Ovarian Masses

Signs and Symptoms

Many women at some time in their lives will be diagnosed with an ovarian mass or cyst. An ovarian cyst is a closed sac within the ovary that contains fluid or solid material.

Sometimes cysts are found because a woman is having pain or discomfort, and sometimes they are felt on a routine pelvic examination. The majority of ovarian cysts in pre-menopausal women will be "normal" cysts, related to development of the egg in the ovary and ovulation. These cysts will almost always go away over time.

Diagnosis

When a cyst or mass is identified in a woman who is still having normal periods, the most important thing to do is see if it gets smaller or resolves over the course of four to six weeks. An ultrasound, a process that uses sound to create an image somewhat similar to an X-ray, is an accurate and painless way to monitor what is happening with an ovarian cyst. Cysts that get smaller between two different ultrasounds usually require no further treatment.

Ovarian cysts that do not get significantly smaller or go away over the course of a month or two are more likely to be tumors. These tumors are generally benign, or non-cancerous, especially in younger women. Sometimes ultrasound or other X-ray tests like an MRI can determine that the cysts are the non-cancerous type, and if they are small and don't cause any symptoms, they can often just be monitored periodically. If a cyst is larger, or if it is difficult to accurately determine exactly what kind of cyst is present, it most likely will need to be removed surgically.

Treatment

Ovarian cysts or masses can often be removed via laparoscopy, a surgical technique using several tiny incisions in the abdomen to do the operation. Sometimes, if the cyst is quite large, or if a woman is older, it is better to do the operation through a larger abdominal incision. Often just the cyst or mass can be removed, leaving the ovary in place, but sometimes it is necessary to remove the entire ovary. If an ovary is removed, the other remaining ovary will take over the function for both ovaries, so periods and fertility generally aren't affected.