Ovarian Cysts

Ovarian Cysts

What are ovarian cysts?

Ovarian cysts are masses on the ovaries that can contain fluid or tissue. Ovarian cysts are very common because a woman having regular menses develops a cyst on her ovary every month before she ovulates (corpus luteum cyst). This is a normal monthly process of cyst development, releasing of the egg and then involution of the cyst. However, many times the cyst may not resolve spontaneously or may grow.

What types of ovarian cysts are there?

Ovarian cysts can be cancerous or non-cancerous (benign). Benign cysts tend to be filled with fluid and either go away or stay the same. Signs of cancerous cysts include solid components in the cyst or rapid growth. Cancer is also more likely in cysts that are larger or in women who are older (especially after menopause).

How are ovarian cysts diagnosed?

Ovarian cysts can be diagnosed by pelvic examination, pelvic ultrasound or MRI scan of the pelvis. Cysts can cause pain especially if they cause the ovary to twist (ovarian torsion), cause bleeding into the cyst (hemorrhagic) or become large. CA-125 is a blood test that can help determine if the cyst is cancerous but it should be used with caution especially if the women is premenopausal (still having periods) as there are other non-cancerous conditions that can cause an elevation of CA-125 (fibroids or endometriosis). Because of this, CA-125 is NOT routinely recommended to screen women without a cyst for ovarian cancer.

What is the treatment?

Treatment of ovarian cysts can include observation to see if the cyst will go away on its own, drainage of the cyst, removal of the cyst or removal of the entire ovary. Drainage of the cyst can be accomplished by putting a needle into the cyst under ultrasound guidance. Cysts can be drained or removed during laparoscopy (minimally invasive surgery using a thin tube with a camera that is placed through an incision right under the belly button). If the cyst is large or worrisome for cancer, a full incision on the abdomen to open up the abdominal cavity and remove the cyst or ovary may be necessary.