Diagnosis and Treatment of Ovarian Cysts

Ovarian cysts usually are found during routine pelvic examinations. During this examination, your doctor is able to feel the swelling of the cyst on your ovary. Once a cyst is found, the doctor may perform an ultrasound, or a screening to see if the cyst is hollow or solid, determine its size and exact location, and see if it contains fluid or abnormal structures that help show its type. The doctor may decide to "wait and see" if the cyst will shrink on its own in a few months. If you frequently develop cysts, your doctor may prescribe birth control pills to prevent you from ovulating. This will prevent follicles from developing and new cysts from forming. Your doctor might talk with you about birth control pills, and if they are right for you.

If the cyst does not go away after several menstrual periods, if it has gotten larger or more painful, or it does not appear to be a functional cyst, your doctor may want to perform other tests or procedures to look at and remove the cyst. To detect your risk for ovarian cancer, your doctor may want to do a blood test to measure a substance in the blood called CA-125. The amount of this protein is increased in the blood of women with ovarian cancer. However, some ovarian cancers do not produce enough CA-125 to be detected by the test, and there are other non-cancerous diseases that also increase the levels of CA-125. For these reasons, the CA-125 test is recommended mostly for women who are at high risk for the disease.

If the cyst is small and looks benign on the ultrasound, your doctor may perform a laparoscopy. This procedure is done under general anesthesia on an outpatient basis and allows the doctor to closely examine all of your reproductive organs. A very small incision is made above or below the navel, and a small instrument that acts like a telescope is inserted into the abdomen. If the cyst is small and looks benign, it can be removed after the doctor makes very small incisions in the pubic hairline.

If the cyst is too large to remove this way, the doctor may perform a procedure called a laparotomy. This procedure involves making bigger incisions in the stomach to remove the cyst. While you are under general anesthesia, the doctor is able to have the cyst tested to find out if the tissue is cancerous. If it is cancerous, the doctor will then be able to remove other tissue that could be affected, like the ovary, fallopian tubes, uterus, or lymph nodes. Before any surgery, your doctor will talk to you about what will happen during the surgery, the risks, and how long it will take you to recover. It is important to remember that most cysts are not cancerous and relatively harmless if treated properly.