The ovarian cyst is a sac filled with fluid that develops on or in the ovary. Many women suffer from an ovarian cyst during their lifetime. Ovarian cysts, often painless, are very common and rarely serious.

The vast majority of ovarian cysts are said to be functional and go away over time without treatment. However, some cysts can rupture, twist, grow greatly, and cause pain or complications.

Ovaries are located on either side of the uterus. During each menstrual cycle, an egg emerges from an ovarian follicle and travels to the fallopian tubes to be fertilized. Once the egg has been expelled in the ovary, the corpus luteum forms, which produces a large amount of estrogen and progesterone in preparation for conception.

The different types of ovarian cysts

Ovarian cysts functional

These are the most frequent. They appear in women between puberty and menopause, because they are linked to menstrual cycles: 20% of these women have such cysts if an ultrasound is performed. Only 5% of postmenopausal women have this type of functional cyst.

Functional cysts tend to disappear spontaneously within a few weeks or after two or three menstrual cycles: 70% of functional cysts regress in 6 weeks and 90% in 3 months. Any cyst that persists for more than 3 months is considered to be no longer a functional cyst and should be analyzed. Functional cysts are more common in women using progestin-only (estrogen-free) contraception.

Organic ovarian cysts (non-functional)

They are benign in 95% of cases. But they are cancerous in 5% of cases. They are classified into four types :

• Dermoid cysts may contain hair, skin or teeth because they originate from the cells that produce the human egg. They are rarely cancerous.
• Serous cysts,
• Mucous cysts
• Les cystadénomes serous or mucinous originate from the ovarian tissue.
• Cysts linked to endometriosis (endometriomas) with hemorrhagic contents (these cysts contain blood).

Le polycystic ovary syndrome

Polycystic ovary syndrome is called polycystic ovary syndrome when a woman has multiple small cysts in the ovaries.

Can an ovarian cyst get complicated?

Cysts, when they do not go away on their own, can lead to several complications. The ovarian cyst can:

• Break, in which case fluid leaks into the peritoneum causing severe pain and sometimes bleeding. It takes surgery.
• To bend (cyst twist), the cyst spins on itself, causing the tube to rotate and the arteries to pinch, thus reducing or stopping circulation causing very strong pain and a lack of oxygen for the ovary . This is an emergency surgery to untwist the ovary to prevent it from suffering too much or necrosis (in this case, its cells die from lack of oxygen). This phenomenon occurs especially for large cysts or cysts with a very thin pedicle. The woman feels a sharp, strong and never-ending pain, often associated with nausea and vomiting.
• Bleed : This may be an intracystic hemorrhage (sudden pain) or a peritoneal extracystic hemorrhage (similar to cyst rupture). A priori laparoscopic surgery should also be used.
• Compress neighboring organs. It happens when the cyst gets bigger. This can lead to constipation (intestinal compression), frequent urination (compression of the bladder) or compression of the veins (edema).
• Get infected. This is called an ovarian infection. It can occur following a cyst rupture or following a cyst puncture. Surgery and antibiotic treatment are required.
• Forcing a Caesarean in the event of pregnancy. During pregnancy, complications from ovarian cysts are more common. 

   

How to diagnose an ovarian cyst?

Since cysts are usually painless, a cyst diagnosis is often made during a regular pelvic exam. Some cysts can be seen on palpation during vaginal examination when they are large enough.

A scan allows to visualize it and to determine, its size, its shape and its precise location.

A radiography sometimes allows you to see calcifications related to the cyst (in case of dermoid cyst).

A IRM is essential in case of a large cyst (more than 7 cm)

A laparoscopy allows you to see the appearance of the cyst, puncture it or perform an excision of the cyst.

A blood test is taken, especially to detect is pregnant.

An assay for a protein, CA125, can be performed, this protein being more present in certain cancers of the ovaries, in uterine fibroids or in endometriosis.

How many women suffer from ovarian cysts?

According to the National College of French Gynecologists and Obstetricians (CNGOF), 45000 women are hospitalized each year for a benign ovarian tumor. 32000 would have been operated.