Ovarian cysts

Laparoscopy – Ovarian cysts

Ovarian cysts are a very common finding in women of reproductive age and beyond.
Their size can range from a few millimeters to over 10 centimeters.

Most often these are follicles (which have increased in size) and give the impression of a cyst.
In these cases, the recheck after the next period (up to three months later), will give us the answer, since the follicles are absorbed (functional cysts) while the true cysts persist. Then we talk about organic cysts.

In the vast majority of them, these cysts are benign. Their etiology varies and can be serous, mucous, endometriotic, dermoid, hemorrhagic, paraovarian etc.

Symptoms and treatment

Most of the time, the diagnosis is incidental, after a routine ultrasound check or for some other pathology.
If it is a large cyst (greater than 4-5 cm), the patient may experience symptoms of chronic pain (pressure phenomena) or a feeling of fullness in the abdomen, or acute pain (rupture, twisting).

Malignancy (that is, the likelihood of them developing into malignancy) is rare and increases with age and family history.
Unfortunately, ovarian cancer is a disease whose prevention is impossible with today’s scientific data and which gives symptoms quite late, when the disease has reached an advanced stage.

Depending on the ultrasound findings, the gynecologist will direct the patient and possibly request some additional tests, blood (cancer markers), or radiological (magnetic tomography).
So, after this check-up, the woman will be advised either regular monitoring, surgical removal of the cyst or even the removal of the entire ovary.

In case of surgery, the laparoscopic route is the first choice if the appropriate conditions for this technique are met.
The cyst is removed entirely and the remaining ovary remains in place and continues its function of producing eggs and estrogen.
In postmenopausal women, in whom the ovaries are no longer functional, we usually recommend the removal of both ovaries and fallopian tubes as a precaution, which is also done by laparoscopy. Removing the ovaries after menopause has absolutely no impact on women’s later life. Instead it protects women from a future ovarian and fallopian tube cancer.
Usually in these operations, the hospitalization is only one day and the patient recovers within 24-48 hours with excellent aesthetic results.

Ovarian cysts and centimeters

Cysts vary in size and the bigger the cyst is, it does not necessarily has a dangerous outcome. In women of reproductive age, however, the larger a cyst grows, the more likely it is to affect the function of the corresponding ovary. This means that over time the ovary with the cyst can be damaged, not functional, i.e. not producing eggs. There is no specific size in centimeters above which the ovary does not function properly, this varies from woman to woman.
In older women, the probability of a malignancy increases with size and especially when it exceeds 10 cm and/or when the cyst combines internal solid elements, as we say in medical terminology.
In any case, the treatment is individualized and adapted according to the age of the woman, the size and the radiological findings of the cyst.