Ovarian cysts are common, and can range from being physiological (a normal part of your cycle) to more serious causes. Most cysts are incidental findings, and will resolve on their own. Treatment is only required for persistent cysts causing symptoms or where there are concerning features.
What symptoms do ovarian cysts cause?
- Most cysts are asymptomatic
- Abdominal or pelvic pain
- Pain during intercourse
- Pelvic pressure, or needing to void more frequently
What investigations are required?
- A thorough history including symptoms, personal and family history of ovarian or other cancers
- A pelvic ultrasound (transvaginal and transabdominal)
- Blood tests – including CA-125, which may be raised in ovarian cancers
A risk of malignancy index (RMI) is often used to determine if a cyst has a high or low risk of being malignant (cancerous). This takes into account certain ultrasound features, a woman’s menopausal status, and her CA-125 value.
How are ovarian cysts treated?
Most ovarian cysts resolve on their own after a few months, but may need surveillance with repeat pelvic ultrasounds. Surgery may be required if a cyst is persistent, causing symptoms, or has concerning ultrasound features.
What is an ovarian cystectomy?
A cystectomy is where the cyst is removed from the ovary. Most of the time this can be performed laparoscopically. Sometimes an open procedure is required. This procedure aims to preserve as much ovarian tissue as possible, but sometimes the cyst is so large or involves so much ovarian tissue that an oophrectomy (removal of the ovary) is required.