Women of child-bearing age develop follicles (egg blasts) every month before ovulation. It’s in these follicles that the egg grows. During ovulation (when the follicle is 18-20 mm in diameter) the follicle bursts and the egg moves into the fallopian tube.
But sometimes the follicle fails to burst. This can be the case when receiving hormone stimulation in connection with fertility treatment or in the case of other inexplicable causes. Instead of bursting, the follicle develops into a cyst, often filled with fluid and in rare cases blood as well. Usually such cysts are tiny and just disappear after a while. But sometimes they grow, and then they require treatment.
Sometimes you’ll experience no symptoms at all if you have a cyst because they are usually tiny. But sometimes you may have symptoms like:
- Pain during sex
- A visibly enlarged tummy
- A bearing-down sensation
- Need to go to the toilet more often
- Problems emptying your bladder
Large cysts can rupture suddenly. This means that the fluid is emptied into your abdomen, or if the cyst contained blood, there can be some bleeding. This can be really painful, and you may run a fever as well. It’s very important that you contact the clinic.
Sometimes a cyst can twist on itself, which means that it cuts off the blood supply. This can cause severe pain, and you must contact the clinic.
We’ll perform an ultrasound scan and perhaps we’ll take a blood sample to find out if we need to monitor the cyst or if it needs to be removed in a keyhole operation.
If the cyst requires monitoring, we’ll find a new appointment for you 1-6 months later. Fertility patients usually wait until their next cycle when they come in for a scan anyway on day 2/3 of their cycle. Then we’ll decide what to do next.
If the cyst needs to be removed, you’ll get an appointment for an operation, as you need a general anaesthetic for this procedure. The operation can be performed without any harm to the fallopian tubes. If you’re past menopause and develop a cyst that needs to be removed, we often recommend that you have your fallopian tubes removed as well, to prevent malignant cysts from developing later on.
Below you can read more about what happens during the operation.
- Before the operation
Ovarian cysts are treated through keyhole surgery of the pelvis (laparoscopy).
Having an ovarian cyst removed is usually a small procedure, which means that you can go home 2-4 hours later. But because there may be some side-effects of the anaesthetic, you must have somebody to come and pick you up at the clinic and stay with you for the next 24 hours.
Before the procedure, it’s important that you tell the specialist about any drugs or medicine you take, because some of them may be dangerous in combination with the anaesthetic. If you can, it’s also a good idea to stop smoking before the procedure, because smoking slows down the healing process. That goes for the period after the operation as well.
- You are not allowed to eat anything during the last 6 hours before your operation
- You are allowed to drink water and juice until 2 hours before your operation
- The operation
You’ll have a general anaesthetic for the operation. We’ll put an IV line in the back of your hand and give you the anaesthetic through it. The operation is usually performed using a thin tube with a microscope (laparoscope). We normally make three small incisions in your stomach: one next to your belly button and one further down on the same or both sides of your stomach. The incisions are about 1 cm long. But sometimes there’re adhesions or scar tissue that make it necessary to make the incisions slightly larger.
All the tissue removed is sent to the Aarhus University Department of Histopathology for further analysis. You’ll get the results from the test about 14 days after the operation.
- Post-operative check up
Once the keyhole surgery is over, we close the incisions with soluble thread inside and special tape on your skin. This means that you don’t have to have the threads removed. But you should come in for a check-up 1 month after the operation.
- Good to know
Pain: It’s normal to experience pain after the operation. Your tummy may also feel bloated, and occasionally there’ll be pain in the right shoulder. However, the pain and discomfort should pass in a day or two.
Hygiene: You can take a shower after 24 hours. Take off any bandages first, and afterwards gently dab the wounds with a towel. The wounds heal better if they’re left unbandaged. But if there’s a bit of oozing from the wounds, you should put on a clean bandage.
Activity: Following the keyhole operation, you should be off sick for 1-2 weeks. If you’ve had large incisions, we recommend you take sick leave for 3-4 weeks. After keyhole surgery, there’re no special restrictions on lifting or activity afterwards. But you should never push yourself beyond your pain threshold. If you’ve had major incisions, however, you shouldn’t lift heavy objects (more than 10 kg) or perform any physically demanding exercises such as badminton, tennis or similar activities for 4 weeks after the operation. You can start running, riding your bike, taking walks etc. as soon as you feel up to it. You can take up swimming about 14 days after the wounds have healed.
- Side-effects and complications
If you have severe pain, a fever or other symptoms of an infection, you must contact the clinic at +45 8612 6121 or +45 2320 4221.