Ovarian cysts

Question 1

pathophysiology of functional cysts: corpus luteal and follicular ?

Answer 1

functional
- the ovaries grow follicles each month. they produce oestrogen and progesterone and release an egg when you ovulate. if a monthly follicle keeps growing = cyst

follicular
- develop when the follicle doesn’t release the egg and continues to grow

corpus luteal
- develops after the follicle has released the egg

Question 2

risk factors for ovarian cysts ?

Answer 2

1st trimester of pregnancy 
premenopausal women with
- PCOS 
- endometriosis
- early menarche 
- treatment for infertility 
- oestrogen therapy i.e. tamoxifen

Question 3

1st line management in premenopausal women with ovarian cysts and no suspicion of malignancy?

Answer 3

conservative - serial USS

Question 4

1st line management in postmenopausal women with cysts and no suspicion of malignancy ?

Answer 4

conservative - serial USS

Question 5

1st line management in a patient with ovarian cyst and suspicion of malignancy ?

Answer 5

laparoscopy + gynaecological referral

Question 6

describe the management of ovarian cysts in pregnant women.

Answer 6

asymptomatic and < 8cm then conservative

symptomatic and/or < 8cm = laparoscopy

suspicion of malignancy = gynaecological referral

Question 7

complications of ovarian cysts ?

Answer 7

ovarian cancer
ovarian torture
cyst rupture
dyspareunia

Question 8

when is a cyst rupture more likely to occur ?

Answer 8

during exercise / physical activity

Question 9

when would you treat an ovarian cyst in a patient who was pregnant ?

Answer 9

if symptomatic and/or > 8cm and/or suspicion of malignancy