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[ Types of Ovarian Cysts ] [ Symptoms, Diagnosis & Treatment of Ovarian Cysts ]

What are the signs and symptoms that you may have with an ovarian cyst?

You can't depend on symptoms alone to tell you if you have an ovarian cyst. In fact, you'll likely have no symptoms at all. Or if you do, the symptoms may be similar to those of other conditions, such as endometriosis, pelvic inflammatory disease, ectopic pregnancy or ovarian cancer. Even appendicitis and diverticulitis can produce symptoms that mimic a ruptured ovarian cyst.

Still, it's important to be watchful of any symptoms or changes in your body and to know which symptoms are serious. If you have an ovarian cyst, you may experience the following signs and symptoms:

* Menstrual irregularities
* Pelvic pain — a constant or intermittent dull ache that may radiate to your lower back and thighs
* Pelvic pain shortly before your period begins or just before it ends
* Pelvic pain during intercourse (dyspareunia)
* Nausea, vomiting or breast tenderness similar to that experienced during pregnancy
* Fullness or heaviness in your abdomen
* Pressure on your rectum or bladder — difficulty emptying your bladder completely

The signs and symptoms that signal the need for immediate medical attention include:

* Sudden, severe abdominal or pelvic pain
* Pain accompanied by fever or vomiting

Investigations & Diagnosis

To identify the type of cyst, your doctor may perform the following procedures:

Pregnancy test. A positive pregnancy test may suggest that your cyst is a corpus luteum cyst, which can develop when the ruptured follicle that released your egg reseals and fills with fluid. This will also help to rule out a tubal pregnancy if it is negative.

Pelvic ultrasound. In this painless procedure, a wand-like device (transducer) is used to send and receive high-frequency sound waves (ultrasound) through your pelvic area, creating an image of your uterus and ovaries on a video screen. This image can then be photographed and analyzed by your doctor to confirm the presence of a cyst, help identify its location and determine whether it's solid, filled with fluid or mixed. A typical USG picture of a multiloculated cyst is shown here.

Laparoscopy. Using a laparoscope — a slim, lighted instrument inserted into your abdomen through a small incision — your doctor can see your ovaries and remove the ovarian cyst.

CA 125 blood test. Blood levels of a protein called cancer antigen 125 (CA 125) often are elevated in women with ovarian cancer. If you develop an ovarian cyst that is partially solid and you are at high risk of ovarian cancer, your doctor may test the level of CA 125 in your blood to determine whether your cyst could be cancerous. Elevated CA 125 levels can also indicate noncancerous conditions such as endometriosis, uterine fibroids and pelvic inflammatory disease.

Complications

The following complications are possible:

• large size may cause pressure on your bladder, rectum or kidney tubes [ureter]

• rupture is a serious complication

• twisting is also serious as it is painful and leads to stoppage of blood supply to that ovary [torsion]

• infertility
   

Treatment of ovarian cysts

Treatment depends on your age, the type and size of your cyst, and your symptoms. Your doctor may suggest:

Watchful waiting. You can wait and be re-examined in one to three months if you're in your reproductive years, you have no symptoms and an ultrasound shows you have a simple, fluid-filled cyst. Your doctor will likely recommend that you get follow-up pelvic ultrasounds at periodic intervals to see if your cyst has changed in size. Watchful waiting, including regular monitoring with ultrasound, is also a common treatment option recommended for postmenopausal women if a cyst is filled with fluid and less than 2 inches in diameter.

Birth control pills. Your doctor may recommend birth control pills to reduce the chance of new cysts developing in future menstrual cycles. Oral contraceptives offer the added benefit of significantly reducing your risk of ovarian cancer — the risk decreases the longer you take birth control pills.

Specific treatments. If you have a cyst because of endometriosis etc the treatment will be directed towards the primary disease.

Surgery. Your doctor may suggest removal of a cyst if it is large, doesn't look like a functional cyst, is growing or persists through two or three menstrual cycles. Cysts that cause pain or other symptoms may be removed. Some cysts can be removed without removing the ovary in a procedure known as a cystectomy. Your doctor may also suggest removal of the one affected ovary and leaving the other intact in a procedure known as oophorectomy. Both procedures may allow you to maintain your fertility if you're still in your childbearing years. Leaving at least one ovary intact also has the benefit of maintaining a source of estrogen production. If a cystic mass is cancerous, however, your doctor will advise a hysterectomy to remove both ovaries and your uterus. After menopause, the risk of a newly found cystic ovarian mass being cancerous increases. As a result, doctors more commonly recommend surgery when a cystic mass develops on the ovaries after menopause. This surgery may either be done in the conventional open manner - laparotomy or as a keyhole minimally invasive surgery - laparoscopy.

Pictures of laparoscopic ovarian cyst excision

[ Types of Ovarian Cysts ] [ Symptoms, Diagnosis & Treatment of Ovarian Cysts ]