Classification and types of cyst_ Physiological cysts

You may have some questions about ovarian cysts, particularly if you are a woman in your childbearing years, because these cysts are more common among younger women.  Regardless of whether you’ve had a tubal ligation, a tubal reversal, or no surgery at all, these cysts are common findings during your physical exam or ultrasound.  Ovarian cysts are common and usually occur as a result of the normal monthly fluctuations in hormones in premenopausal women.  Since a tubal ligation reversal does not stop this hormone cycle, a tubal reversal will not stop these cysts from occurring.

Although in most cases ovarian cysts are nothing to be concerned about, occasionally they can cause pain, and in rare instances they can be cancerous.  Non cancerous cysts occur as a result of normal process or a minor abnormality that can clear up on its own.  In those circumstances Dr. Morice may recommend that you follow up in a month or two to see if the cyst has resolved on its own.  In certain circumstances Dr. Morice might recommend further imaging, medications,  or even surgery to better understand what is causing the cyst.

Because there are many different types of cysts, Dr. Morice may want to get a better understanding of what is causing yours, particularly if you are undergoing a tubal ligation reversal.  Identification can be done with an ultrasound before the tubal reversal is performed just to make sure that there isn’t anything more concerning occurring prior to your surgery.

The 5 most common types of ovarian cysts are:

-          Functional cysts

-          Endometrial cysts

-          Cystadenomas

-          Dermoid cysts

-          Polycystic ovaries

Functional cysts are the most common among young women who are cycling normally, regardless of wether they have had a tubal ligation reversal. These cysts are a normal process of menstruation and usually clear up on their own without you or Dr. Morice ever even knowing about them. There are 2 types of functional ovarian cysts. The first comes from the Graafian follicle (or sac) where the egg develops every month. It is the most common and occurs if the sac fails to break open and release its egg.  The second type of functional cyst is a simple fluid filled cyst.  Both types typically resolve on their own in one to three months.

Another remnant from the monthly cycle is a corpus luteum cyst. After the egg is released, this portion of the ovary usually disintegrates. However, if the woman becomes pregnant, for example after a tubal ligation reversal, sometimes this cyst can form if the sac seals off. This ‘sealing’ of the cyst wall results in a buildup of fluid.  Again these cysts normally resolve in a few weeks with most women remaining unaware that they’re even there. The likelihood of getting an ovarian cyst is not increased at all by a tubal reversal.

Occasionally the cysts can become enlarged and rupture. This may cause a little bit of bleeding and pain. Sometimes the blood will collect inside of the cyst itself, and this is called a hemorrhagic cyst. Although a hemorrhagic cyst can be quite painful, it is also a benign condition that can be safely watched without intervention and without concern for an underlying cancer.  As always, if you have concerns about pelvic pain or your risk for ovarian cancer you should discuss these concerns with Dr. Morice.

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