An ovarian cyst may be benign tumour. A common benign tumour that appears on an ovary is a dermoid cyst. Dermoid cysts come from primitive skin tissues that have been present in the ovary from birth. The fluid inside is sebaceous material, like in a blackhead, and often contains hair. Dermoid cysts are more common in younger women, sometimes in both ovaries. Other cysts can be malignant tumours. These cancerous tumours are more often seen in older women. They vary in size but can be large, fifteen centimetres or more, before being detected.
We aim to examine inside your pelvis to confirm that the cyst is on your ovary. We will find out what type of cyst it is so we can decide on the best treatment. If you need a cystectomy, where we remove the cyst, we will leave you with as much healthy ovary as possible.
We do the operation using laparoscopic instruments. These are keyhole instruments that are put through small cuts in your abdomen.
Firstly, you have a laparoscopy. This is where we examine your ovaries with keyhole instruments. This should tell us exactly what has gone wrong so that you can get the best treatment. If we remove the cyst from your ovary, we send any removed tissue for microscope examination. If the cyst is somewhere else in your pelvis we can usually treat it as needed with the keyhole instruments.
A keyhole operation is usually less painful and recovery is faster than with an open operation to remove a cyst.
Are there any alternatives?
Ultrasound scans, x-rays, CT scans and MRI scans are alternative tests that may be used to examine your ovaries without an operation. These tests may show that you have a cyst and a laparoscopy is the best option for further examination and possible removal.
We believe that keyhole surgery is possible in your case. However, if the laparoscopy reveals that you have a very large cyst or ovary that we need to remove, we may need to convert to an open operation. This operation requires a large wound in your lower abdomen. You may also need an open operation if you have scarring in your pelvis from a past operation or infection. Open operations tend to be more painful with a slower recovery.
What if you do nothing?
If you do nothing, the cause of the cysts will remain in doubt. You may miss out on important treatment. Your symptoms will probably get worse.
You could develop serious complications such as bleeding into the cyst or twisting of the cyst cutting off its blood supply. This would leave no alternative but an emergency operation.
If an ultrasound scan shows that you only have a small cyst or cysts, less than a centimetre in diameter, they are unlikely to cause problems. These small follicular cysts do not cause symptoms and can often be ignored. You may need a repeat ultrasound to check this. If the cysts cause problems we usually need to operate to relieve the symptoms.
Author: Dr David Hutchon F.R.C.O.G. Consultant Gynaecologist.
© Dumas Ltd 2006