Maintain pressure on reforms to protect NHSOvarian cysts
VOL: 99, ISSUE: 23, PAGE NO: 30
WHAT IS IT?
WHAT IS IT?
- An ovarian cyst is a globular sac filled with fluid or semisolid material that develops in, or on, an ovary.
AETIOLOGY
- The ovaries, located on each side of a woman's uterus and each measuring about 2.5cm x 2cm, are filled with follicles in various stages of development. Every month one follicle ripens to release an egg.
- After ovulation the ruptured follicle forms a yellowish lump called the corpus luteum. Cysts can occur due to changes in hormone levels during the menstrual cycle and the production and release of eggs.
TYPES OF CYST
- Follicular cysts arise when an ovarian follicle fails to rupture in the course of its development and ovulation. This type of cyst is common and usually asymptomatic.
- Luteal cysts are formed when the corpus luteum fails to degenerate, and fills with blood instead. Both follicular and luteal cysts are known as functional cysts.
- Dermoid cysts may contain fat, hair, teeth and other tissue.
- Chocolate cysts (or endometriomas), filled with dark, thick blood, are found on the ovaries as a result of endometriosis.
POLYCYSTIC OVARIES
- Polycystic ovaries are defined by the presence of numerous follicular cysts. The affected ovary may double in size as a result.
- Polcystic ovarian syndrome is generally defined in the UK as polycystic ovaries together with one or more characteristic features: hirsutism, acne, male pattern baldness, amenorrhoea or oligomenorrhoea.
SIGNS AND SYMPTOMS
- Most ovarian cysts are harmless and benign. However, some cysts cause severe symptoms that can be life-threatening.
- Dull, mild abdominal pain or acute pain caused by torsion.
- Occasionally cysts can cause pain or discomfort during intercourse.
- Irregular, painful periods.
- If a cyst ruptures, twists or haemorrhages, there may be severe abdominal pain, vomiting and low grade pyrexia.
INVESTIGATIONS
- Medical history and physical findings: large cysts may be palpable on abdominal examination.
- Pelvic examination.
- Pelvic ultrasound.
- Laparoscopy.
TREATMENT
- Follicular and luteal cysts usually disappear without intervention. Follicular cysts typically disappear within 60 days.
- Dermoid cysts require surgical removal but are always benign.
- Large or persistent cysts may be drained or removed.
- Oral contraceptives may be prescribed to help establish normal menstrual cycles.
RESEARCH AND DEVELOPMENT
Crayford, T.J.B. et al (2000)Benign ovarian cysts and ovarian cancer: a cohort study with implications for screening The Lancet; 355: 9209, 1060-1063.
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