Ovarian Cysts: Diagnosis and Treatment

First, the doctor will take the medical history and ask exactly about the symptoms. During the gynecological palpation, he may be able to feel a (painful) enlargement of the ovary. By means of ultrasound examination through the vagina, he will see whether the cyst shows any abnormalities. Further examinations such as an ultrasound of the vessels (Doppler sonography), determination of tumor markers in the blood and imaging procedures such as computer tomography may be necessary. Malignant diseases may also be hiding behind them.

What therapy is available?

In many cases, it is worthwhile to initially observe the growth of the cyst, because in up to 98% of cases it will regress on its own. Nevertheless, even small cysts that do not cause symptoms should be monitored regularly by ultrasound and palpation. If they grow particularly quickly, do not respond to medication, cause the woman more severe discomfort, or appear suspicious on ultrasound examination, surgical removal is advised.

Regular checkups

In postmenopausal women, if the cysts are inconspicuous, waiting with regular checkups is also warranted, but the decision to have them surgically removed is more likely to be considered because the risk of malignant neoplasm increases at older ages.

Medication

Birth control pills or other hormonal preparations containing progestin or progestin and estrogen suppress ovarian function. Thus, they can stop the growth of the cyst or even lead to its regression. They also prevent the cyst from forming again. Other drugs that interfere with hormonal regulation are GnRH analogues and danazol; the latter substance is used mainly for endometriosis cysts.

Surgery to remove ovarian cysts

Various surgical procedures are available for surgical intervention, from so-called keyhole surgery to abdominal incision with opening of the abdominal wall. Which procedure is chosen depends on the size of the cyst and the findings obtained. Many cysts can be removed using so-called “keyhole surgery” during an abdominal endoscopy (laparoscopy or pelviscopy).