- Clinical science
Ovarian cysts are fluid-filled sacs within the ovary. The most common types are functional follicular cysts, corpus luteum cysts, and theca lutein cysts, which all develop as part of the menstrual cycle and are usually harmless and resolve on their own. Nonfunctional cysts include chocolate cysts, which are related to endometriosis, dermoid cysts, cystadenomas, and malignant cysts (a type of ovarian cancer). All types can be diagnosed via pelvic ultrasound. While ovarian cysts are usually asymptomatic, complications due to rupture of a cyst can occur and may require treatment. Moreover, individuals with ovarian cysts are at increased risk of ovarian torsion, which requires surgical correction.
Ovarian cysts are fluid-filled sacs within the ovary.
Functional cysts: result from a disruption in the development of follicles or the corpus luteum; often resolve on their own
- Follicular cyst of the ovary (most common ovarian mass in young women)
- Corpus luteum cyst
Theca lutein cysts
- Multiple cysts that typically develop bilaterally
- Result from exaggerated stimulation of the theca interna cells of the ovarian follicles due to excessive amounts of circulating gonadotropins such as β-hCG
- Strongly associated with and multiple gestations
- Usually resolve once ß-hCG levels have normalized
- Nonfunctional cysts
- Most often asymptomatic unless complications occur
- In some cases, there may be signs of the underlying cause (e.g., menorrhagia in endometriosis or hirsutism, acne, and infertility in PCOS).
- Pelvic ultrasound
- In most patients with functional cysts, watchful waiting is recommended, as cysts often regress spontaneously.
- NSAIDs in the case of painful cysts
- Surgery in the case of complications, large cysts, or persistent cysts that are painful
- Treatment of underlying conditions such as PCOS, endometriosis, or ovarian cancer
- Etiology: physical activity
- Clinical features
- Diagnosis: Pelvic ultrasound shows free fluid, most commonly in the ().
- Hemodynamically stable patients can be observed and given analgesics.
- Hemodynamically unstable patients require laparoscopy to control hemorrhaging.
- Physical activity
- The primary risk factor is ovarian enlargement (e.g., due to cysts, ovarian stimulation, pregnancy, tumors).
- Sudden-onset unilateral lower abdominal pain
- Nausea and vomiting
- Diagnosis: Pelvic ultrasound with Doppler velocimetry shows enlarged, edematous ovaries with decreased blood flow.
- Treatment: Detorsion via laparoscopic surgery is recommended as soon as possible to restore blood flow.