Conditions and Treatment

OVARIAN CYSTS AND BENIGN TUMORS

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Understanding Your Options

An ovarian cyst is a sac or pouch filled with fluid or other tissue that forms on the ovary. It is normal for a small cyst to develop on the ovaries. In most cases, cysts are harmless and go away on their own. In other cases, they may cause problems and need treatment.

In the US, a woman has a lifetime risk of 5-10% of undergoing surgery for a suspected ovarian cyst or tumor. Out of this group, 13-21% of women are diagnosed with ovarian cancer. Thus most ovarian masses are benign. The most common ovarian mass in a menstruating woman is a functional simple ovarian cyst that resolves by her next menstrual cycle. In a post-menopausal woman, the most common ovarian mass is a non-cancerous cystadenoma. The goal of evaluation is to rule out cancer. Management decisions are often based on patient’s age, family history, patient’s symptoms, imaging studies, and blood testing results.

Masses with a low risk of cancer are often managed conservatively without surgery unless the patient is having pelvic pain or other associated symptoms. If your cyst is not causing any symptoms, the cyst may be monitored for 2-3 months and checked later to see whether it has changed in size. Most functional cysts go away on their own after one or two menstrual cycles.

If you are past menopause and have concerns about cancer, your health care provider may recommend regular ultrasound exams to monitor your condition. If the appearance of your cyst changes or if it gets bigger, treatment may be needed. Usually if cancer is expected, evaluation and surgery are performed by a gynecologic oncologist.

Laparoscopic (or Robotic-assisted) Ovarian Cystectomy
Benign cysts can be removed using laparoscopic surgery via a few small incisions on the abdomen, usually on an outpatient basis (you leave the hospital the same day). Normal activity can be resumed in a week or two.

Ovarian cysts usually do not require surgery, with some exceptions:

  1. When they do not go away after several weeks
  2. When they continue to grow and/or are very large
  3. When cancer is suspected
  4. When they cause severe pain

Dr. Rebeles performs the vast majority of cases laparoscopically or using the assistance of the da Vinci robot. Cystectomy is the surgical removal of a cyst. Most ovarian cysts are benign growths known by names such as “dermoid cysts” or “cystadenomas”. Often the cyst can be removed leaving the ovary intact, but occasionally the entire ovary must come out, for example, if the cyst is very large and has destroyed the ovary.
(Please also see: Robotic-Assisted Ovarian Cystectomy under Robotic Surgery )

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