgery is a minimally invasive surgical approach that uses small incisions usually 5-10mm each to perform the surgery. A slender tube (laparoscope) fitted with a light source and video camera, together with other surgical instruments such as scissors and graspers are inserted through the incisions. The procedure is done under general anaesthetic.
This approach allows for faster recovery and less pain compared to traditional open surgery. Further, laparoscopic surgery also has a lower risk of bleeding and infection compared to open surgery. Laparoscopic surgery is performed by gynaecologists for ovarian cystectomies and laparoscopic hysterectomies.
Who should perform your Laparoscopic ovarian cystectomy?
Laparoscopic ovarian cystectomies are performed by specialist gynaecologists. Surgical procedures performed by gynaecologists who have completed additional training either in minimally invasive gynaecology surgery, or in surgical gynaecological oncology are associated with lower complication rates and a quicker recovery period. They learn techniques and procedures to complete the most complex of surgeries and also perform a higher volume of complex cases.
The best treatment options for ovarian cyst will depend on the size, type of cyst and the patient’s overall health. This will be determined by your gynaecologist. If you suspect you have an ovarian cyst or have been diagnosed with one, it is important to speak with a gynaecologist to determine the best treatment option for you.
Dr Kent Kuswanto specialises in complex gynaecological pelvic surgery and minimally invasive gynaecology surgery. This includes laparoscopic surgery for ovarian cyst treatment.