Ovarian cysts
Women of child-bearing age develop follicles (egg blasts) every month
before ovulation. It’s in these follicles that the egg grows. During ovulation
(when the follicle is 18-20 mm in diameter) the follicle bursts and the
egg moves into the fallopian tube.
But sometimes the follicle doesn’t burst. That’s often the situation when
we opt for hormone stimulation in fertility treatment or in case of inexplicable
infertility. Instead of bursting, the follicle develops into a cyst, often
filled with fluid and in rare cases blood as well. Usually such cysts are
tiny and just disappear after a while. But sometimes they grow and then
they require treatment.
Symptoms
Often you’ll experience no symptoms at all if you have a cyst because
they are usually tiny. But sometimes you may have symptoms like:
- pain during sex
- a visibly enlarged tummy
- a bearing-down sensation
- need to go to the toilet more often
- problems emptying your bladder.
Sometimes a cyst can twist on itself, which means that it cuts off the blood supply. This can also cause severe pain, and you must contact the clinic.
Treatment
We use ultrasound scan and perhaps take a blood sample to find out if
we need to monitor the cyst or if we need to remove it in a keyhole operation.
If the cyst requires monitoring, we’ll find a new appointment for you 1-6 months later. Fertility patients usually wait until their next cycle when they come in for a scan anyway on day 2/3 of their cycle. Then we’ll decide what to do next.
If the cyst needs to be removed, you’ll get an appointment for an operation, as you must have general anaesthesia for this procedure. The operation can be performed without any harm to the fallopian tubes. If you’re past menopause and develop a cyst that needs to be removed, we often recommend that you have your fallopian tubes removed as well, to prevent malignant cysts from developing later.
Below you can read more about what happens during the operation.
Before the operation
Having an ovarian cyst removed is usually a small procedure, which means you can go home 2-4 hours later. But because there may be some side-effects of the anaesthesia, you must have somebody to come and pick you up at the clinic and stay with you for the next 24 hours. It’s important that you tell the specialist before the procedure about any drugs or medicine you take, because some of them are dangerous in combination with the anaesthesia. It’s also a good idea to stop smoking before the procedure if you can, because smoking slows down the healing of wounds, and that goes for the period after the operation as well.
Fasting:
- You are not allowed to eat anything 6 hours before your operation.
- You are allowed to drink water and juice until 2 hours before your operation.
The operation
You’ll have general anaesthesia for the operation. We’ll put an IV line in the back of your hand and give you the anaesthesia through it. The operation is usually performed using a thin tube with a microscope (laparoscope). We normally make 2-3 small incisions in your stomach: one next to your belly button and one further down on the same or both sides of your stomach. The incisions are about 1 cm long. But sometimes there’re adhesions or scar tissue that make it necessary to make the incisions slightly larger. All the tissue removed is sent to the University’s Department of Pathology for further analysis. You’ll get the results from the test about 14 days after the operation.After the operation
After keyhole surgery you can usually go home 2-4 hours later. But if you’ve got larger incisions, we recommend that you spend the night at the clinic.
Pain
It’s normal to experience pain after the operation. Your tummy may also
feel bloated, and occasionally there’ll be pain in the right shoulder.
However, the pain and discomfort should pass in a day or two.
Hygiene
You can take a shower after 24 hours. Take off any bandages first, and
afterwards gently dab the wounds with a towel. The wounds heal better if
they’re left unbandaged. But if there’s a bit of oozing from the wounds
you should put on a clean bandage.
Activity
Following the keyhole operation, you should be off sick for 1-2 weeks.
If you’ve had large incisions, we recommend you take sick leave for 3-4
weeks. After keyhole surgery there’re no special restrictions for lifting
or activity afterwards. But you should never push yourself beyond your
”pain threshold”. If you’ve had major incisions, however, you shouldn’t
lift heavy objects (more than 10 kg) or take hard physical exercise such
as badminton, tennis or similar activities for 4 weeks after the operation.
You can start running, riding your bike, taking walks etc. as soon as you
feel up to it. You can take up swimming about 14 days after the wounds
have healed.
Check-up
Once the keyhole surgery is over, we close the incisions with soluble
thread inside and special tape on your skin. This means that you don’t
have to have the threads removed. But you should come in for a check-up
1 month after the operation.