Ovarian cysts are a common health problem in women of all ages, especially during reproductive years. Although most cysts (over 90%) are benign and often asymptomatic, in some cases they can cause pain or severe complications that require surgical treatment.
Currently, laparoscopic surgery has become the standard and very popular method due to its many advantages compared to open abdominal surgery.
Types of Ovarian Cysts You Should Know
Medically, ovarian cysts are broadly classified into the following groups:
Functional Cysts are harmless ovarian cysts caused by the normal menstrual cycle. They usually resolve on their own within 1-3 months, are common in reproductive-age women, and are often asymptomatic unless the cyst is large or ruptures.
Dermoid Cysts are benign ovarian tumors most commonly found in women of reproductive age, especially under 20 years old. They arise from cells that develop into various tissue types present in the ovary from birth and are stimulated to grow. Inside, they often contain fat, hair, bone, or teeth. These cysts are usually asymptomatic but may cause pain from pressure on adjacent organs and have a high risk of ovarian torsion.
Chocolate Cysts result from endometriosis on the ovary. During menstruation, the endometrial tissue sheds as blood but cannot drain, accumulating as cysts filled with old, dark brown blood resembling chocolate. These cysts do not resolve on their own and often cause dense adhesions in the pelvic cavity, leading to progressively severe menstrual pain, chronic lower abdominal pain, or infertility.
Cystadenoma is an ovarian tumor arising from the ovarian epithelial tissue. It includes both serous (clear fluid) and mucinous (mucus-filled) types. These cysts do not resolve spontaneously and can grow very large. When large, they may cause abdominal fullness, rapid abdominal enlargement, or pressure on the bladder causing frequent urination.
When Should Surgery Be Considered?
Doctors recommend surgery if the cyst is large (usually more than 5-10 cm), suspected to be malignant, does not resolve on its own, or if there are emergency complications such as ovarian torsion or cyst rupture causing sudden severe abdominal pain.
Advantages of Laparoscopic Surgery
Laparoscopic surgery is the standard treatment with advantages over open abdominal surgery as follows:
- Small incisions with wounds only 0.5-1 cm wide at about 3-4 points, compared to open surgery incisions of 10-20 cm long.
- Less pain due to less injury to tissues and internal organs.
- Faster recovery patients usually stay in the hospital for only 1-2 days and can return to normal life within 1-2 weeks.
- Reduced adhesions lowering the chance of abdominal adhesions after surgery.
- Cosmetic benefits small incisions result in almost invisible scars.
Preoperative Preparation
- Provide health information including medical history, regular medications (especially those affecting blood clotting), and drug allergies.
- Fasting for at least 6-8 hours before surgery to prevent aspiration during anesthesia.
- Physical examination including blood tests, X-rays, and ultrasound to assess readiness.
- Avoid smoking and alcohol for at least 2-4 weeks before surgery.
Postoperative Care and Possible Complications
After surgery, patients may experience shoulder or chest pain caused by carbon dioxide gas used to inflate the abdomen during surgery. This discomfort usually subsides within 48-72 hours.
Home care instructions
- Avoid heavy lifting or strenuous exercise for 4-6 weeks.
- Avoid sexual intercourse for about 4-6 weeks.
- Keep wounds dry If waterproof dressings are used, normal showering is allowed but soaking in water is prohibited.
- Watch for abnormal symptoms such as high fever, wound redness and swelling, persistent nausea and vomiting, or abnormal vaginal bleeding, and seek medical attention immediately.
Laparoscopic ovarian cyst surgery is a safe and effective option that helps women return to a good quality of life faster. However, regular annual pelvic exams and ultrasounds remain the best methods for early detection and timely treatment planning.