Do ovarian cysts require the removal of the ovary?

Written by Shen Li Wen
Obstetrics and Gynecology
Updated on September 26, 2024
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When women discover ovarian cysts, it is not necessarily required to remove the entire ovary. For example, in women of childbearing age, the ovary can continue to ovulate, aiding in normal conception and secreting hormones to maintain normal endocrine function. In such cases, surgery to remove the ovarian cyst while preserving the healthy ovarian tissue can be performed. However, if a woman is nearing menopause or has already undergone menopause and discovers a large ovarian cyst, the function of the ovaries may have gradually declined or already ceased. If surgery is performed to remove the ovarian cyst, there is a possibility of recurrence, and the function of the ovary may already be lost. In this case, it might be appropriate to proceed with the removal of the ovary.

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Written by Li Shun Hua
Obstetrics and Gynecology
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Ovarian cysts have no symptoms

Most ovarian cysts are physiological, so few people experience symptoms. Common ovarian cysts include corpus luteum cysts and other ovarian cysts, which generally disappear naturally after two to three months. Therefore, if the ovarian cyst is not large, within five centimeters, and there are no symptoms, it is possible to temporarily observe it and perform an ultrasound after two to three months. If the cyst has not decreased in size or continues to grow, it may be an ovarian tumor, which would require surgical treatment. This is because if an ovarian tumor is left for a long time, it may become malignant or may lead to ovarian torsion.

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Obstetrics and Gynecology
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Causes of ovarian cysts

The cause of ovarian cysts is unclear, with many factors that can lead to ovarian cysts. The most common type of physiological ovarian cyst is the follicular cyst. The most common pathological causes are chronic inflammation or abnormalities in hormone secretion and endocrine factors, but most causes are unclear. If an ovarian cyst is discovered, it is recommended to regularly check with a color Doppler ultrasound, which is a common gynecological test for tumor markers. If the results are abnormal, timely surgical treatment is recommended to more directly understand the nature of the ovarian cyst. If the cyst is smaller than five centimeters in diameter and has good internal sound transmission, it can be observed regularly; otherwise, aggressive surgical treatment is advised.

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Written by Xia Hu
Obstetrics and Gynecology
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Causes of ovarian cysts

There are several common causes of ovarian cysts. The first is during the ovulation process where the follicle fails to release an egg, resulting in the formation of follicular cysts. The ultrasound typically shows these as simple cysts containing follicular fluid. Another situation is the corpus luteum cyst, which occurs after ovulation when the ovary forms a wound surface and a corpus luteum. Cysts can also develop during the growth of the corpus luteum. These two types of cysts generally disappear after the next menstrual period and are considered physiological cysts that usually require no treatment. However, some cysts result from pathological changes in ovarian cells, or even from tumors. On an ultrasound, these appear differently, often as mixed composition masses, in which case surgical treatment is recommended.

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Written by Xia Hu
Obstetrics and Gynecology
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Symptoms of ovarian cyst carcinogenesis

The main symptom of malignant transformation of ovarian cysts is increased abdominal pain, which generally occurs on one side, including either the left or right side, since the ovaries are present on both sides. If the cyst is unilateral, rapid growth can cause lower abdominal distension and pain. Therefore, when such symptoms aggravate, timely examination is necessary. Initially, a gynecological examination is recommended to assess the boundaries of the ovarian cyst and to palpate its nature and texture. These are essential evaluations. If there is a potential for malignancy, sometimes nodular changes, which may be metastases, can be detected in the posterior cul-de-sac. Subsequently, an ultrasound should be performed, with vaginal ultrasound generally providing greater accuracy.

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Written by Li Shun Hua
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How to treat ovarian cysts?

The majority of ovarian cysts are physiological. If an ovarian cyst is detected for the first time during an ultrasound, it can be observed temporarily. Generally, such cysts will gradually shrink or disappear naturally after two to three months. If the cyst is relatively large, exceeding 5cm, and the ovary has not shrunk after two to three months of observation, but instead the cyst has grown, it is likely an ovarian tumor, which requires surgical treatment. If an ovarian tumor occurs, there is a potential for malignancy or torsion, so timely surgical intervention is necessary.