Ovarian cysts are very common in the reproductive age group women. The contents of the ovarian cysts vary depending on the pathology. Ovarian tumors usually do not resolve and require surgical removal.
Do all ovarian cysts require surgical intervention?
An ovarian cyst smaller than 8 cm (in whom CA 125 is within normal limits) in diameter can be monitored by ultrasound every 3-4 weeks.
An ovarian cyst, which does not regress in size (or enlarges in size), requires surgical intervention.
What are the types of benign ovarian cysts?
There are several different types of ovarian cysts and the most common ones are
- Mucinous cysts
- Endometriotic cysts
A picture of dermoid cyst showing its contents
How is the procedure performed?
We first separate the cysts away from the normal ovarian tissue.
We then use a specialized “endo” bag to retrieve the cyst and its contents out of the abdomen. These “endo” bags help us to retrieve the specimen without spilling the contents into the abdomen.
Will I be able to conceive after the procedure?
Our specialists (being reproductive medicine specialists) are very much concerned about your ovarian functions, thus every effort is made to conserve as much normal ovarian tissue as possible.
However, particular patients in whom we suspect cancer or have a family history of cancer, a complete removal of the ovary may be needed.
What if the ovarian tumor is cancerous?
If we identify cancer, a staging operation is performed during the same procedure. We evaluate the lymph nodes and other organs to rule out metastasis (spread of cancer). Next, we proceed with optimal debulking, wherein we remove as much macroscopic cancerous tissue as possible.
Sometimes for more optimal debulking an open surgery may to be needed.
Polycystic Ovarian Disease:
A diagnosis of PCOS is given if you have
• Several multiple tiny cysts seen in ultrasound scan (a necklace appearance)
• Irregular menstruation or anovulation (no release of eggs during menstruation)
• Hyperandrogenism (excessive facial or body hair)
How does PCOS cause infertility?
Due to excessive androgen released from the ovarian theca cells, the follicles (which usually rupture to release egg during menstruation)
Become hard and cystic.
This causes an array of “cause-disease-cause” loops that ultimately leads to infertility.
How is PCOS treated?
The treatment depends on a lot of factors; a patient looking for fertility has a complete different management form a patient who wants to rid themselves of PCOS.
In patients looking for fertility, studies have shown that Polycystic ovarian drilling helps release the excess androgen stored within the ovarian cortex, thus restoring normal menstruation.
How is ovarian drilling performed?
Tiny punctures are made on the affected ovaries using a specialized instrument called the tritome , which produces high frequency , low amplitude electrical current .This helps release the excessive androgen stored in the ovarian tissue. After the procedure majority of the patients regain their normal ovulatory functions.