Ovarian Cysts
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Ovarian Cysts

Obstetrics and GynaecologyReproductive Medicine

Ovarian Cysts refer to a sac-like structure filled with fluid or solid material formed within the ovaries of females. Ovarian cysts typically develop during ovulation and are generally benign, but certain diseases can also cause them.

Category

Ovarian cysts are sacs located in or on the surface of the ovaries, typically filled with fluid. Ovarian cysts are common gynaecological conditions. Most of the time, patients experience little to no discomfort, and most cysts are harmless, resolving on their own within a few months without needing treatment. However, at times, ovarian cysts can twist or rupture, potentially leading to severe symptoms that should not be ignored.

Category

Ovarian cysts can be classified in detail based on their nature and origin, mainly into the following two categories:

Functional Cysts
Functional ovarian cysts typically form on the surface of the ovaries during or after ovulation and disappear after the release of an egg. However, if the ovary does not release the egg or the cyst persists after egg release, the cyst may enlarge, filling with fluid.

  • Follicular Cyst: During the ovarian ovulation process, a follicle fails to release an egg and instead forms a cyst filled with fluid.
     
  • Corpus Luteum Cyst: After ovulation, the corpus luteum tissue in the ovary is not absorbed properly, forming a cyst filled with fluid.

Harmful Cysts
Harmful cysts are unrelated to the female menstrual cycle. These ovarian cysts may grow larger and rupture, potentially causing pain or harm to the body, and there is a chance of ovarian displacement.

  • Dermoid Cyst: An abnormal cyst containing tissues such as hair, tooth, or skin usually requires surgical removal.
     
  • Cystadenoma: Cysts, which are large cysts filled with fluid, occur on the surface of the ovary and can affect ovarian function.
     
  • Endometrioma: Also known as an endometriotic cyst or "Chocolate Cyst," it is formed by the growth of endometrial tissue inside the ovary, typically associated with endometriosis.

Factors

The reasons for developing ovarian cysts are diverse and may involve physiological changes, diseases, or other factors:

  • Physiological Reasons: Most ovarian cysts are functional and related to normal physiological processes. Ovulation disorders or luteal phase dysfunction may lead to the formation of fluid-filled cysts.
  • Polycystic Ovary Syndrome (PCOS): This is a common condition affecting ovarian function, potentially resulting in the formation of multiple small cysts.
  • Endometriosis: Endometrial tissue growing inside the ovaries can form cysts.
  • Abnormal Endometrial Development: Abnormal growth of endometrial cells in unusual locations may also cause cyst formation.
  • Trauma and Surgery: Ovarian cysts may be associated with trauma or surgery to the ovaries.
  • Ovarian Tumours: Tumours on the ovaries may develop into cysts.
  • Hormonal Changes: Fluctuations in hormone levels can impact the normal functioning of the ovaries, leading to cyst formation.
  • Genetic Factors: Individuals with a family history of ovarian cysts may be more prone to developing this condition.

Symptoms

Ovarian cysts may cause a range of symptoms, and the severity and presentation of symptoms can vary from person to person. Here are the symptoms that may be associated with ovarian cysts:

  • Abdominal discomfort: Patients may experience abdominal bloating, a sense of pressure, or pain.
  • Abdominal pain: One of the most common symptoms may be dull, sharp, or intermittent pain. Pain may occur in the pelvic area or on one side of the abdomen.
  • Irregular menstruation: Ovarian cysts may disrupt the menstrual cycle, leading to inconsistent or abnormal bleeding.
  • Lower back pain: Patients may feel aching in the lower back or lower abdomen.
  • Frequent urination: The presence of cysts may exert pressure on the bladder, causing a sensation of needing to urinate more frequently.
  • Nausea or vomiting: In some cases, ovarian cysts may exert pressure on the digestive system, leading to nausea or vomiting.
  • Pain during coitus: Pain may be experienced during sexual intercourse.
  • Pelvic pain: Pain may be localized in the pelvic area.

Diagnosis and Treatments

The diagnosis and treatment of ovarian cysts usually require a detailed evaluation by a doctor to determine the nature of the cyst and whether treatment is necessary. 
Here are the diagnostic methods for Ovarian Cysts:

Pelvic ExaminationDoctors may conduct a pelvic examination to assess the ovaries' size, shape, and abnormalities.
UltrasoundPelvic ultrasound is the most commonly used diagnostic method, providing detailed information about ovarian cysts, including size, shape, and content (solid or liquid).
CT Scan or MRIImaging studies such as CT scans or MRI can offer more detailed information about ovarian structures to aid further treatment decisions.
CA-125 Blood TestThis blood test measures tumour markers and is sometimes used to assess whether the cyst may be malignant.

 



Treatment Methods:

Observation and MonitoringDoctors may recommend observation and monitoring for functional cysts since most of these cysts will resolve independently within a few months.
MedicationTo control cyst growth and symptoms, doctors may prescribe hormone medications, such as oral contraceptives, to help regulate ovarian function.
Surgical Treatment
  • Cyst Removal: For more significant, persistent, or symptomatic cysts, surgical removal may be necessary.
  • Ovarian Cystectomy: Only the cyst may be removed in cases where the ovary is preserved.

Emergency surgery may be required in cases of cyst torsion, rupture, or other acute issues.

Treating Underlying CausesIf the Cysts is associated with other conditions (such as polycystic ovary syndrome or endometriosis), treatment will address the underlying causes.

FAQ

Some cysts may have a particular impact on fertility, especially when the cysts interfere with regular ovulation. In such cases, treatment may be necessary to improve fertility chances.
Surgical treatment may involve certain risks, including infection, bleeding, anaesthesia reactions, etc. The risks vary depending on the nature of the surgery and the patient's overall health condition.
Most ovarian cysts are benign, but sometimes, they may be confused with ovarian cancer. CA-125 blood tests and other examinations help distinguish between benign and malignant cysts.
Most ovarian cysts cannot be prevented. However, maintaining a healthy lifestyle, regular health check-ups, and seeking early treatment may help reduce the risk.

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