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Ovarian cysts

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Abstract

VOL: 99, ISSUE: 23, PAGE NO: 30

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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.

WEBSITES

The National Research Register

OMNI

PubMed

NHS Direct

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