Ovarian Cysts


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Similar to other cysts, ovarian cysts are fluid-like sacs; of course ovarian cysts only affect women, appearing within or on the surface of the ovaries. Ovarian cysts can develop in either one or both of the ovaries.  These types of cyst only tend to encountered among pre-menopausal women. There are a number of different kinds of ovarian cyst too: Follicular cysts, Luteal cysts, Dermoid cysts and Cystadenomas.  

Functional cysts

Follicular cysts and Luteal cysts can be described as Functional cysts: Follicular cysts form inside a small structure inside the ovary known as the follicle. During the regular ovulation cycle, the follicle contains the fluid to safeguard the egg as it grows. When the egg is released, this follicle disintegrates. However, sometimes a follicle does not release an egg, leading it to grow and become a fluid-filled ovarian cyst. A Luteal cyst is relatively more infrequent than a follicular cyst, and occurs after the tissue left following the egg’s release fills with blood. Luteal cysts again should be harmless and should disappear within time, although sometimes if they burst they can cause bleeding and sharp pain.

Pathological cysts

Dermoid cysts and Cystadenomas are categorised as Pathological cysts; and are more common among middle-aged women.  Dermoid cysts can stem from the cells which used to create eggs. These cysts can become extremely large, sometimes up to six inches in diameter, Obviously should the cyst increase to this size surgery will most definitely be required, yet it must be stressed that Dermoid cysts are non-cancerous. Cystadenomas develop from cells that cover the outer part of the ovary: they are either categorised as serous cystadenomas or mucinous cystadenomas. The former do not grow large but can cause complications should they rupture. Mucinous cystadenomas can expand to up to twelve inches, expanding and filling the abdomen, and pressurising the bladder and the bowel. This in turn can affect the frequency of urination and cause indigestion. 

Causes

The origin of ovarian cysts has yet to be determined, however it is largely thought to be due to endometriosis (when pieces of the tissue which line the womb are found in areas exterior to the womb, forming blood-filled cysts in this tissue) or an ovarian cyst can be an indicator of polycystic ovarian syndrome. However, ovarian cysts only pose a problem if it grows exponentially to a large level, if torsion occurs (where the cysts twists, splits and causes severe pain in the abdomen) or if the cyst grows to the extent where it impedes the blood flow to the ovaries.

Treatment

If the cyst is causing you pain, then obviously it needs to be removed. On occasion, this might even be necessary regardless of whether or not the cyst is causing symptoms, eradicating any chance of it becoming cancerous in the process. There are two methods in which an ovarian cyst can be removed: laparoscopy and laparotomy. Both methods are described below. With both methods, you will be put under general anaesthetic (i.e. you will be put to sleep).

Laparoscopy

If the cyst is relatively small it can be removed with a laparoscopy. A laparoscopy involves a small cut into the lower abdomen. Then gas is blown into the pelvis to move the wall of the abdomen away from your organs. Following this, a laparoscope, a tiny microscope is inserted into your abdomen, allowing your surgeon to see where your cyst is on a monitor. From here, your surgeon can locate the cyst and remove it manually.

The cuts will be stitched up following the surgery. All in all, the process should take no longer than thirty minutes.

Laparotomy

If the cyst is cancerous, or could potentially become cancerous, a laparotomy will be required. A laparotomy requires a larger cut than a laparoscopy to be made, to give the surgeon better access to where the cyst is. The cyst as well as the whole ovary will need to extracted. This will then be analysed at a laboratory to check whether it is cancerous or not. This is not so much of a problem if only one ovary is removed, as your fertility should not be affected. However, if both ovaries are removed, then it could spark a premature menopause (providing you are still fertile prior to the operation).


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