Ovarian cysts are common for women who are still in their menstrual days. You may have had at least one cyst but may never know as it goes away on its own. Complications may arise when the cyst does not go away or may form into a bigger size. The ovaries are a pair of reproductive organs in the female body responsible for the release of an egg every month and, producing female estrogen and progesterone.
Ovarian cysts are fluid accumulated in the ovaries covered by a thin shell that can be small and harmless. They can be as small as a pea or big like a pregnant womb. A problem arises when they become larger in size, when they twist, or when they burst inside the ovary. This could cause the blood supply to the ovaries being stopped and if it is not treated, it could damage the ovaries tissues. Cysts can also be cancerous. These situations call for surgery as they also cause symptoms.
Ovarian cyst can be removed by surgery which can either be through a small incision called Laparoscopy for a smaller cyst or a larger abdominal incision called Laparotomy for a cyst that may be cancerous.
Types of Ovarian Cyst
There are many types of cysts. Cysts are categorised under Functional cysts and Pathological cysts.
- Functional cysts: they are linked to the menstrual cycle. Under this are two main types:
- Follicle cyst: Every month, the ovaries release one egg that is contained in a sac called the follicle. When the egg is ready, the follicle opens and releases it. If there is no release, it is called a Follicle cyst and may go away in 1 – 3 months.
- Corpus luteum cyst: Once the follicle breaks open, it shrinks and helps ready the next egg to be released. But when the follicle closes back up and collects fluid, it becomes a cyst which causes bleeding or pain as it grows. This may go away in a few weeks. There are three types:
- Dermoid cysts: Contains hair, fats, and other tissues
- Cystadenomas: Occurs in the outer walls of the ovaries
- Endometriomas: Cysts grow outside the womb and gets attached to the ovaries.
- Pathological cysts: They are caused by abnormal cell growth and not related to the menstrual cycle. They can develop before and after the menopause. They are created either by cells that help in the create the eggs or cells outside the ovary. Some can be cancerous and are surgically removed.
Causes of Ovarian Cyst
- Endometriosis: This occurs when tissues that line the uterus grow outside the womb – in the fallopian tubes, ovaries, rectum, bowel, and bladder developing into a cyst. The cysts are sometimes filled with blood.
- Poly cystic ovarian syndrome (PCOS): They are small cysts in the ovaries, they are egg follicles that do not ovulate due to altered hormones levels. These cysts make it hard to get pregnant.
Symptoms of an Ovarian Cyst
- Pelvic pain which can range from a dull pain to sharp and severe pain
- Pain during intercourse
- Abdominal swelling or bloating
- Pain in the lower back or thighs
- Painful bowel movements
- Tender breasts
- Nausea or vomiting
- Dizziness or faintness
- Rapid breathing
Diagnosis and tests
- Physical examination of the pelvic region
- CT Scan
- Blood tests
- Physical examination of the pelvic region
- Diagnostic tests will be done
- You may inform your doctor of all your medical history, current medications, and allergies
- You may be asked to stop certain medications if you are taking any like blood thinners
- Your surgeon will inform you which surgery will be required
- You will be asked to stop smoking as it affects the healing process
- If you are given medications, you may do so with small sips of water
- You will be asked to fast 8 – 12 hours before surgery
- You will be given general anaesthesia, so you will feel no pain
- A small incision is made in your abdomen
- Gas is blown in the pelvis so that the ovaries may be accessed
- A laparoscope is inserted in your abdomen so that your surgeon will see the organs inside
- The cysts are removed by making small cuts in the areas
- After the cysts are removed, the incision is closed with stitches
- If the cyst is larger and/or cancerous, a laparotomy will be performed
- A larger cut is made in the stomach to allow your surgeon a good access to the cyst
- While the cyst is removed, the ovary may also be removed
- A biopsy of the ovary may be done to confirm whether it is cancerous or not
- The incision is closed in stitches or staples.
- You may be able to go home on the same day or stay overnight if a laparoscopy is done
- For laparotomy, you may need to be hospitalised for at least 2 days
- You will experience pain in your abdomen although this will pass after a day or two
- Recovery for laparoscopy takes about 2 weeks while laparotomy takes about 6 – 8 weeks
- If biopsy is taken, when the result comes back, your surgeon will discuss any further treatment needed with you
- Follow-up will be scheduled.
Risks and complications
As with any surgery, no operation is without risks. Some of the complications that could develop are:
- Recurrence of ovarian cyst
- Pain may remain uncontrolled
- Scar tissues may be formed in the surgical site, fallopian tubes, ovaries, or pelvis
- Bowel or bladder may be damaged during the surgery
- Excessive bleeding
- Pain or swelling in the abdomen
Factors affecting the cost of Ovarian Cyst removal
Factors that affect the price are:
- Location of the hospital
- Duration of stay
- Diagnostic tests
- Medical amenities
- Surgeon’s fee