Procedure Description:
OVARIAN CYSTS

What To Expect:
In a reproductive age woman, an egg is formed each month in the first two weeks of the menstrual cycle. It is surrounded by a cystic area full of fluid called a follicle. Usually a follicle does not get bigger than 2.5 cm. At approximately 2 weeks after menses and 2 weeks before the next menses the egg extrudes from the follicle (ovulation) and the cystic area heals over to become a corpus luteum (luteal) cyst. This cyst forms some cells which secrete estrogen and progesterone. When pregnancy does not occur, the cyst just dissolves and goes away. Both the follicular cyst and the luteal cyst can sometimes go "haywire" and just continue to grow and not go away when they should. Eventually they both go away but sometimes they can swell up, rupture, bleed or even twist causing moderate pain before they go away. Most cysts under 3 cm will gradually regress on their own and do not cause symptoms.

Preprocedure:
Cysts up to 5 cm in size almost always regress eventually and most doctors do not recommend surgery without giving those cysts 3-4 months to dissolve themselves. Sometimes other cysts can form in the ovary that do not come and go with the monthly menstrual cycle. Endometriotic cysts(endometriomas) and benign ovarian tumors like cystadenomas or dermoids can form in the ovary. Endometriosis can cause pain whereas the other ovarian tumors generally do not. When cysts, other than endometriomas cause moderate pain, they usually do so rather acutely such as when they rupture, bleed or twist. If you get a sudden onset of lower abdominal pain then you need to be evaluated for a cyst. Also if you have a sudden onset of pain and nausea and vomiting, that may represent a twisted cyst. If you have a ruptured cyst, bleeding into a cyst (some call it a bruised ovary), the pelvic pain may take as long as 3-4 months to totally go away. At other times the pain is incapacitating enough that emergency surgery must be performed.