Ovarian Cyst Management

Comprehensive Care for Women’s Reproductive Health

Ovarian cysts are fluid-filled sacs arising from the ovarian tissue. While the majority are functional and benign, resolving spontaneously, some cysts may cause complications such as rupture or ovarian torsion. These complications necessitate prompt diagnosis and intervention to prevent morbidity. With extensive experience in laparoscopic and robotic gynecological surgery, we ensure personalized, precise care aimed at complete recovery and sustained reproductive health.

Pathophysiology & Clinical Significance

Ruptured Ovarian Cyst: The rupture leads to spillage of cystic fluid into the peritoneal cavity, potentially causing peritoneal irritation, acute abdomen, hemoperitoneum, and significant pelvic pain. Internal hemorrhage may result depending on the cyst type and vascular involvement.

Ovarian Torsion: This occurs when an enlarged ovary – often due to a cyst – twists around the suspensory ligaments, resulting in compromised arterial inflow and venous outflow. The ensuing ischemia poses a risk of ovarian necrosis, requiring emergent surgical detorsion to preserve ovarian viability.

Clinical Presentation

Patients with ovarian cyst complications may present with:

•       Sudden onset of severe unilateral lower abdominal or pelvic pain
•       Associated nausea and vomiting
•       Abdominal distension or bloating
•       Syncope or presyncope
•       Dyspareunia or dyschezia
•       Menstrual irregularities

Diagnostic Workup

Accurate diagnosis relies on a multimodal approach:

Transvaginal and/or Transabdominal Ultrasonography: Initial imaging modality to characterize cyst morphology, size, and presence of free fluid.
• Doppler Ultrasonography: Critical for assessing ovarian vascular perfusion and detecting torsion.
• Cross-sectional Imaging (CT/MRI): Employed selectively for equivocal cases or complex adnexal masses.
•  Laboratory Investigations: CBC to assess for anemia or infection, inflammatory markers, and pregnancy testing to exclude ectopic pregnancy.

Tumour markers: to rule out ovarian malignancies