Benign ovarian cysts

Ovarian cysts are small fluid-filled sacs that

develop in a woman's ovaries.
Most cysts are harmless, but some may cause
problems such as rupturing, bleeding, or pain;
and surgery may be required to remove the
cyst(s).
It is important to understand how these cysts
may form.

Follicular Cyst
This is simple cyst formed when ovulation does not
occur or when a mature follicle does not rupture.
size : it can grow to about 2.3 inches.
- usually they produce no symptoms and
disappear by themselves within few months.
Pain : occurs when the cyst ruptured usually in the
middle of the menstrual cycle during ovulation.
- 1/4
th
of women with this type of cyst
develop pain
- The pain characterized by sharp pain on the
side of the ovary on which the cyst appear.
Corpus luteum cyst
This is functional cyst occurs after an egg has been
released from the follicle
After this happens, the follicle becomes what is
known as a corpus luteum.
If a pregnancy doesn't occur, the corpus luteum
usually breaks down and disappears.
It may, however, fill with fluid or blood and persist
on the ovary.
Usually, this cyst is found on only one side and
produces no symptoms.
Hemorrhagic cyst
This type of functional cyst occurs when bleeding
occurs within a cyst.
Symptoms such as abdominal pain on one side of
the body may be present with this type of cyst
ultrasound image of this cyst type can vary
because of the spectrum of contents
CT scan and magnetic resonance imaging (MRI) can
show the presence of fat and dense calcifications.
Dermoid cyst
This is an abnormal cyst that usually affects younger
women.
Size : may grow to 6 inches in diameter.
It is a type of benign tumor sometimes referred to
as mature cystic teratoma.
It contains fat and occasionally bone, hair, and
cartilage.
They can become inflamed. They can also twist
around (a condition known as ovarian torsion),
causing severe abdominal pain
Cystadenoma
It is a type of benign tumor that develops from
ovarian tissue.
They may be filled with a mucous-type fluid
material.
Cystadenomas can become very large and may
measure 12 inches or more in diameter.
Risk Factors of Ovarian Cysts

History of previous ovarian cysts.
Irregular menstrual cycles.
Increased body fat distribution
Early menstruation (11 years or younger)
Infertility
Hypothyroidism or hormonal imbalance
Tamoxifen therapy for breast cancer

contraceptive/birth control pill use decreases
the risk of developing ovarian cysts because
they prevent the ovaries from producing eggs
during ovulation.

Ovarian Cysts Symptoms (I)
Usually ovarian cysts do not produce symptoms and are found
during a routine physical exam or are seen by chance on an
ultrasound performed for other reasons.
However, the following symptoms may be present :

1. Lower abdominal or pelvic pain, which may start and
stop and may be severe, sudden, and sharp
Pelvic pain after strenuous exercise or sexual
intercourse

2. Pain or pressure with urination or bowel movements

3. Feeling of lower abdominal or pelvic pressure or
fullness
Ovarian Cysts Symptoms (II)
4. Irregular menstrual periods.
5. Nausea and vomiting.
6. Vaginal pain or spots of blood.
7. Infertility.
8. Fever.
9. Pallor or anemia (possibly from loss of blood).
10. Abnormally heavy or irregular menstruation.
11. Abdominal swelling or unusual increased
abdominal girth.
12. Increased facial hair similar to a male pattern.





Ovarian Cysts Symptoms (III)
13. High or low blood pressure unrelated to
medications.
14. Unexplained weight loss.
15. A noticeable abdominal or pelvic mass.
A woman with the following symptoms should go
immediately to a hospital's emergency department:
1) Weakness, dizziness, or faintness, especially from standing
2) Persistent fever
3) Severe lower abdominal or pelvic pain
4) High or low blood pressure unrelated to medications
5) Excessive thirst or urination
6) Unexplained shoulder pain combined with abdominal pain
7) Persistent nausea and vomiting


Tests For Diagnosis (I)
Endovaginal ultrasound: the best test for
diagnosing an ovarian cyst. A cyst can be diagnosed
based on its appearance on the ultrasound
This type of ultrasound produces is much better
than abdominal ultrasound because the probe can
be positioned closer to the ovaries.
Using an endovaginal ultrasound, the internal cystic
structure may be categorized as simple (just fluid
filled), complex (with areas of fluid mixed with solid
material), or completely solid (with no obvious
fluid).

Tests For Diagnosis (II)
Other imaging:
1. CT scanning aids in assessing the extent of the
condition.
2. MRI scanning may also be used to clarify results of an
ultrasound.

Laparoscopic surgery: The surgeon identifies the cyst
through the scope and may remove the cyst or take a
biopsy from it.

Serum CA-125 assay: which is associated with ovarian
cancer .

Hormone levels: LH, FSH, estradiol, and testosterone
levels may indicate potential problems concerning
these hormone levels.

Tests For Diagnosis (III)
Pregnancy testing: The treatment of ovarian cysts is
different for a pregnant woman than it is for a
nonpregnant woman. An ectopic pregnancy
(pregnancy outside the uterus) must be ruled out
because some of the symptoms of ectopic
pregnancy may be similar to those of ovarian cysts.

Culdocentesis: This test involves taking a fluid
sample from the pelvis with a needle inserted
through the vaginal wall behind the uterine cervix.

Ovarian Cysts Treatment
Functional ovarian cysts are the most common type
of ovarian cyst. They usually disappear by
themselves.
Growths that become abnormally large or last
longer than a few months should be removed or
examined to determine if they are in fact something
more harmful
Self-Care at Home
Pain caused by ovarian cysts may be treated at
home with pain relievers.
Limiting strenuous activity may reduce the risk of
cyst rupture or torsion.

Medical Treatment
Endovaginal ultrasound are used repeatedly and
frequently to monitor the growth of the cyst.
Medications:
1. Oral contraceptives: may be helpful to regulate the
menstrual cycle, prevent the formation of follicles
that can turn into cysts, and possibly reduce the
size of an existing cyst.
2. Pain relievers: Anti-inflammatories such as
ibuprofen, may help reduce pelvic pain.

Surgical Treatment
Laparoscopic surgery : The surgeon fills a woman's
abdomen with a gas and makes small incisions
through which a thin scope (laparoscope) can pass
into the abdomen. The surgeon identifies the cyst
through the scope and may remove the cyst or take
a sample from it .

Laparotomy : This is a more invasive surgery in
which an incision is made through the abdominal
wall in order to remove a cyst.

Surgery for ovarian torsion : An ovarian cyst may
twist and cause severe abdominal pain as well as
nausea and vomiting. This is an emergency, surgery
is necessary to correct it.

Follow-up depends largely on the type of cyst
noted.
This a picture of an ovary containing small cysts on
endovaginal ultrasound (looks similar to a chocolate
chip cookie).

This is a picture of an ultrasound image of a
functional ovarian cyst. The round, dark, bubble like
structure is a cyst present on the ovary.