First, the doctor will raise the medical history and ask for the complaints. In the gynecological palpation examination, he may possibly feel a (painful) enlargement of the ovary. By means of ultrasound examination through the vagina, he will see if the cyst has abnormalities. It may be followed by further examinations such as ultrasound of the vessels (Doppler sonography), determination of tumor markers in the blood and imaging techniques such as computed tomography. In women over the age of 40 years, cystic changes in the ovary should be clarified. It can also hide malignant diseases behind it.
Which therapy is there?
In many cases, it is worthwhile first to observe the growth of the cyst, because it regresses by itself in up to 98% of the cases. Nevertheless, even small cysts that cause no discomfort should be monitored regularly by ultrasound and palpation. If they are particularly fast-growing, do not respond to medications, cause more discomfort to the woman, or appear suspicious in the ultrasound scan, surgical removal is advised.
In post-menopausal women, with regular celiac disease, waiting with regular controls is also warranted, but the decision to remove it will be more likely to be considered, as the risk of malignant neoplasm increases at older ages.
Contraceptive pill or other hormone preparations containing progestin or progestin and estrogen suppress ovarian function. They can stop the growth of the cyst or even lead to its regression. In addition, they prevent a renewed cyst formation. Other drugs that interfere with the hormonal cycle are GnRH analogs and danazol; the last substance is mainly used in endometriosis cysts.
Surgery to remove ovarian cysts
For a surgical procedure, various surgical procedures are available, from the so-called keyhole surgery to the abdominal incision with opening of the abdominal wall. Which method is chosen depends on the size of the cyst and the findings. Many cysts can be removed with the help of the so-called "keyhole surgery" as part of a laparoscopy (laparoscopy or pelviscopy).