Simplifying understanding of Ovarian Cysts

• From a general perspective – ovarian cysts are very common
• Misinterpretation and mismanagement is rife
• Most ovarian cysts are simple, they don’t need any treatment, patience and reassurance is all that is needed , Ex- functional cysts- extremely common.

Name- ‘functional’ gives you a clue, they are there for while and disappear over time.

If someone is troubled with such cysts, we do consider giving birth control pills. This is because, when someone is on birth control pills (combined) the ovarian activity is suppressed as long as she is on them.

The idea is that, if a woman doesn’t ovulate she won’t form the functional cysts

• Polycystic ovarian condition is a misnomer ( ref. below) , it should be called as – poly-follicular condition as the tiny fluid like lesions are in fact arrested mid follicular stage of human egg development
• No one knows why Dermoid cysts happen to some women, the content is mixed – I.e., clear fluid to concentrated sweat to bone and teeth and thyroid tissue and many more stuff…. These usually won’t go away, but not all Dermoid cysts need intervention
• Then we have borderline and cancerous ovarian cysts
• We take many parameters to consider a patient for intervention generally a size of > 5cms, persisting over time or causing pain or cyst having suspicious features, will be considered for surgery.
• Modern trend is to discuss patient’s condition in a multidisciplinary meeting and to take a consensus and then have a chat with the patient about the way forward
• Keyhole surgery is majority of the time a preferred route. But, having said this, size of the cyst matters as well as its content and it’s adherence to adjacent structures and many more parameters are taken before the invasive intervention…
• Hope my video with analogies gives you an understanding of complexities of ovarian cysts…..

Ref – Commentary: Polycystic ovarian disease (PCOD): a misnomer, looking for a new name Mahantesh Karoshi et al. Int J Fertil Womens Med. Jul-Aug 2004.