Ovarian Cyst

Ovarian cysts develop as fluid pockets in the ovaries or on their surface. Women have two  ovaries on either side of the uterus that releases eggs every month. The released eggs go to  the uterus through the fallopian tubes. Most ovarian cysts disappear naturally on their own  and are not noticeable. However, some cysts burst, and this could cause lead to serious  health problems.  

Associated Anatomy 

Ovarian cysts could form in one or both ovaries present on either side of the uterus. 

Causes Of Ovarian Cyst 

There are no known exact causes for ovarian cysts.  However, the formation of cysts can be attributed to these reasons: 

  • Hormonal Problems - Hormone imbalances can be caused by drugs or medicines  that help women ovulate.  
  • Pregnancy - Cysts may form during early pregnancy to help support the pregnancy to  term. They may disappear naturally during the curse of pregnancy or will need to be  removed after delivery. 
  • Endometriosis - For women with endometriosis, an endometriosis tissue might attach  to the ovaries, and a cyst called endometrioma could form.  
  • Pelvic Infections - Severe infections in any part of the pelvis could spread to the  ovaries and cause the formation of cysts. 
  • Cancer - Ovarian cancer may also cause cysts in the ovaries. 

Ovarian Cyst Symptoms 

Small ovarian cysts generally do not have any symptoms since they usually dissolve by  themselves. However, if ovarian cysts do not dissolve, they may cause the following  symptoms: 

  • Pelvic pain before and during periods.  
  • Pain in the lower back 
  • Breast tenderness 
  • Nausea 
  • Pain during intercourse 
  • Pain during bowel movements 
  • Painful cramps during periods 
  • Bloated feeling 
  • Clotted blood during periods 

Possible Treatment of Ovarian Cyst 

Most small cysts usually go away on their own. However, doctors may prescribe birth control  pills to stop ovulation for 2-3 cycles. This prevents further cysts from forming, and slowly  existing cysts reduce and disappear.  However, cysts do not disappear on their own and need external help in some cases.  Subsequently, the surgery type also depends on the size of the cysts and how they appear  in the ultrasound scans.  

Laparoscopy 

If the cysts are smaller, doctors would recommend laparoscopy. First, through a small cut  near the belly button, a tool with a camera is inserted for doctors to view the cyst. Then,  another small tool is used to remove the cyst. The procedure is not overly complicated, and  the patient might be discharged on the same day.

Laparotomy 

If cysts are huge or are cancerous, doctors might suggest laparotomy. Here, the doctor  makes a more significant cut on the abdomen. Then, a biopsy is done to determine if the  cysts are cancerous. IF it is cancerous, a hysterectomy is performed to remove the affected  ovaries and, if needed, the entire uterus.  

Risk Factors For Ovarian Cysts 

Ovarian cysts can form at any age. However, they are more common during peak  reproductive years.   Risk factors for ovarian cysts include: 

  • Treatment for Infertility - infertility treatments involve the introduction of many  hormones to create the ovulation cycle in the body. Hyperstimulation of eggs in the  ovaries could cause cysts to form.  
  • Pregnancy - Before the formation of the umbilical cord, a woman's body might form  cysts in the ovaries to help support early pregnancy. 
  • Tubal Ligation - Tubal ligation is the procedure of tying up the fallopian tubes. It  essentially means female sterilization. The process permanently prevents pregnancy  in women. The procedure might cause cysts to form in the ovaries. 
  • Hypothyroidism - Thyroid imbalance cause changes in hormone levels in the body.  These hormones could cause cysts to form in the ovaries.  
  • PCOS: It is a condition that causes lots of small cyst to develop in ovaries as a result  of altered hormonal levels.  

Stages of Ovarian Cysts 

There are no specific stages for ovarian cysts. An ovarian cyst forms naturally as a regular  part of the menstruation cycle and disappears naturally during the cycle. However,  sometimes, cysts do not dissolve but become bigger. The bigger cysts cause discomfort to the affected women. However, the cysts can be treated  accordingly with proper diagnosis and treatment.  

Tests For Ovarian Cysts 

Doctors, typically gynecologists, need to perform multiple tests to analyze the symptoms and  diagnose ovarian cysts. The tests used to conclude the affliction are: 

Pregnancy Test 

A positive pregnancy test without actual pregnancy can indicate cysts - usually corpus  luteum cysts. 

Pelvic Ultrasound 

Pelvic ultrasounds use sonic waves to get a clear picture of the ovaries and the uterus.  Cysts can be seen clearly in the ultrasound. They can help doctors determine the cysts'  shape, size, and consistency for proper treatment. 

Blood Tests 

In the case of solid or semi-solid cysts, there may be the presence of a protein called CA  125. It is a cancer antigen and is present in the case of cancerous cells. Therefore, blood  tests can help doctors identify cancer and begin treatment accordingly. 

Primary Prevention 

Ovarian cysts occur naturally. There is no clear, identifiable way to prevent cysts. The only  way to prevent the rapid progression of growth of cysts is to have regular pelvic  examinations.  Another simple way to identify ovarian cysts is to pay attention to your periods. Any changes  in menstruation or sudden increase in painful cramps need to be communicated to the  doctors immediately. 

Secondary Prevention 

There are no secondary ways to prevent ovarian cysts.  

Additional Types Of Ovarian Cysts  

There are different types of ovarian cysts. 

Functional cysts 

These cysts usually form over the ordinary course of a woman's menstrual cycle.  

Endometriotic cysts 

These cysts form when endometrial tissue attaches to the ovaries and forms cysts. 

Malignant cysts 

Most cysts are benign. However, a few may turn malignant or cancerous. The existence of  malignant cysts indicates ovarian cancer. Regular pelvic tests or biopsies can help identify  malignant cysts quickly and start treatment.  

Benign Neoplastic cysts. 

Although rare, these cysts grow abnormally. Rather than a follicle, neoplastic cysts form out  of germ cells. These cysts do not disappear on their own and need external intervention to  being removed. 

Epidemiology 

Most ovarian cysts resolve naturally on their own, even before being detected. However,  globally, it is theorized that at least 7% of the female population has had ovarian cysts in  their lifetime.  

Expected Prognosis 

Functional cysts that form during a woman's menstrual cycle resolve independently. Other  cysts or benign tumors can be removed surgically with laparoscopy or laparotomy. Usually,  ovarian cysts do not cause long-term complications for affected women. 

Natural Progression 

Ovarian cysts form due to fluid buildup in the follicles. If they do not dissolve on their own,  they grow and remain in the follicles. The growth of the cysts causes pain to the affected  women and may affect the ability to conceive. 

Pathophysiology 

Ovarian cysts affect the ovaries and, consequently, the reproductive organs in a woman's  body. Cysts form in the ovaries due to fluid buildup in follicles. If they do not reduce on their  own, they may grow and cause issues during menstruation. 

Possible Complication 

Ovarian torsion : Ovarian torsion happens when cysts grow bigger and move, which causes the ovaries to twist. The torsion can cause sudden pain, nausea, and even lightheadedness.  Ovarian cyst rupture: It commonly occurs in corpus luteal cyst. Outcome is evaluated based on assosiated symptoms.   Few specific conditions:  Torsion of ovary : Ovarian torsion can be easily managed laparoscopically .   ⚫ Dermoid: Dermoid cyst contains multiple types of tissue, it can be easily performed  laparoscopically and most of the ovarian tissue can be preserved.   Although most cysts are harmless and go away on their own but an early diagnosis and  careful track of any cyst is required so that it doesnot grow and cause complications.

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If you are facing any similar signs or symptoms please contact the BLK-Max team to schedule an appointment at : +91-11-30403040

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