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Michael East
M.B.B.S, FRANZCOG, FRCOG, MAOG

T +64 9 522 3797
F +64 9 520 9526

Level 2, Suite 3
Ascot Hospital
90 Greenlane Rd East
Remuera
Auckland 1051
New Zealand
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Ovarian Cysts

Ovarian cysts occur frequently and generally they are physiological (normally occurring).

Many ovarian cysts are asymptomatic and symptoms of ovarian cysts can include:

  • Pain (on one side only or both sides of the pelvis)
  • Abdominal swelling and bloating (if the cyst is particularly large)
  • Urinary frequency
  • Constipation

Diagnosis of an ovarian cyst involves:

  • Taking a history of symptoms
  • A physical examination  
  • Ultrasound scan
  • CA125 blood test if an ovarian cyst is found on ultrasound (see Ovarian Cysts video)

Types of ovarian cysts:

  • The great majority are physiological (normally occurring)
  • Dermoid cysts – can contain hair and sebaceous fluid from the skin and very rarely teeth
  • Serous and mucinous cyst adenomas – these are benign cysts
  • Endometriomas – these are cysts that are found in association with endometriosis containing old blood, these are also known as chocolate cysts
  • Borderline ovarian cysts – They have the potential to become malignant
  • Malignant or cancerous ovarian cysts. These cases are referred to a Gynaecological Cancer Specialist

Management of ovarian cysts

If there are few symptoms and the cyst is less than 5cm in diameter then:

  • CA125 blood test is required
  • If this is normal a follow-up ultrasound scan in 6-8 weeks
  • If the ovarian cyst is persisting at follow-up scan then Laparoscopic removal may be indicated

If there is significant pain associated with ovarian cysts then Laparoscopic surgery is recommended for their removal.

Laparoscopic cyst removal involves;

  • Insertion of a laparoscope or telescope through the umbilicus (tummy button)
  • Distending the abdomen with gas to obtain a good view
  • Three small incisions in the lower abdomen
  • Removal of the cyst from the ovary
  • It is rare to have to remove an ovary unless it is malignant (cancerous) or the women is post-menopausal

The surgery takes 1-1½ hours, requires 1-2 days in hospital and 10-14 days to recover.