Ovarian cysts – What are they ?

I have been told I have an ovarian cyst, what is it?

• Ovarian cysts – a fluid-filled sac 
• Very common –the majority are asymptomatic 
• Usually detected on routine USG
• 1 in 10 requires intervention 10 

Risk factors

• No definitive factors
• Hormonal imbalance
• Genetic factors - BRCA gene

Symptoms

Non-specific

• Bloating
• Pelvic / abdominal pain
• Early satiety
• Urinary symptoms
• Menstrual disturbances.

What tests are done?

• Ultrasound
• CT /MRI scan if doubtful
• Blood tests – CA 125, HCG, AFP, LDH
• FNAC / biopsy is not to be done FNAC

Types of ovarian cyst

• Not all ovarian cysts are cancerous, the majority are benign.
• Diagnosis depends on scanning report – complex cysts, solid component.
• Blood tests – CA 125, HCG, AFP, LDH.

Do all ovarian cysts require surgery?

• Cysts that are benign on imaging and blood tests.
• Small cysts - close monitoring
• Surgery
  1. if the size is increasing
  2. Causing symptoms due to torsion/infection/hemorrhage
  3. Large cysts >6cm
  4. Simple cysts with no symptoms - further imaging and assessment
  5. Surgery – if any doubts about cancer/symptoms/complex cyst

What is the surgery for a benign ovarian cyst?

• Surgical removal of the cyst.
• Surgery - open/keyhole
• Keyhole surgery is to be avoided if there is any doubt of cancer in the cyst.

Do all ovarian cysts become cancer?

• The cyst is either cancerous or benign from the beginning.
• The chance of a benign cyst going to become cancer is very minimal.
• Surgery is not to be done just because a cyst is present.

In a nutshell

• The majority of ovarian cysts are benign and require no intervention.
• The Nature of cysts is determined by scans and blood tests.
• When indicated surgery is the only treatment option.