Ovarian
Ovarian cysts are closed, sac-like structures within the ovary that are filled with a liquid or semisolid substance. Ovarian cysts may not cause signs or symptoms.
Larger cysts are more likely to cause signs and symptoms such as:
- Pain in the abdomen, pelvis, sometimes radiating to the low back.
- Bloating or indigestion
- Increased abdominal girth
- Feeling an urge to have a bowel movement or having difficult, painful bowel movements
- Urgency or frequency of urination
- Dyspareunia-pain during intercourse
There are many types of cysts affecting the ovaries:
Physiological due to ovulation,
which should resolve after 1-2 months
Benign cysts
– e.g. Dermoid (benign teratoma). This is a cyst that may contain hair, skin, teeth, cartilage and virtually any type of cell within the body
Endometriomas
– associated with endometriosis
Cystadenomas (Serous, Mucinous)
– benign simple cysts that are the most common type
Cancers
– mostly commonly serous adenocarcinoma
Metastatic
– (spread from another cancer to ovaries ) e.g. Breast or Bowel
Low malignant Potential tumours (Borderline tumours)
– somewhere in between benign and malignant
Most ovarian cysts are not cancerous. The majority of ovarian cysts are diagnosed with a transvaginal ultrasound or physical examination. A tumour marker (blood test) may be helpful in determining what risk there is that the cyst is cancerous. The treatment of an ovarian cyst depends upon the type of cyst, it’s size, whether it is causing any symptoms to you, and the risk that it may be a borderline tumour or a cancer. Treatment varies from observation and monitoring, to surgical treatment.
Depending on history and examination, if a cyst appears small (less than 5 cm) and is simple on imaging (i.e. there are no solid areas or internal complex features) then observation with a repeat ultrasound in 6- 8 weeks may be all that is necessary.
Most other cysts if they are low risk can be dealt with conservatively (i.e. by just removing the cyst and conserving the ovary) by laparoscopy.
High-risk cysts, particularly in the older age group, may still be dealt with laparoscopically if appropriate but are generally removed along with the ovary and tube. Frozen section (a pathologist looks at the removed tissue while you are still asleep) is available for intraoperative assessment of these or any suspicious cysts or lumps so that any treatment that is necessary can be performed during the same procedure to minimise disruption to you.
Whatever the type of cyst, Dr Farrell will take appropriate steps to ensure that you are offered the most appropriate treatment for your type of cyst at the first operation. As she works closely with pathologists on site who perform frozen section analysis when required, and she is appropriately trained in cancer surgery if required, the right operation is performed at the initial surgery by Dr Farrell.
