13 February 2019
- Dr. Haroon Khamisa
There are two ovaries in all human females and are an essential part of the female reproductive and endocrine systems. The ovaries are made up of a number of follicles/eggs which are released from puberty to menopause. Sometimes a fluid filled cyst forms in the ovary. The contents of the cyst/cysts determines its seriousness and further treatment.
The cyst may contain clear watery fluid, blood stained fluid, mucinous fluid, fresh or old blood, hair, teeth etc, and may have inclusions or growths within the cysts. The presentation of the cyst may be by an incidental finding, sometimes with severe pain, abnormal bleeding, swelling, infertility or torsion (i.e. it twists on itself.)
The diagnosis is made normally by ultra sound, sometimes CT scan and/or MRI are necessary especially to exclude any cancer spread to the pelvic lymph nodes. A pelvic ultra sound therefore constitutes an essential part of annual gynae visits.
The treatment of cysts may be conservative (that is no treatment) if it is a simple cyst, laparoscopy - to remove fluid, biopsy or to remove the cyst and sometimes the whole ovary. There is a blood test that may be done if cancer is suspected called CA 125. It is also used to follow up patients who have had ovarian cancer.
Often PCOS (polycystic ovarian syndrome) is confused for an ovarian cyst. Polycystic Ovarian syndrome /disease is due to a genetic hormonal metabolic disorder where patients have irregular or no periods. Often with high BMI, insulin resistance and subfertility. The ovaries are large and contain numerous cysts/follicles due to anovulation (not ovulating). The treatment of PCO, is multidisciplinary and long term.