Gynaecology is the medical practice dealing with the female health and its reproductive systems (vagina, uterus and ovaries) and the breasts. It means "the science of women".
Here the consultation for all women health related problems is offered with evidence based treatment and women is also provided with the information which aims to help women make informed decisions about the treatment choices . The most common problems dealt are;
• The ovaries are part of the female reproductive system. They’re located in the lower abdomen on both sides of the uterus. Women have two ovaries that produce eggs as well as the hormones estrogen and progesterone.
• An ovarian cyst is a larger fluid-filled sac (more than 3 cm in diameter) that develops on or in an ovary. A cyst can vary in size from a few centimetres to the size of a large melon. Many women will develop at least one cyst during their lifetime. In most cases, cysts are painless and cause no symptoms
• Ovarian cysts may be thin-walled and only contain fluid (known as a simple cyst) or they may be more complex, containing thick fluid, blood or solid areas.
• An ovarian cyst is a fluid-filled sac that develops on a woman's ovary. They're very common and don't usually cause any symptoms.
• Most ovarian cysts occur naturally and disappear in a few months without needing any treatment.
• The ovaries
• The ovaries are two small, bean-shaped organs that are part of the female reproductive system. A woman has two ovaries – one each side of the womb (uterus).
• The ovaries have two main functions:
• to release an egg approximately every 28 days as part of the menstrual cycle
• to release the female sex hormones, oestrogen and progesterone, which play an important role in female reproduction
• Ovarian cysts may affect both ovaries at the same time, or they may only affect one.
• An ovarian cyst usually only causes symptoms if it splits (ruptures), is very large, or blocks the blood supply to the ovaries.
• In these cases, you may have:
• pelvic pain – this can range from a dull, heavy sensation to a sudden, severe and sharp pain
• pain during sex
• difficulty emptying your bowels
• a frequent need to urinate
• heavy periods, irregular periods or lighter periods than normal
• bloating and a swollen tummy
• feeling very full after only eating a little
• difficulty getting pregnant – although fertility is unaffected in most women with ovarian cysts (see ovarian cysts and fertility)
• See your GP if you have persistent symptoms of an ovarian cyst.
• The two main types of ovarian cyst are:
• functional ovarian cysts – cysts that develop as part of the menstrual cycle and are usually harmless and short-lived; these are the most common type
• pathological ovarian cysts – cysts that form as a result of abnormal cell growth; these are much less common
• Ovarian cysts can sometimes also be caused by an underlying condition, such as endometriosis.
• The vast majority of ovarian cysts are non-cancerous (benign), although a small number are cancerous (malignant). Cancerous cysts are more common in women who have been through the menopause.
• ultrasound scan, carried out by using a probe placed inside your vagina.
• If a cyst is identified during the ultrasound scan, you may need to have this monitored with a repeat ultrasound scan in a few weeks, or your GP may refer you to a gynaecologist (a doctor who specialises in female reproductive health).
• If there's any concern that your cyst could be cancerous, your doctor will also arrange blood tests to look for high levels of chemicals that can indicate ovarian cancer.
• However, having high levels of these chemicals doesn't necessarily mean you have cancer, as high levels can also be caused by non-cancerous conditions such as:
• endometriosis
• a pelvic infection
• fibroids
• your period
• Whether an ovarian cyst needs to be treated will depend on:
• its size and appearance
• whether you have any symptoms
• whether you've been through the menopause
• In most cases, the cyst often disappears after a few months. A follow-up ultrasound scan may be used to confirm this.
• As post-menopausal women have a slightly higher risk of ovarian cancer, regular ultrasound scans and blood tests are usually recommended over the course of a year to monitor the cyst.
• Surgical treatment to remove the cysts may be needed if they're large, causing symptoms, or potentially cancerous.
• Ovarian cysts don't usually prevent you from getting pregnant, although they can sometimes make it harder to conceive.
• If you need an operation to remove your cysts, your surgeon will aim to preserve your fertility whenever possible. This may mean removing just the cyst and leaving the ovaries intact, or only removing one ovary.
• In some cases, surgery to remove both your ovaries may be necessary, in which case you'll no longer produce any eggs. Make sure you talk to your surgeon about the potential effects on your fertility before your operation.
There are various types of ovarian cysts, such as dermoid cysts and endometrioma cysts. However, functional cysts are the most common type. The two types of functional cysts include follicle and corpus luteum cysts.
• Follicle cyst
During a woman’s menstrual cycle, an egg grows in a sac called a follicle. This sac is located inside the ovaries. In most cases, this follicle or sac breaks open and releases an egg. But if the follicle doesn’t break open, the fluid inside the follicle can form a cyst on the ovary.
• Corpus luteum cysts
Follicle sacs typically dissolve after releasing an egg. But if the sac doesn’t dissolve and the opening of the follicle seals, additional fluid can develop inside the sac, and this accumulation of fluid causes a corpus luteum cyst.
• Other types of ovarian cysts include:
• dermoid cysts: sac-like growths on the ovaries that can contain hair, fat, and other tissue
• cystadenomas: noncancerous growths that can develop on the outer surface of the ovaries
• endometriomas: tissues that normally grow inside the uterus can develop outside the uterus and attach to the ovaries, resulting in a cyst
• Some women develop a condition called polycystic ovary syndrome. This condition means the ovaries contain a large number of small cysts. It can cause the ovaries to enlarge. If left untreated, polycystic ovaries can cause infertility.
Often times, ovarian cysts do not cause any symptoms. However, symptoms can appear as the cyst grows. Symptoms may include:
• abdominal bloating or swelling
• painful bowel movements
• pelvic pain before or during the menstrual cycle
• painful intercourse
• pain in the lower back or thighs
• breast tenderness
• nausea and vomiting
• Severe symptoms of an ovarian cyst that require immediate medical attention include:
• severe or sharp pelvic pain
• fever
• faintness or dizziness
• rapid breathing
• These symptoms can indicate a ruptured cyst or an ovarian torsion. Both complications can have serious consequences if not treated early.
• Most ovarian cysts are benign and naturally go away on their own without treatment. These cysts cause little, if any, symptoms. But in a rare case, doctor may detect a cancerous cystic ovarian mass during a routine examination.
• Ovarian torsion is another rare complication of ovarian cysts. This is when a large cyst causes an ovary to twist or move from its original position. Blood supply to the ovary is cut off, and if not treated, it can cause damage or death to the ovarian tissue. Although uncommon, ovarian torsion accounts for nearly 3 percent of emergency gynecologic surgeries.
• Ruptured cysts, which are also rare, can cause intense pain and internal bleeding. This complication increases your risk of an infection and can be life-threatening if left untreated.
• Your doctor can detect an ovarian cyst during a routine pelvic examination. They may notice swelling on one of your ovaries and order an ultrasound test to confirm the presence of a cyst. Ultrasound tests help determine the size, location, shape, and composition (solid or fluid filled) of a cyst.
• Imaging tools used to diagnose ovarian cysts include:
• ultrasound device: an imaging device used to visualize the ovary
• CT scan: a body imaging device used to create cross-sectional images of internal organs
• MRI: a test that uses magnetic fields to produce in-depth images of internal organs
• Because the majority of cysts disappear after a few weeks or months, doctor may not immediately recommend a treatment plan. Instead, they may repeat the ultrasound test in a few weeks or months to check your condition.
• If there aren’t any changes in your condition or if the cyst increases in size, doctor will request additional tests to determine other causes of your symptoms.
• These include:
• pregnancy test to make sure you’re not pregnant
• hormone level test to check for hormone-related issues, such as too much estrogen or progesterone
• CA-125 blood test to screen for ovarian cancer
We recommend treatment to shrink or remove the cyst if it doesn’t go away on its own or if it grows larger.
• Birth control pills
If you have recurrent ovarian cysts, we can prescribe oral contraceptives to stop ovulation and prevent the development of new cysts. Oral contraceptives can also reduce your risk of ovarian cancer. The risk of ovarian cancer is higher in postmenopausal women.
• Laparoscopy
If your cyst is small and results from an imaging test suggest to rule out cancer, doctor can perform a laparoscopy to surgically remove the cyst. The procedure involves doctor making a tiny incision near your navel and then inserting a camera laden small instrument into your abdomen to remove the cyst.
• Laparotomy
If you have a large cyst, doctor can surgically remove the cyst through a large incision in your abdomen. They’ll conduct an immediate biopsy, and if they determine that the cyst is cancerous, they may perform a hysterectomy to remove your ovaries and uterus
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