Ovarian Cyst Removal

Ovarian cysts are sacs filled with fluid on the surface of the ovary which are common in women during their menstruation. At many times, they disappear on their own. However, in some cases, the cyst starts increasing in size and may become painful. Ovarian cysts may also be the start of ovarian cancer, cause ovarian torsion or they may rupture to create other problems.

Most ovarian cysts are functional and develop as a part of the menstrual cycle such as Follicular cyst and Corpus Luteum cyst. The non-functional cysts are the ones that require removal using surgical methods.

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The signs/symptoms of ovarian cysts are- 

  • Abdominal bloating
  • Pain in the abdomen and pelvic region
  • Dizziness and Weakness
  • Pain in the pelvic region before or after period
  • Pain during bowel movements
  • Nausea and Vomiting
  • Pressure on the bladder

Routine pelvic exams can diagnose ovarian cysts. The doctor may also recommend a pregnancy test. If the test results are positive, it indicates that the cyst is a functional corpus luteum cyst and may not require removal. Pelvic ultrasounds use high frequency sound waves to produce images of the ovaries and hence, the location and size of the cyst can be determined. Other imaging tests like CT scan and MRI scan may also be carried out in order to know if the cyst is cancerous or not. 

There are several types of ovarian cysts and depending on their location and size, different types of methods of cyst removal are used. 
 
  • Laparoscopic surgery: This method is recommended for small cysts. A small cut is made in the abdomen through which a laparoscope is inserted. The laparoscope is a tube with a camera fixed on it, which allows the doctor to observe the cyst while operating on it. The cyst is then removed using another instrument. 
  • Laparotomy: This approach is used for cysts that are larger or may be cancerous. It requires a larger incision in the abdomen. 

There are several risks of an ovarian cystectomy. There are chances of scar tissue to develop or infection to occur at the site of infection. The cyst may even reappear after the surgery. During surgery, there are possibilities of causing damage to the bladder. There are also risks of rupturing the cyst while operating on it or causing it to spread more if it is cancerous. 

After an ovarian cystectomy, the patient may undergo pain in the abdomen for which painkillers may be prescribed. Laparoscopic surgery may take less time of recovery than a laparotomy. It is essential to call the doctor in case of bleeding, severe pain or unusual vaginal discharge.

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Ovarian Cyst Removal

Ovarian cysts are sacs filled with fluid on the surface of the ovary which are common in women during their menstruation. At many times, they disappear on their own. However, in some cases, the cyst starts increasing in size and may become painful. Ovarian cysts may also be the start of ovarian cancer, cause ovarian torsion or they may rupture to create other problems.

Most ovarian cysts are functional and develop as a part of the menstrual cycle such as Follicular cyst and Corpus Luteum cyst. The non-functional cysts are the ones that require removal using surgical methods.

Symptoms

The signs/symptoms of ovarian cysts are- 

  • Abdominal bloating
  • Pain in the abdomen and pelvic region
  • Dizziness and Weakness
  • Pain in the pelvic region before or after period
  • Pain during bowel movements
  • Nausea and Vomiting
  • Pressure on the bladder

Diagnosis

Routine pelvic exams can diagnose ovarian cysts. The doctor may also recommend a pregnancy test. If the test results are positive, it indicates that the cyst is a functional corpus luteum cyst and may not require removal. Pelvic ultrasounds use high frequency sound waves to produce images of the ovaries and hence, the location and size of the cyst can be determined. Other imaging tests like CT scan and MRI scan may also be carried out in order to know if the cyst is cancerous or not. 

Treatment

There are several types of ovarian cysts and depending on their location and size, different types of methods of cyst removal are used. 
 
  • Laparoscopic surgery: This method is recommended for small cysts. A small cut is made in the abdomen through which a laparoscope is inserted. The laparoscope is a tube with a camera fixed on it, which allows the doctor to observe the cyst while operating on it. The cyst is then removed using another instrument. 
  • Laparotomy: This approach is used for cysts that are larger or may be cancerous. It requires a larger incision in the abdomen. 

Risks

There are several risks of an ovarian cystectomy. There are chances of scar tissue to develop or infection to occur at the site of infection. The cyst may even reappear after the surgery. During surgery, there are possibilities of causing damage to the bladder. There are also risks of rupturing the cyst while operating on it or causing it to spread more if it is cancerous. 

After Procedure

After an ovarian cystectomy, the patient may undergo pain in the abdomen for which painkillers may be prescribed. Laparoscopic surgery may take less time of recovery than a laparotomy. It is essential to call the doctor in case of bleeding, severe pain or unusual vaginal discharge.

FAQ Section

1) What is an ovarian cyst and what does it feel like?

Ovarian cysts are cysts (fluid-filled sacs) that develop on the ovaries in women. Most cysts are small, painless and don’t cause any symptoms. Symptoms, if any, include pressure, swelling, pain or bloating in the lower abdomen on the side where the cyst is located. If a cyst ruptures, it causes sudden and considerable pain in the abdomen. Rarely, these cysts are cancerous. Cancerous cysts are mostly found in older women after their menopause. Certain conditions such as endometriosis or polycystic ovary syndrome (PCOS) also result in ovarian cysts, but these conditions are very rare and harmless.

2) When should ovarian cyst removal be performed?

Ovarian cyst removal should be performed provided:

•    The cyst is suspected to be cancerous or is cancerous.

•    The cyst is larger than 2.0 inches in diameter.

•    The cyst is causing prolonged symptoms.

3) Do ovarian cysts cause bleeding?

There may be some internal bleeding if the cyst ruptures, but it is rare. There may be external bleeding in some severe cases. Such bleeding can be life-threatening, and medical attention should be sought immediately.

4) How long does ovarian cyst pain last?

Normally, ovarian cysts are painful. There might be some pain in the lower abdomen towards the side of the cyst, but it will be mild. If the pain is severe and/or prolonged, medical attention should be sought.

5) Are ovarian cysts genetic?

Ovarian cysts are not hereditary or genetic. However, there is a genetic component to them which means that women with a family history of ovarian cysts are more likely to have these problems.

6) How do you prepare for ovarian cyst removal?

The most important thing is to talk to the doctor about the course of action if the cyst is found to be cancerous. The doctor will most likely suggest removal of the ovary. Rest all will be a standard procedure like a blood test, urine test, ultrasound, CT scan and other tests as seen fit by the doctor. You need to talk to the doctor about any medications or prescribed drugs that you are taking which may cause any complications. Habits like smoking, drinking which again might cause complications should be abstained from.

7) What are the alternatives to ovarian cyst removal?

If the cyst is large and is causing symptoms or is cancerous, there is no alternative to surgery. Milder forms of cysts can be dealt with by using medications. It is upon the doctor to decide what is best based on your symptoms and medical condition/history. It should be remembered that most ovarian cysts are harmless and resolve on their own.

8) What happens during ovarian cyst removal?

Ovarian cyst removal can be done in two ways-

•    Laparoscopy – It is performed if the cyst is smaller and uses a laparoscope (small, tube-like a microscope and a light attached to it) to find the cyst and remove it through small incisions made in the abdomen. The incisions are then closed using dissolvable stitches. It has a recovery period of about two weeks. Patients are generally discharged on the same day.

•    Laparotomy – It is performed if the cyst is bigger and/or is cancerous and the ovaries have to be removed as well. A single, larger cut is made in the abdomen to get access to the ovary and then is closed with staples or stitches. The recovery period is six to eight weeks. Patients are required to stay in the hospital for at least a couple of days.

Both types of surgeries are done under general anaesthesia and can take 1-2 hours to complete

9) What to expect after the operation?

You will be required to stay in the hospital for two days in case of a laparotomy. You can return home on the same day in case of a laparoscopy. You will be given IV fluids and medications during this recovery period. The recovery period is two weeks for a laparoscopy and six to eight weeks for a laparotomy. You are required to not put stress on the wounds during the recovery period.

10) Can ovarian cysts cause infertility?

Ovarian cysts can cause infertility in the following cases –

•    The cysts are because of endometriosis. Endometriosis is a condition in which the tissue lining your uterus grows outside of the uterus.

•    The cysts are because of Polycystic Ovary Syndrome (PCOS). It is condition marked by irregular periods, numerous small cysts on your ovaries, and higher levels of hormones. It is associated with irregular ovulation which might cause infertility

•    The cysts become infected causing pelvic infection which may cause scarring of the fallopian tubes and lead to infertility.

11) Can ovarian cysts lead to cancer?

Ovarian cysts are generally not cancerous. The chances of them being cancerous are more if the cysts are found in a woman after her menopause. 

12) How do you test for ovarian cysts?

If symptoms synonymous with ovarian cysts are observed, your doctor may recommend the following tests

•    Ultrasound or CT scan

•    CA-125 blood (in case of cancerous cysts)

•    Pregnancy test (they can also reveal corpus luteum cysts)

13) How does recovery work after ovarian cyst removal?

Recovery after an ovarian cyst removal is pretty normal. Recovery period of a laparoscopy is two weeks and of a laparotomy is six to eight weeks. You should not do any physical activities that put a strain on the wounds for the recovery period. You might be given medications and some dietary instructions. Some post-op tests are generally done to check for any complications or recurrence of the cysts.

14) What are the side-effects of ovarian cyst removal?

Side effects of ovarian cyst removal include-

•    Discomfort in the lower abdomen area

•    Vaginal bleeding or discharge for up to 48 hours

•    Tiredness

•    Pain in your shoulders

•    Infertility (if the cyst is cancerous and the ovaries are removed)

15) What are the complications of ovarian cyst removal?

Complications of ovarian cyst removal include

•    Recurrence of cysts

•    Need for removal of ovaries

•    Infection at the site of surgery

•    Excessive bleeding (Haemorrhage)

•    Blood clots

•    Damage to other organs 

16) What is the cost of ovarian cyst removal in India?

The cost of ovarian cyst removal in India varies from Rs. 50,000 to Rs. 1,50,000 depending upon the hospital and the surgeon involved.