Ovarian Cyst - MITR

Ovarian Cyst

Ovarian Cyst

Ovarian cyst is a collection of fluid in the ovary.

Classification of Ovarian cyst are

Simple ovarian cyst
Follicular ovarian cyst
Endometriotic/Chocolate ovarian cyst
Dermoid ovarian cyst

Simple Cyst and follicular cyst are commonly seen . Follicular cyst resolves over sometime
and does not need active treatment.
Some cyst which grow more than 5-6 cm in size are at risk for undergoing torsion of ovary
and may need treatment.

Endometriotic cyst
Endometriotic cyst also called endometrioma, there is chocolate coloured collection in the
ovary.It is seen in 17-45% of cases of endometriosis.

Symptoms
Severe dysmenorrhoea,painful intercourse,pain while passing motions,nausea,vomiting.
Diagnosis
It is diagnosed on Ultrasound.CA125 blood test .Laparoscopy is the best modality to
diagnose endometriotic cyst.

Treatment
Small endometrioma can be managed with medications- progestins ,anti-inflammatory
preparation.
Larger painful endometrioma needs surgical intervention. Operative Laparoscopy is
performed for endometrioma.
25% of operated endometrioma have a chance to recur.

Dermoid ovarian cyst
These cyst contents are hair,teeth,cartilage,sebum -any component from the body(germ) cell
.They are usually diagnosed on ultrasound and are silent cyst ,present from birth.Once the
cyst size becomes larger than 5 cm it needs to be removed surgically.
These cysts do not respond to medications.

OVARIAN CYST

Ovarian Cyst is a fluid filled sac within the ovarian tissue is known as ovarian cyst.

Classification:
1 .Functional ovarian cyst: are physiological cyst formed due to hormonal variation. It is also seen in infertile women on ovulation inducing agents.
2 .Benign ovarian cyst: commonly seen cysts are endometriotic cyst, dermoid cyst and cystadenoma.

The exact etiology of Endometriotic cyst is unknown. Dermoid cysts are formed from the layers of growing embryonic tissue. Cystadenomas are epithelial ovarian cysts.

Symptoms

➾ Abdominal pain
➾ Menstrual irregularities
➾ Nausea, vomiting, bowel obstruction symptoms
➾ Urinary complaints
➾ Dyspareunia – pain while having intercourse
➾ Infertility
➾ Ocassionally cyst size enlarges and twists on itself giving rise to severe abdominal pain and surgical emergency.

Investigations

1. Tumor markers – Ca-125, B – HCG, CEA antigen are performed though they are not specific indicators of a particular type of cyst.
2. Abdominal sonography or Ultrasound – ovarian cysts are best diagnosed on sonography.
3. CT scan, MRI are performed in cases where there is diagnostic dilemma.

Treatment:

Except in functional ovarian cyst, all ovarian cyst which are symptomatic and above 5cms in dimension, need surgical management.
Laparoscopic ovarian cystectomy is the treatment of choice for ovarian cyst. In suspected cases of malignancy staging laparotomy is performed.