Ovarian cysts

Definition

A collection of fluid within a small sac of skin, within an ovary.

Epidemiology

Almost all pre-menopausal women will have cysts. The point is that the vast majority (about 95%) don't cause any problems. I can't find any statistics on this, but they are a common finding in cases of abdominal pain.

Pathophysiology

There are three types:

Functional cysts

The normal menstrual cycle often causes small cysts that cause no problems. They usually last 3-6 weeks, and are rarely large enough to be detected or problematic. Sometimes they can swell up larger, causing sharp pain, and occasionally some bleeding. Usually, even in these cases, the cyst usually sorts itself out completely within a few months.

Dermoid cysts

Don't really get what these are, except they are benign teratomas, and can occasionally progress to malignant teratomas. This is obviously bad. See the page on ovarian cancer for these.

Endometroid cysts

These are cysts in endometrial tissue inside the ovaries. They occur in endometriosis and can cause heavy bleeding.

Risk Factors

There are no known risk factors for ovarian cysts. Not often you get to write that!

Clinical Features

• Lower abdominal pain, sometimes worse after sex.
• Menstrual disturbance
• In large cysts, pressure may be put on the bladder.

Be aware of the possibility of cancer or endometriosis with similar symptoms.

Investigations

• Vaginal examination
• Ultrasound, looking for abnormal fluid collections.

Management

Not a lot can be done for small