Ovarian cysts and tumors are among the most common disorders of the female reproductive system. While these structures often present no symptoms, in some cases they can lead to serious complications and may require surgical intervention. The decision to undergo surgery is generally based on the size and type of cyst or tumor, the likelihood of malignancy, and the patient's symptoms.

What are Ovarian Cysts?

They are fluid-filled sacs that form in the ovary. Functional cysts are the most common type and usually disappear on their own. However, surgery is unavoidable for endometriomas (chocolate cysts), dermoid cysts, or malignant cysts.

Ovarian tumors can be benign or malignant. Treatment for malignant tumors is more successful if detected in the early stages.

Why Do Ovarian Cysts Form?

Ovarian cyst symptoms can manifest differently depending on an individual's age and stage of life. Certain types of cysts are more common during adolescence, reproductive years, or menopause. Ovarian cysts typically present by age include:

1. Functional Cysts : Functional cysts are most prevalent during adolescence, encompassing the ages of 13-18. These cysts generally resolve spontaneously and do not require surgical intervention. Transient cysts may occur during this period because hormonal balance is not yet fully established. Functional cysts generally require only monitoring; however, in rare cases, complications such as ovarian torsion or rupture due to the weight of the cyst can occur. Similarly, functional cysts can also be seen during the reproductive years.
2. Germ Cell Tumors : These cysts, which can appear from adolescence to the early years of reproductive age, constitute a subgroup of ovarian tumors. Depending on the diagnosis, some types may require surgery alone, while others may require additional chemotherapy. These solid cysts can be easily detected with ultrasound.
3. Corpus Luteum Cysts : These cysts, which form during ovulation and are usually seen during menstruation, largely disappear on their own. Rarely, they may cause bleeding.
4. Dermoid Cysts : Dermoid cysts, more common during pregnancy, can contain tissue such as skin, hair, fat, bone, or teeth. These cysts can rapidly accumulate weight and potentially cause ovarian torsion. Torsion usually requires immediate surgical intervention. Currently, surgical procedures tend to preserve the ovaries, and only the cystic mass can be removed to restore the ovary to its former function.
5. Endometriotic (Chocolate) Cysts : Chocolate cysts get their name from the brown liquid they contain, which resembles melted chocolate, and are often identified as a formation of endometriosis in the ovaries. They are common in women of childbearing age, affecting one in 10 women. Caution is advised when deciding on surgical intervention for these cysts, especially if the patient is planning to become pregnant. Surgery is considered if chocolate cysts are larger than 9-10 cm or if they cause significant symptoms such as pain. However, smaller, homogeneous cysts are generally monitored. Surgery becomes a priority when the CA-125 tumor marker level increases. While the risk of cancer in chocolate cysts is low during the reproductive years, it can increase with age.

The follow-up and treatment process for ovarian cysts is determined depending on the type of cyst, its size and the general condition of the patient.

Situations Requiring Surgery

Cysts larger than 5 cm are generally monitored, and if they continue to grow, surgery may be necessary. Urgent surgery is also necessary if the ovary rotates, disrupting blood flow. A rupture can cause intra-abdominal bleeding. In such cases, surgery is unavoidable. Especially in postmenopausal women, if blood tests (CA-125) and imaging studies suggest that the cyst may be malignant, surgery may be necessary if cancer is suspected. Surgery is also considered for cysts that cause chronic abdominal pain, menstrual irregularities, or difficulties conceiving.

Surgical Methods for Ovarian Cysts and Ovarian Tumors

1. Laparoscopic Surgery (Closed Surgery):

It's performed through small incisions in the abdomen using a specialized camera and surgical instruments. This type of surgery, which offers the advantages of a faster recovery, less scarring, and a shorter hospital stay, is often preferred for removing benign cysts.

2. Laparotomy (Open Surgery):

This type of surgery involves accessing the abdomen through a larger incision. While it allows for the removal of larger cysts or malignant tumors, it has the disadvantages of a longer recovery time and more scarring.

Surgical methods are effective and safe for the treatment of ovarian cysts and tumors. The decision to undergo surgery is based on factors such as the type and size of the cyst, the patient's age, and overall health. Early diagnosis and treatment are crucial for preventing potential complications. Therefore, regular checkups are essential for maintaining women's health. Private Magnet Hospital is at your service with expert obstetricians and gynecologists. Contact us now and make a good investment in your health.