Ovarian cysts are very common with majority of women showing small cysts up to 4-5 cm that may come and go as part of a normal menstrual cycle. These cysts are usually simple fluid filled sacs within the ovary which usually cause no symptoms, often being diagnosed incidentally on an ultrasound scan. These are known as functional cysts and usually disappear on a follow up ultrasound scan in a few weeks. Women are usually in the younger age group and usually just need reassurance.
However, some cysts may be pathological and may need surgery, for example cysts from endometriosis and dermoid cysts (teratomas) (cysts arising from specialised cells normally in the ovary known as totipotential cells which can change into hair, teeth, bone and skin). These dermoid cysts are usually benign.
Rarely, ovarian cysts may be cancerous and cysts that grow rapidly in size or have some worrying features on an ultrasound scan may need further tests and surgery. Cysts in women in the peri menopause or menopause may be worrying and need close monitoring or surgery.
Sometimes, ovarian cysts may twist (especially dermoid cysts) or may burst or bleed causing pain and hospital admission. Surgery may be needed in some of these situations. Most ovarian cysts if needing surgery can be removed using a keyhole laparoscopic (see separate leaflet on Laparoscopy) approach, which allows excellent visualisation and a quick recovery. However as some cysts may be very large or may be suspected to be cancerous, in these situations, an open operation (laparotomy) may be needed.
Nitu Bajekal Nov 2013