Ovarian cysts

An ovarian cyst is a fluid-filled sac within the ovary. Most ovarian cysts are benign and resolve over time, without requiring treatment.  A pelvic ultrasound can indicate the size and type of ovarian cyst, and help your doctor to decide whether medical or surgical intervention is required.

Types of benign ovarian cysts include:

• Functional: these ovarian cysts are formed from the follicles within the ovary and are related to the ovulation process. Treatment is generally not required, as these cysts often resolve on their own.
• Dermoid (Mature teratoma): these cysts are usually made up of several different types of tissue, such as hair, muscle, and bone. Dermoid cysts can grow over time and may require surgical treatment.
• Endometrioma: these cysts are formed in women with endometriosis. They are also called "chocolate cysts", as the cyst contains brown fluid which represents old blood. Endometriomas can cause pelvic pain and/or infertility, and may require medical and/or surgical treatment.
• Cystadenoma: these are benign fluid-filled cysts within the ovary that may require surgical treatment if they grow large in size or cause pain/pressure symptoms.

Most ovarian cysts do not cause any symptoms. Symptoms may occur in the following cases:

• Ovarian Torsion: Severe pain occurs when the ovary twists on itself and cuts off the blood supply to the ovary. This is considered a surgical emergency, as ovarian tissue can be damaged if torsion is not treated immediately.
• Ovarian cyst rupture: Pain may occur when an ovarian cyst ruptures it's contents into the pelvic cavity.
• Hemorrhage: there may be bleeding into the cyst itself, causing pain.
• Large cyst size: large cysts can cause pain and pressure symptoms by compressing neighboring structures within the abdominal cavity.

A basic pelvic ultrasound scan can determine the size, location, shape, and composition (solid or fluid filled) of an ovarian cyst.  Ovarian cysts may be watched over time with repeat pelvic scans, to ensure the cyst resolves or that there are no concerning changes in the cyst appearance (i.e. increase in size).

Your doctor may request a second "advanced" pelvic ultrasound to assess your ovarian cyst in greater detail. This advanced scan is typically performed at a specialist gynaecological ultrasound centre and is offered here at Sonacare.  

If you have a benign ovarian cyst, and do not any experience symptoms, then you probably do not require any treatment. Management options for ovarian cysts include:

• Conservative: No is treatment required. Ultrasound surveillance (repeat ultrasound scans) may be recommended.
• Medical: Sometimes medications such as the oral contraceptive pill are recommended to reduce the risk developing functional cysts, by inhibiting ovulation. Medications may also be used to manage painful endometriomas.
• Surgical treatment: If you are symptomatic (i.e. experiencing pelvic pain, back pain, bowel/bladder symptoms, infertility), then surgical removal of the cyst may be necessary. The surgery performed is called "laparoscopic ovarian cystectomy", where the cyst within the ovary is removed and healthy ovarian tissue is preserved. In older women, both the Fallopian tube and affected ovary are usually removed (i.e. laparoscopic salpingo-oophorectomy), instead of performing an ovarian cystectomy.