Ovarian cyst treatment – Is surgery really necessary?

Doctor and healthy female reproductive system

If you have been diagnosed with ovarian cysts and worry about surgical procedures, then this might be a helpful read for you. Indeed, surgery is usually recommended as an ovarian cyst treatment, but that is not always the case.

At PK Women’s Clinic in Singapore, we understand that having reproductive health issues like ovarian cysts can be daunting and can make a woman feel anxious about what to do next and some are afraid to go under the knife. So, in the next sections, we discuss the different ovarian cyst treatments other than surgery and answer the question if surgery is really necessary for your case.

Not all ovarian cysts are the same

Doctor showing the structure of female reproductive organs

From birth, a woman’s ovaries already contain a fixed number of eggs. When she reaches puberty and starts to have her menstrual cycle, an egg is released every ovulation phase. The eggs are housed in follicles or small sacs where eggs continue to mature. When the eggs mature, the follicles break open to release the eggs during the ovulation phase of the menstrual cycle and directs them into the uterus for fertilization.

Most ovarian cysts form as a result of the follicles not breaking away to release the egg or when they do not properly close after releasing the egg, so they become filled with fluids and form into cysts. These are called functional cysts.

However, some cysts result from abnormal cell growth such as dermoid cysts that are typically made up of various structures like bone, hair, teeth or skin glands. They develop from a germ cell or embryonic cell. There are also abnormal growths called endometriomas (when endometrial tissue settles in the ovaries) and cystadenomas (cysts filled with mucous material).

You should see a doctor right away when you feel symptoms

Although most ovarian cysts do not show any symptoms and resolve over time, some cysts can continue growing and rupture and cause serious symptoms like:

  • Mild to severe pain on the lower abdomen and pelvic area
  • Longer menstrual periods than normal
  • Lighter or heavier periods than usual
  • Frequent urination and difficulty in bowel movements
  • Bloating
  • Pain during sexual intercourse
  • Abnormal vaginal discharge

If you experience any of the following symptoms, see a doctor right away.

  • An abruptand intensepain on the pelvic or abdominal area
  • Lightheadedness,
  • Sudden weakness as though you are about to faint
  • Shortness of breath
  • Severe lower abdomen pain accompanied by vomiting
Ovarian cyst symptoms

These symptoms often mean that your ovarian cysts have ruptured or they have become too large that they twist the ovary, or what we call as ovarian torsion. These conditions require immediate medical attention so make sure you call your doctor or healthcare provider right away.

Ovarian cysts are detected through a pelvic exam

A pelvic exam is a routine medical examination for women at the age of 21. During the exam, your external and internal reproductive organs are examined for irregularities to ensure over-all reproductive health.

Also, during a pelvic exam, we will ask about your medical history including sensitive questions about your sexual activity and the extent of pain and related symptoms that you feel in your private areas. All of these can be uncomfortable for most women, but we always ensure that our patients feel comfortable and safe. We offer personalized, compassionate and confidential care to help women become more open about their symptoms and plan out a treatment plan specific for their condition.

When ovarian cysts are suspected during a pelvic exam, we typically require patients to undergo the following confirmatory tests to determine the location, type, and size of ovarian cysts:

  • Pelvic ultrasound
  • Laparoscopy (Keyhole diagnostic procedure using asmall device with a camera attachment to view the ovaries and other reproductive organs through a small incision in the abdomen)
  • Pregnancy test (A positive test can suggest the presence of a functional cyst)

You don’t always need surgery for ovarian cyst treatment

Functional ovarian cysts usually do not show any symptoms and resolve on their own as they are part of the normal menstrual cycle. Therefore, we usually do not employ immediate medical interventions. For these cases, we often recommend watchful waiting or close monitoring of the development of the cysts through routine ultrasound scans over a few weeks to months. This enables us to see whether the cysts continue to grow or goes away on their own. If the scans show that the cysts have resolved on their own, further treatments aren’t usually needed.

For these cysts that have an abnormal appearance or growth (dermoid, endometriomas, cystadenoma), we usually recommend ovarian cyst treatment such as medication or surgery, especially when they become large or become potentially cancerous. We also advise women who are past menopauseto have routine blood tests because they have higher risks of having ovarian cancer.

For medication, pain-relievers are usually prescribed to help you manage the symptoms. As a preventive measure, we often prescribe birth control pills to prevent ovulation and the development of more cysts. For existing, recurring and persistent ovarian cysts,hormonal contraceptives may not be effective and surgical removal of cysts may be required.

Especially with large and persistent ovarian cysts that cause rupture, ovarian torsion and cancer, surgery is usually the best treatment option. Depending on the severity and size of the cysts, we may recommend any of the following surgical procedures:

  • Laparoscopy (keyhole surgery for removal of smaller cysts)
  • Laparotomy (an invasive procedure to remove large cysts are potentially cancerous)
  • Ovarian cystectomy (removal of cysts while preserving the ovary)
  • Oophorectomy (surgical removal of affected ovary)

PK Women’s Clinic view on ovarian cyst treatment

Do note that there is no such thing as one size fits all type of treatment. It is important to understand that each condition is unique and response to treatment can vary from one patient to another. If you have been diagnosed with ovarian cysts, do not jump into the conclusion that you will have to undergo surgery right away. Remember that your doctor will always have the final word about the appropriate treatment for you, so you must be honest with your symptoms and work together with your doctorfor a successful ovarian cyst treatment.

PK Women's Specialist Clinic
2,Tai Thong Crescent, #01-12,
The Venue Shoppes., Singapore 347836
+65 6636 9909

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