OVARIAN CYSTS

What Are Ovarian Cysts?

Ovarian cysts are sacs filled with fluid or tissue that develop in a woman’s ovaries. Ovarian cysts are very common. They can occur at any age from childhood to postmenopause. Most of them are benign and regress without treatment. However, sometimes these cysts can be malignant and turn into cancer.

What Are the Different Types of Cysts?

• Functional Cyst: This is the most common type of ovarian cyst we encounter. It usually does not cause any symptoms. Functional cysts often disappear within 6-8 weeks without treatment.
• Teratoma: This type of cyst contains different types of tissues that make up the body, such as bone, teeth, hair, etc. These cysts may be present from birth, but they can also develop later. In very rare cases, some teratomas can turn into cancer.
• Cystadenoma: These cysts form on the outer surface of the ovary. Although they can grow very large, they are usually benign.
• Endometrioma (Chocolate Cyst): This cyst results from endometriosis. For more detailed information, you can refer to the Endometriosis section.

What Symptoms Do Ovarian Cysts Cause?

Ovarian cysts usually do not cause any complaints. They are often detected during routine examinations. Some cysts may cause abdominal pain or pressure sensation. If the cyst is large, it can twist around itself, causing a disruption in blood flow to the ovary. This condition is called ovarian torsion. Severe, twisting, and sudden onset abdominal pain, nausea, and vomiting may occur in this situation. Emergency surgery is required in this case. Sometimes, cysts can rupture or bleed into themselves, resulting in severe pain. It is necessary to monitor the amount of bleeding; sometimes surgical intervention may be required.

How Are Ovarian Cysts Diagnosed?

Imaging and blood tests are performed.

• Imaging tests: The most common type is ultrasound. This test relies on the use of sound waves to create images of your uterus and ovaries. Ultrasound provides information about the location, size, and structure of the cyst. Your doctor may also request an MRI or CT scan.
• Blood tests: The value of a substance called CA 125, which is expected to increase in ovarian cancer, is measured in the blood. Since this substance can also increase in conditions other than ovarian cancer (e.g., endometriosis), HE4 blood test has also been examined in recent years. The evaluation of HE4 and CA125 together has a high success rate in indicating the risk of ovarian cancer.

CA 125, HE4, along with specific findings from ultrasound and physical examinations, particularly after menopause, provide an indication of the risk of ovarian cancer in a woman.

How Are Ovarian Cysts Treated?

Treatment is selected by evaluating the cause, appearance, size, blood values, and growth rate of the cyst together.

Possible treatments include:

WATCHFUL WAITING The cyst is monitored with repeated ultrasound checks. Your cysts may remain the same size, shrink, or even disappear. In such cases, no additional treatment is necessary. Most cysts disappear spontaneously after one or two menstrual cycles.

SURGICAL Some cases may require surgery to remove the cyst or the entire ovary. Surgery is necessary if the cyst is large, causing symptoms, or if there is suspicion of cancer.

How Is Surgery Performed?

If your cyst is considered benign, laparoscopic surgery is often preferred. Sometimes, this may not be suitable (if the cyst is very large or suspected of cancer), and surgery is performed through an abdominal incision.