Ovarian cysts | Glengarry Private Hospital, Perth
Ovarian cyst removal – Summary
Most cysts can be dealt with by day case laparoscopy
1. Most cysts are not cancerous, but full assessment is needed.
2. Day case laparoscopy (keyhole surgery) is suitable for many cysts.
3. Generally, a week or so is needed for recovery.
4. Significant complications are very rare.
5. Simple small cysts often resolve without treatment.
6. It is common to wait 6 weeks to see if cysts resolve by themselves.
Any surgical or invasive procedure carries risks. Before proceeding, you should do your own research. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner. For instance, your GP’s opinion will be very helpful, if you have not already fully discussed surgery with him or her.
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Ovarian cysts – Introduction
Ovarian cysts or masses are common. There are many different types, both benign and cancerous. Common symptoms associated with ovarian cysts are pain, swelling, bloatedness, hormonal effects. Occasionally there is intense pain if they twist and become gangrenous or rupture. Many cysts don’t give any symptoms and we regularly see women in our rooms at Glengarry hospital, Perth who have had them picked up whilst being examined or during an ultrasound for another reason.
Simple functional ovarian cysts can be monitored and left for 6 weeks with a repeat scan – many will resolve by themselves. They can also be suppressed using the contraceptive pill for a couple of menstrual cycles. This is particularly important in fertility, where cysts can interfere with ovarian stimulation to produce eggs.
Ovarian cysts – Removal
However, many cysts need to be removed with day case keyhole surgery (laparoscopy). We can arrange this easily for you here at Glengarry Private Hospital, Perth. Recovery times are generally short with keyhole surgery, with most women back to normal in a week or so. We would probably do a laparoscopy or two every week for women with ovarian cysts here in Glengarry Hospital, Perth; we’re well used to doing these laparoscopy procedures.
Functional ovarian cysts
There are several different types of functional ovarian cysts. The commonest type is where an egg is not released from a follicle as normal. Instead the follicle grows further and becomes a functional cyst. Most of these will be reabsorbed over time. This is less likely if they become large eg. larger than 5cm, or become compartmentalised with different sections within. Another type of functional cyst occurs after egg release. Normally a corpus luteum forms after the egg is released from the ovary. This releases hormones and supports the lining of the womb. It then is absorbed and then a period occurs. Occasionally the corpus luteum persists and grows greater than 3cm, which can lead to menstrual irregularity and pain. Again, these ovarian cysts will often sort themselves out without intervention.
Endometriotic cysts (or chocolate cysts) are benign but can be particularly painful & troublesome. They are often stuck to the side of the pelvis, the bowel, the Fallopian tube or other ovary. They can require complex keyhole surgery to strip them off the various structures in the pelvis eg. bowel, ureters and remove them. They can usually be picked up with ultrasound prior to surgery. Sometimes it’s a good idea to drain and deroof them first, give some medical treatment to shrink them, and only them strip them out of the ovary. This tactic is important in fertility patients with large endometriomas to preserve function of the ovaries and optimise egg retention.
Dermoid ovarian cysts
These fascinating cysts do not resolve by themselves. They can contain hair, sweat glands, cartilage, sebum and quite often, teeth. They need to be removed when found. If they grow and rupture, the sebum within can cause terrible problems. There are special techniques to remove these cysts without spillage using keyhole surgery. Often the ovary can be preserved.
Haemorrhagic ovarian cysts
These cysts occur when there is bleeding into a functional or other kind of cyst. They can be very painful. Many will resolve spontaneously if left. Some will require laparoscopy to remove.
Benign ovarian tumours
Ovarian cysts or tumours are often benign, but this can only be definitively established by removing them or the ovary and examining them under the microscope.
Cancerous ovarian cysts
Sometimes, ovarian cysts can be cancerous. There are numerous tests that can be performed to estimate the likelihood of a cancer. Should the risk be high, then you will be referred to a cancer specialist for further discussion and treatment. Subsequent surgery is likely to be radical and would generally not be by laparoscopy, unless very early.
The contraceptive pill can be used to prevent further ovarian cysts developing if you’re prone to them.
This is the method of keyhole surgery we use here at Glengarry Private Hospital, Perth to remove ovarian cysts that are judged likely to be benign. 3 or 4 small incisions in the abdomen are required to manipulate the ovary and shell out the cyst, leaving healthy ovarian tissue. Alternatively the whole ovary may be removed, depending upon the circumstances. Most women can go home same day following this surgery and recover fully in a week or so. See the laparoscopy page for more details on this keyhole method of surgery.
Should you wish to make an appointment here at Glengarry hospital to have your ovarian cyst removed, give us a call and we will prioritise your treatment as much as possible.