Removal of ovarian cysts

We use the Fast Track Surgery Protocol for quick recovery. This means minimal surgery preparation, reducing of pain and restrictions after surgery, and returning to a normal lifestyle in 1-2 days.

Ovarian cyst is a very common disease. According to the statistics, it develops in 30-50% of various aged women. The probability of a cyst development is reduced after menopause – it is diagnosed only in 6%.

Ovarian cyst can be successfully treated. Functional cysts occasionally resolve themselves, while other types are usually treated with medication or surgery. In case of well-timed seeking for medical attention, minimally invasive organ-preserving operations are performed, after which you can return to normal life in 1-2 days.

The treatment is carried out in a surgical hospital which has two high-tech operating units, an intensive care unit and comfortable individual wards.

The «Oxford Medical» Clinic’s surgeons use the Fast Track Surgery Protocol for rapid rehabilitation, which makes it easier to prepare for surgery and facilitate the postoperative period.

The surgeon determines individually the tactics of the operation and the amount of tissue removed, taking into account the diagnosis and other peculiarities of the patient. The «Oxford Medical» Clinic’s surgeons always try to perform organ-preserving operations. In most cases laparoscopic cystectomy is usually sufficient for ovarian cysts. This is a low-traumatic operation, during which the cyst is removed but healthy ovarian tissue and its function is preserved.

Depending on the size of the cysts, their number and the presence of other pathologies in the patient, one of the following operations is performed:

• cystectomy - removal of the ovarian cyst with maximum preservation of healthy tissues;
• ovariectomy – removal of the ovary;
• аdnexectomy - removal of the ovary and fallopian tube.

Removal of the entire ovary, as well as along with the fallopian tubes, is rarely performed and takes place only when we deal with large cysts or in case of the complications development or the presence of other diseases.

In most cases the cyst is removed by laparoscopic method. This is a low-traumatic operation, during which healthy tissues are injured minimally. This reduces the rehabilitation period and allows the patient to leave the clinic right on the day of the operation or the next day.

During laparoscopic surgery 3 punctures are made on the abdominal cavity, through which endoscopic surgical instruments and optical devices are inserted into it. The latter transmit the image to the monitor, providing multiple zooming, which allows the surgeon to perform all manipulations with maximum accuracy.

Although laparoscopic surgeries are now used more often, in some cases a classic open-access laparotomy is necessary. Indications are large cysts, suspected malignant process, the presence of adhesions in the abdominal cavity, etc.

The «Oxford Medical» Clinic’s surgeons were among the first in Ukraine to start working with the Fast Track Surgery Protocol for rapid rehabilitation. It helps to simplify the preparation for surgery, gives better control for the depth of anesthesia, prevents postoperative pain and abandons restrictions in nutrition and motion immediately after the operation,  makes it possible to return to a usual patient’s lifestyle in 1-2 days. This makes surgical treatment even faster and more comfortable.

Due to the Fast Track Surgery Protocol:

• The patient doesn't need to clean the bowel before surgery.
• During the procedure the doctor can do without installing a urinary catheter.
• Permanent control for the depth of anesthesia is carried out, which ensures rapid awakening after surgery;
• The skin at the puncture sites is anaesthetized, which prevents the development of pain after surgery;
• There are no restrictions in nutrition and motion in the early postoperative period;
• There is no need to make bandages or remove sutures;
• The patient can return to a usual lifestyle in 1-2 days.

In most cases removal of an ovarian cyst is a simple operation. But it is important to prevent its increase and the development of complications. It is easier to notice the disease in time, knowing its symptoms.

A variety of reasons can cause the development of ovarian cysts. The key reason is a hormone imbalance – correlation of the follicle-stimulating and luteinizing hormones, the production of which changes throughout the menstrual cycle. They affect ovulation, follicle development, egg production, and other processes. Also cysts often develop in addition to endometriosis and other diseases.

The following factors increase the probability of ovarian cyst formation:

• genetic disposition;
• endocrine diseases and hormonal disorders;
• abortion;
•  gynecological pathologies;
• metabolic disorder;
• congestion in the pelvic area;
• early or late menstruation;
• late menopause;
• medical stimulation of ovulation;
• long-term use of hormonal and some other medications.

Depending on the cause of development and the type of tissue that makes up the neoplasm, there are several different types of ovarian cysts. They differ in structure and characteristics. For example, some of them may regress, while others require only medical or surgical treatment.

Types of ovarian cysts:

• Follicular - a mature follicle that did not break in time due to a violation of the ovulation cycle;
• Lutein cyst is a cyst that has developed from the corpus luteum (a temporary gland formed after ovulation) due to the accumulation of fluid in it;
• Thecalutein cyst - a neoplasm that develops in early stages of pregnancy due to poor production of progesterone by the yellow body;
• Endometrial cyst is a cyst, which consists of endometrial tissue (it develops if endometriosis takes place);
• Mucinous cyst - a formation with a bumpy surface and a multi-chamber cavity filled with mucus, predisposed to rapid growth to a large size;
• Paraovarian – a neoplasm that consists of the tissues of the parovarium and is located on its outer side;
• Dermoid cyst (teratoma) - a neoplasm made of epithelial cells that entered the ovary during the embryonic development of a woman.

The most common are follicular and luteal cysts. They are called functional, since they develop due to a violation of the ovulation and menstruation cycle. Functional cysts may develop asymptomatically and regress within a few months. Thecalutein cysts possess the same property. In some patients they resolve after childbirth or lactation.

Ovarian cyst is usually diagnosed with an ultrasound. However, in some cases, additional hardware diagnostics may be required – color dopplerography or computed tomography (CT). The doctor may also prescribe laboratory tests and other examinations to find out the cause of the cyst.

The method of treatment of a cyst depends on its type and size, the presence of symptoms, the patient's age and reproductive plans, as well as on the presence of chronic diseases and general state of health.

Two types of treatment are usually used:

• conservative therapy;
• surgery (laparoscopy).

Conservative therapy, as a rule, is aimed at eliminating the cause of cyst development – normalization of the hormonal balance or treatment of other gynecological diseases. Your doctor may prescribe hormonal, anti-inflammatory and other medications to treat the symptoms. Such therapy can last for several weeks or months, during which ultrasound is periodically performed to assess the effect on the cyst. If it does not decrease or continue to grow, the gynecologist may prescribe surgical treatment.

In some cases, if the cyst is small, not accompanied by any symptoms and the woman has no other diseases, the doctor may choose a monitoring tactic, that is, do not prescribe treatment, but regularly repeat the examination and control the cyst. A functional cyst may resolve within a few months. If this does not happen, it is deleted.

 Indications for surgical treatment of ovarian cysts are:

• Ovarian cyst that has been existing for more than 3 months and does not respond to conservative therapy;
• The cyst developed during menopause;
• The cyst has a large size and pronounced symptoms;
• The cyst leg twisted, suppuration in the cyst cavity or it’s rupture and other complications take place;
• Infertility caused by the ovarian cysts;
• Risk of developing a malignant process.

Many people know about the ability of ovarian cysts to regress so they consider this disease to be not dangerous. But in some cases, in the absence of timely therapy, cysts can provoke the development of serious complications.

Complications of an ovarian cyst may include:

• rupture of the cyst;
• twist of the cyst leg;
• formation of pus in the internal cavity of the cyst;
• disorders of the ovaries and other organs of the reproductive system;
•  infertility;
• recurrent pregnancy loss.

Almost all of these complications lead to the development of an acute condition that requires immediate hospitalization and medical care. In addition to this a woman may experience severe abdominal pain, fever, rapid pulse, nausea, dizziness and other symptoms.

The risk of developing a cyst is significantly increased by hormonal disorders and gynecological diseases, so for prevention, it is recommended to visit a gynecologist regularly, undergo preventive examinations and treat all diseases in time. It is also necessary to monitor the regularity of the menstrual cycle and avoid hormonal disorders – all hormonal drugs and oral contraceptives should be taken only as prescribed by a doctor.

To make an appointment for a consultation with an «Oxford Medical» Clinic’s doctor, call our contact center or write to the chat.