How to Manage Ovarian Cysts?
Ovarian Cysts? What Options do Women have?
Ovarian cysts or masses are very prevalent in reproductive-age women; very frequently they are undiagnosed, hence untreated which is usually followed by spontaneous resolution within couple of weeks or months. Once ovarian, or adnexal cyst is diagnosed, usually by pelvic ultrasound or computed tomography, a detailed evaluation of all characteristics is performed. There are various types of adnexal cysts: functional (follicular and corpus luteum), endometrioma, polycystic ovary, dermoid (usually noncancerous), and neoplastic (cancerous). The most common are functional cysts, which are formed during a regular menstrual cycle secondary to lack of resolution of a follicle after ovulation or a persistence of a corpus luteum.
The management of adnexal/ovarian cysts depends on many factors such as the size, complexity, age, index of suspicion for a cancerous lesion, and severity of symptoms. Generally smaller (less than 10cm) functional cysts may be followed conservatively by means of serial pelvic ultrasounds, every 3-6 months because they tend to regress spontaneously. In the event, the cyst increases in size, or causes severe pain, a consideration is made to proceed with a surgical exploration via laparoscopy. Polycystic ovaries, which are associated with multiple peripheral, benign follicles, are generally treated medically with birth control pills. In reproductive-age women only teratomas, endometriomas, and any cancerous cysts need surgical excision followed by a pathological evaluation.
Ovarian Cysts in Menopause
On the other hand in postmenopausal women any cyst larger than 5 cm, should be removed. Tumor markers are of benefit to aid in diagnosis and follow up on management of cancerous adnexal cysts.
In conclusion, a simple, functional, smaller than 10 cm ovarian cyst in young menstruating woman does necessitate immediate resection because most likely they will resolve spontaneously without any intervention. If you need additional information, please do not hesitate to contact us.