Abnormalities in the human body can manifest in many ways, varying according to each disease. For women, abnormalities of the internal female organs are quite concerning because there are many risks of various diseases, even if observed only from menstrual irregularities. One of the diseases that women should not overlook when experiencing menstrual abnormalities is “Ovarian Cysts”
Ovaries Are Very Important for Women
Rear Admiral Dr. Sosakul Boonyawiroj, Obstetrician-Gynecologist Specialist, Phyathai 1 Hospital explained the function and importance of the “ovaries” as organs found only in females. They are oval-shaped, normally 2-3 cm in size (about the size of a quail egg), located on both sides of the uterus, with two main functions:
- Egg production When an egg is fertilized by sperm, it implants in the uterus to develop into an embryo. If the egg is not fertilized, it will be expelled.
- Hormone production which causes physical changes in girls as they enter puberty, such as breast development, widened hips, higher-pitched voice, and hair growth in the pubic and underarm areas.
Comparing to male reproductive organs, the ovaries are similar to the testes, which clearly play a role from puberty onwards. Therefore, throughout a woman’s youth, it is important to take care and regularly observe any abnormalities to prevent risks and reduce the severity of diseases.
How Many Types of Ovarian Cysts Are There?
Ovarian cysts are divided into 3 types
- Cysts (Cyst) are tumors that appear as sacs containing fluid, water, or tissue.
- Benign tumors or non-cancerous types (Benign)
- Malignant tumors or cancerous types (Malignant)
Risk Factors for Ovarian Cancer
The exact cause is unknown, but risk factors include
- Genetics: family history of cancer in grandmother, aunt, mother, sister
- Women who breastfeed have a lower risk
- Age entering menopause or over 55 years old
What Are the Symptoms of Ovarian Cysts?
Rear Admiral Dr. Sosakul Boonyawiroj, Obstetrician-Gynecologist Specialist, Phyathai 1 Hospital explained the symptoms of non-malignant ovarian cysts as follows:
- Menstrual irregularities
- Frequent urination due to the cyst pressing on the bladder
- Constipation due to the cyst pressing on the intestines
- Abdominal enlargement
- Sudden abdominal pain, which may be caused by complications such as the cyst twisting, rupturing, bleeding, or infection
- Bloating and loss of appetite
What Are the Symptoms of Ovarian Cancer?
For symptoms suspected to be malignant ovarian cysts (ovarian cancer), Rear Admiral Dr. Sosakul Boonyawiroj recommended observing the following abnormalities:
- Loss of appetite and weight loss due to rapid tumor growth
- Ascites (fluid in the abdominal cavity) detected by physical examination or ultrasound, caused by cancer cell spread to other organs
- Biopsy results can classify the type of ovarian cyst
How to Examine Ovarian Cysts?
- Doctor takes medical history, asks about symptoms, and performs a general physical examination
- Abdominal palpation to detect any masses
- Internal examination or rectal examination
- Ultrasound examination via abdomen or vagina
- Computed tomography (CT scan)
- Magnetic resonance imaging (MRI)
Treatment Guidelines for Ovarian Cysts
- If diagnosed as a benign tumor, treatment involves medication and monitoring whether the cyst shrinks or grows, with periodic ultrasound follow-ups
- If diagnosed as ovarian cancer, surgery will be performed to remove as much malignant tissue as possible, combined with chemotherapy or radiation therapy
- For benign cyst surgery, indications include failure of medication and monitoring to reduce the cyst, cyst growth, or complications such as acute pain from cyst twisting, rupture, or bleeding, in which case surgery is recommended
How Is Ovarian Cyst Surgery Performed?
For ovarian cyst surgery, Rear Admiral Dr. Sosakul Boonyawiroj, Obstetrician-Gynecologist Specialist, Phyathai 1 Hospital, recommends two methods:
- Traditional Surgery involves a 10 cm long abdominal incision, requiring a longer recovery time and leaving a scar
- Modern Technology Surgery called Gynecological Laparoscopic Surgery, suitable for gynecological diseases such as ovarian cysts, ovarian cysts, chocolate cysts, etc., but may not be suitable for reproductive organ cancers as it may increase the risk of cancer cell spread
This Special Surgical Equipment Includes the Following Important Devices
- A small camera with a lens that magnifies the image and transmits it to a monitor
- A light source to provide clear images
- Forceps for grasping tissue
- Scissors for cutting tissue and dissecting adhesions
- Electrocautery device to stop bleeding
- Suturing instruments
The equipment used in laparoscopic surgery is designed for high efficiency.
Advantages of Gynecological Laparoscopic Surgery
- Very small surgical wounds, less pain
- Less blood loss, faster recovery
- Most patients can eat immediately after surgery
- Hospital stay is about 1-2 days, whereas open abdominal surgery requires a longer stay
Steps of Gynecological Laparoscopic Surgery
Anesthesiologists will administer general anesthesia. Then, the doctor will make 3-4 small abdominal incisions, each about 0.5-1 cm, to insert small surgical instruments. During the surgery, the doctor and team can view the internal organs on a monitor receiving signals from the laparoscopic camera.
Complications from Laparoscopic Surgery
Because carbon dioxide gas is introduced into the patient’s abdominal cavity to facilitate surgery, after the operation, the doctor will remove as much gas as possible. Some gas may remain, which can push against the diaphragm, causing a dull pain similar to shoulder soreness. This symptom usually resolves within 1-2 days as the body naturally absorbs the gas.
Limitations of Gynecological Laparoscopic Surgery
- It may not be suitable for cancer cases due to the risk of cancer cell spread, but this depends on the doctor’s judgment and the cancer stage
- Patients with anesthesia problems may not be suitable candidates
How to Prepare for Ovarian Cyst Surgery
Once the decision to undergo surgery is made, it is important to strictly follow the doctor’s instructions. Preparation can be divided into two simple steps:
General Preoperative Preparation
- Fasting from food and water for 6-8 hours before surgery
- Patient signs the surgical consent form
Postoperative Care
- For open abdominal surgery, fasting from food and water for at least 24 hours until the doctor permits eating. For laparoscopic surgery, most patients can eat immediately, depending on the doctor’s discretion
- Avoid sexual intercourse and heavy lifting for a period determined by the doctor
- Keep the wound dry
- Walking and light exercise are allowed
- Take medication regularly as prescribed
- Attend follow-up appointments
Since the exact cause of ovarian cysts is still unknown, it is advisable to reduce risk factors such as controlling weight, breastfeeding, exercising regularly, and observing any abnormal symptoms. For asymptomatic individuals with a family history of ovarian cancer, screening can be done through annual physical exams such as ultrasound or blood tests for ovarian cancer markers.
Rear Admiral Dr. Sosakul Boonyawiroj
Gynecologic Oncology Specialist
Women’s Health Center, Phyathai 1 Hospital
