Functional cysts

Functional cysts of the ovaries are managed conservatively, unless complications arise, such as torsion, rupture and haemorrhage, which are treated laparoscopically. The term functional cysts of the ovaries, refers to the cysts of the follicle and the cysts of the corpus luteum.

Follicular cysts

Cysts of the follicle appear quite often during reproductive age range and are a result of Graafian follicle rupture failure in cases of unovulation. Their diameter ranges between 4-10 cm. They usually absorb on their own after 2-3 menstrual cycles or they rupture and they rarely persist. The administration of contraceptive pills or progesterone preparations may aid their disappearing. In young women of reproductive age, the contents of the cysts can be aspirated via a transvaginal, ultrasound guided paracentesis and sent for cytological examination. Ofcourse, criteria for the exclusion of any malignancy (ultrasound criteria for vascularisation with transvaginal Doppler ultrasound and indicators such as CA-125) should be taken in mind. However, generally none of these criteria can totally ensure that the cysts are functional and benign.

Corpus luteum cysts

They develop after ovulation and they represent the cystic transformation of the corpus luteum. Usually, they do not cause any symptoms or they may appear as a persistent corpus luteum and also they subside on their own.

They are of unknown cause and when they are many, they are usually seen after administration of ovulation induction drugs. They are more common in women with unexplained subfertility and high FSH values on day 3 of the menstrual cycle. The diagnosis is usually made with ultrasound, hormone assessment and clinical examination. In rare instances of cyst rupture, when it is haemorrhagic, the symptoms are caused by large intra-abdominal haemorrhage and they are similar to those of ectopic pregnancy. Such conditions are mainly managed laparoscopically.