An ovarian cyst is a fluid-filled sac in or on the ovary. Almost all ovarian cysts in women of reproductive age are benign. Often they are physiologic, or functional, cysts, which come and go on their own within 1-3 months and do not require surgery unless they cause problems. Common reasons to cause an ovarian cyst to become symptomatic are:
Transvaginal ultrasound is the preferred way to detect and characterize ovarian cysts. Cysts are typically classified as either simple or complex and cystic or solid on ultrasound. These ultrasound characteristics are useful in the differential diagnosis of the cyst. Simple fluid-filled cysts without any solid components are typically physiologic and will often go away with observation; whereas complex cysts are more likely to represent a pathologic process. The differential diagnosis for ovarian cysts in premenopausal women include:
Two simple ovarian cysts.
A complex ovarian cyst consistent with an endometrioma
Laparoscopic picture of a 6-7 cm right ovarian cyst prior to laparoscopic removal.
Persistent or symptomatic cysts, may require require laparoscopic surgery to remove them. The procedure is referred to as an ovarian cystectomy.
As with any surgery, the experience and expertise of the reproductive surgeon are very important to the outcome, especially in women who are attempting pregnancy or want to maintain their child bearing potential. It is important to recognize that any surgery on the ovaries can remove or damage healthy ovarian tissue and eggs or cause scar tissue formation around the ovaries and fallopian tubes, making natural pregnancy more difficult.
Dr. Lipskind will not operate on your ovaries unless there is a clear reason to do so. When cystectomy is necessary, he will use meticulous microsurgical technique to remove the cysts while minimizing any potential damage to the remainder of the ovary and nearby structures. In almost all cases, including those involving larger cysts, he will perform the surgery laparoscopically so that his patients can benefit from smaller incisions and shorter recovery time.
If you would like a consultation with Dr. Lipskind regarding ovarian cysts, please call your ACFS fertility team today.