Ovarian cyst treatment

An ovarian cyst is a fluid-filled cavity that forms on the surface of or inside an ovary. Most ovarian cysts are benign and often resolve spontaneously; however, some may cause symptoms or complications and require treatment. The management strategy depends on the type of cyst, its size, associated symptoms, and the woman’s overall health status.

Types of ovarian cysts

Functional cysts:

• Follicular cyst. Occurs when a follicle fails to rupture and release an egg. It usually resolves on its own within several menstrual cycles.
• Corpus luteum cyst. Forms after ovulation if the corpus luteum does not regress. These cysts also often resolve without treatment.

Pathological cysts:

• Endometriotic cyst (endometrioma, “chocolate cyst”). Develops in endometriosis, when endometrial tissue grows outside the uterus, including within the ovaries.
• Dermoid cyst (mature cystic teratoma). Contains various tissues such as skin, hair, or bone. These cysts are congenital and may increase in size over time.
• Cystadenoma. Filled with serous or mucinous fluid and may reach considerable size.

Polycystic ovary syndrome (PCOS). A condition characterized by multiple small cysts in the ovaries associated with hormonal imbalance.

Symptoms of an ovarian cyst

Many ovarian cysts are asymptomatic and detected incidentally during ultrasound examination. However, some cysts may cause symptoms:

• Lower abdominal pain, usually on one side;
• Sensation of pelvic pressure or heaviness;
• Menstrual cycle disturbances;
• Urinary or bowel symptoms due to pressure on adjacent organs;
• Nausea and vomiting;
• Increase in abdominal girth.

Treatment of ovarian cysts in Belarus

Treatment may be conservative (observation and medication) or surgical.

1. Expectant management (observation)

If the cyst is small, asymptomatic, and functional (follicular or corpus luteum cyst), observation without immediate intervention may be recommended:

• Follow-up ultrasound is performed after 1–3 months to assess changes in cyst size.
• In most cases, such cysts resolve spontaneously within several menstrual cycles.

2. Medical treatment

• Hormonal therapy. Oral contraceptives may be prescribed to regulate the menstrual cycle and prevent the formation of new cysts, although they do not eliminate existing cysts.
• Analgesics. Nonsteroidal anti-inflammatory drugs (NSAIDs) may be used to relieve pain or discomfort.

3. Surgical treatment

Surgical intervention is indicated if:

• The cyst causes significant pain or complications;
• The cyst persists after several cycles of observation;
• There is suspicion of malignancy;
• The cyst increases in size;
• Cyst rupture or ovarian torsion occurs.

Main surgical approaches:

• Laparoscopy. A minimally invasive technique in which the cyst is removed through small abdominal incisions using specialized instruments. Laparoscopy is preferred for smaller cysts and is associated with faster recovery.
• Laparotomy. An open surgical approach used for large cysts or when malignancy is suspected. This method requires a longer recovery period.

During surgery, the following procedures may be performed:

• Cystectomy. Removal of the cyst with preservation of the ovary.
• Oophorectomy. Removal of the ovary if the cyst is large or there is a significant risk of malignancy.

4. Management of endometriotic cysts

Endometriotic cysts require a specific approach. Depending on disease severity, treatment may include:

• Hormonal therapy. Medications that suppress endometrial growth may be prescribed to reduce cyst size.
• Surgical removal. Laparoscopic excision is performed for large cysts or when medical therapy is ineffective.

Prevention of ovarian cysts

• Regular gynecological examinations and pelvic ultrasound help detect cysts early and prevent complications.
• Hormonal contraceptives may reduce the risk of developing new functional cysts.
• Hormonal balance monitoring is particularly important in women with endometriosis or polycystic ovary syndrome.

Regular visits to a gynecologist enable timely diagnosis and treatment of ovarian cysts, helping to prevent progression and potential complications.