Treatment of Ovarian cyst

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Treatment of ovarian cysts depends on your age, whether youâ€™ve been through the menopause, the appearance and size of the cyst, and whether there are symptoms.

Observation:

In some cases, observation may be all thatâ€™s necessary. This is common in pre-menopausal women who have a small, functional cyst. Youâ€™ll need to have another ultrasound scan after a month or so to check on the cyst, but most disappear after a few weeks without treatment.

Women with ovarian cysts whoâ€™ve passed their menopause are usually monitored with ultrasound scans and blood tests for the CA125 protein. However, this varies depending on factors such as the size of the cysts and how it changes over time. The risk of developing cancer is very low if you have small cysts on one ovary and more than half these type of cysts disappear within 3 months. Post-menopausal women are also advised to have a follow up ultrasound scan 4 months after the cysts have gone.

Surgery:

If the cyst is large, appears in pregnancy, or is causing symptoms, it will probably be removed. Sometimes doctors recommend taking the cyst out even if you donâ€™t have symptoms, because it isnâ€™t always possible to tell what type of cyst it is without looking at it under a microscope. This reduces the risk of the cyst turning cancerous.

Smaller cysts can sometimes be removed using a surgical technique called laparoscopy. This is a type of â€˜keyhole surgeryâ€™ in which two small cuts are made in the lower abdomen and air is blown into the pelvis to lift the abdominal wall away from the organs inside. A laraposcope (a small, tube-shaped microscope with a light on the end) is then passed into the abdomen so the surgeon can see the internal organs. Using tiny surgical tools attached to the laparoscope, the surgeon can make a small cut in the cyst to drain the fluid away. Sometimes they just take a sample of the cyst to see what type it is.

If thereâ€™s a risk the cyst may burst and spill while itâ€™s being removed, you may be advised to have a more serious operation called a laparotomy. For this operation, a larger cut is made across the top of the pubic hairline to give the surgeon better access to the cyst. The whole cyst is taken out and sent to a laboratory to check that it isnâ€™t cancerous.

Cancer:

If the cyst is found to be cancerous, you may need more serious treatment to remove both of the ovaries, the uterus (womb), a fold of fatty tissue called the omentum and some lymph nodes. If this is recommended, your doctor will talk to you beforehand about the risks of each kind of surgery, how long you are likely to be in hospital and how long it will be before you can go back to your normal activities.

Please see the separate encyclopaedia entry for further information about cancer of the ovary.