• Clinical science
  • Physician

Ovarian cysts

Summary

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.

Overview

Definition

Ovarian cysts are fluid-filled sacs within the ovary.

Types

Clinical features

Diagnosis

Complications

Treatment

  • 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

References:[1][2]

Ruptured ovarian cyst

  • Etiology: physical activity
  • Clinical features
    • Sudden-onset unilateral lower abdominal pain
    • In the case of a very large cyst: Fluid and blood loss may cause acute abdomen and shock.
  • Diagnosis: Pelvic ultrasound shows free fluid, most commonly in the pouch of Douglas (rectouterine pouch).
  • Treatment
    • Hemodynamically stable patients can be observed and given analgesics.
    • Hemodynamically unstable patients require laparoscopy to control hemorrhaging.

References:[3]

Ovarian torsion

References:[5]

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  • 5. Laufer MR, Sharp HT, Levine D, Falk SJ. Ovarian and Fallopian Tube Torsion. In: Post TW, ed. UpToDate. Waltham, MA: UpToDate. https://www.uptodate.com/contents/ovarian-and-fallopian-tube-torsion. Last updated June 1, 2017. Accessed July 10, 2017.
  • Ashwal E et al. Characteristics and Management of Ovarian Torsion in Premenarchal Compared With Postmenarchal Patients. Obstet Gynecol. 2015; 126(3): pp. 514–520. doi: 10.1097/aog.0000000000000995.
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  • Yancey LM. Intermittent Torsion of a Normal Ovary in a Child Associated with Use of a Trampoline. J Emerg Med. 2012; 42(4): pp. 409–412. doi: 10.1016/j.jemermed.2010.11.046.
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  • Committee on Adolescent Health Care. Adnexal Torsion in Adolescents, ACOG Committee Opinion No. 783. Obstet Gynecol. 2019; 134(2): pp. e56–e63. doi: 10.1097/aog.0000000000003373.
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last updated 03/25/2020
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