Most ovarian cysts disappear on their own. The video explains which cysts are planned for surgery and why endometriomas are assessed differently.
In the video, Prof. Dr. İkbal Kaygusuz explains when surgery is planned for ovarian cysts. Most cysts are functional: each month an egg develops, and if it does not release and disappear, it can grow into a cyst; sometimes bleeding into it turns it into a haemorrhagic cyst. Most of these cysts disappear within one or two menstrual cycles, and a cyst found by chance is often no longer seen at a check-up a month later.
Although rare, some cysts can grow. A growing cyst can cause the ovary to twist around itself (torsion) and damage ovarian tissue, or it can rupture and release its fluid into the abdomen, sometimes together with internal bleeding. These situations can require urgent intervention.
The approach described in the video can be summarised as follows:
- Cysts larger than 8 cm are planned for surgical removal even if they look simple, regardless of marital status.
- In a woman after menopause, a cyst over 5 cm that does not disappear on follow-up is removed even if it looks simple.
- Cysts that look complex on ultrasound need surgery regardless of size. A thick wall, finger-like projections inward, thick septa, tissue areas with increased blood flow and free fluid in the abdomen suggest a complex cyst; when the distinction is unclear, tumour markers and MRI can help.
- Dermoid cysts, which can contain hair, teeth or fatty tissue, are removed regardless of size because, even when benign, they have the potential to become malignant.
The chocolate cyst (endometrioma) is a special case: it can reduce ovarian reserve, and healthy ovarian tissue can also be damaged during its surgery. The decision to operate therefore takes into account whether the woman has given birth before, her wish to have children, the size of the cyst and accompanying symptoms such as pelvic pain.
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The information on this website is for general information only and does not replace a medical consultation.
