Ovarian cysts

Ovarian cysts are sacs containing fluid or semisolid material that develop inor on the surface of an ovary. Most are harmless, but because they cause some of the same symptoms as ovarian tumors that may be cancerous, ovarian cystsshould always be checked out.

The most common types of ovarian cysts are follicular cysts and corpus luteumcysts, which are related to the menstrual cycle. Follicular cysts occur whenthe cyst-like follicle on the ovary in which the egg develops does not burstand release the egg. These cysts are usually small and harmless, disappearing within two to three menstrual cycles. Corpus luteum cysts occur when the corpus luteum--a small, yellow body that secretes hormones--doesn't dissolve after the egg is released. They usually disappear in a few weeks but can grow to more than 4 in (10 cm) in diameter and may twist the ovary.

Ovarian cysts can develop any time from puberty to menopause, including during pregnancy.

Many ovarian cysts have no symptoms. However, when the growth is large or there are multiple cysts, the patient may experience any of the following symptoms:

  • Fullness or heaviness in the abdomen.
  • Pressure on the rectum or bladder.
  • A constant dull ache in the pelvic area that may spread to the lower back and thighs. The pain occurs shortly before the beginningor end of menstruation or may occur during intercourse.

A physician may find ovarian cysts during a routine pelvic exam. If a patientcomplains of symptoms typical of ovarian cysts, a doctor can confirm the diagnosis using a pelvic exam and ultrasound. For an ultrasound test, a technician uses a hand-held wand to send and receive sound waves to create images ofthe ovaries on a computer screen. The images are photographed for later analysis. This painless test takes about 15 minutes and is usually done in a hospital or a physician's office.

Many ovarian cysts require no treatment and disappear on their own. Often thephysician will wait and re-examine the patient in four to six weeks before taking any action. Postmenopausal patients and patients who have not reached puberty and have an ovarian mass may need surgery. Surgery is also recommendedfor growths that are larger than 4 in (10 cm), and are complex, growing, persistent, solid and irregularly shaped and for growths that are on both ovaries or that cause pain or other symptoms.

More than 90% of noncancerous ovarian cysts can be removed using laparoscopy,a simple, outpatient procedure. The patient receives a general or local anesthetic, then a small incision is made in the abdomen. The laparoscope is inserted into the incision and the cyst or the entire ovary is removed. Usually,the patient can return to normal activities within two weeks.

For cysts that cannot be removed with laparoscopy, regular surgery may be necessary. The operation is performed under general anesthesia in a hospital andrequires a stay of five to seven days. Recovery takes four weeks.

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