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

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

Frequently asked questions about Ovarian Cysts

- Will medical insurance companies cover the procedures we offer?

In most cases the surgical procedures we perform are covered by medical insurance. It is important to obtain prior approval from your insurance company before surgery. Linda my Secretary will give you a breakdown of the costs related to your surgery.

- Do I need to have medical insurance?

No, medical insurance is not essential. However, it is important to obtain costings for the consultation and any proposed surgery prior to embarking on any course of action.

- If I am seen in Private can I be operated on by you in a Public Hospital?

Unfortunately I do not work in the Public Hospital system. In this instance I would refer you to the appropriate hospital depending on where you live in Auckland.

- I am concerned I will not be able to absorb all the information I am given during my consultation. How can I learn more about my condition and proposed management?

Studies have shown that at most we retain somewhere between 30-40% of what we are told at a medical consultation. For this reason we have developed this website so that information relevant to your condition is available to you at any time. You are encouraged to bring a support person to your consultation, as having two people will enhance retention of the information given. You will also be given written information at the conclusion of your consultation.

- What happens if I have any worries or concerns after surgery?

Written post-operative information will be given to you before going home, and these hand-outs can also be found on our website (view recovery guide). My telephone number is included in this information and I would encourage you to phone me if you have any concerns.

- Is minimal access surgery such as Laparoscopic surgery better than more conventional open surgery?

Minimal access surgery has the advantage of more precise surgery; less discomfort post operatively, shorter stay in hospital and early return to work.

- If I have an ovarian cyst on ultrasound scan which is suggestive of endometriosis, how is this managed?

A cyst which contains endometriosis is called an endometrioma. This can be associated with more severe endometriosis. CA125 detected by a blood test can be a marker of endometriosis and is often increased if an ovarian cyst contains endometriosis.

We manage an endometrioma by removing the cyst from the ovary Laparoscopically. Ovaries are rarely removed. Any endometriosis in the pelvis is usually removed at the same time.

- After a Hysterectomy will the quality of my orgasm and my desire to have sex be diminished in any way?

The great majority of women who have a Hysterectomy will find that their libido (sex drive) will improve. The symptoms that resulted in a Hysterectomy being performed often cause decreased libido. After a Hysterectomy these symptoms improve as does libido. In general terms the quality of orgasm is no different following Hysterectomy.