Ovarian Cysts & Uterine Fibroids Treatment
Caring for your reproductive health can be daunting, especially with conditions like ovarian cysts and uterine fibroids. These challenges can impact daily life and knowing how they are diagnosed, managed and treated are the first steps to achieving better health.
What Are Ovarian Cysts?
Ovarian cysts are sacs filled with fluid that form on the ovaries. They are a normal part of the menstrual cycle for many women and may resolve independently without causing symptoms. However, in some instances, ovarian cysts can grow larger and cause pain and other complications.
What causes ovarian cysts?
Ovarian cysts can develop for various reasons, including hormonal imbalances, endometriosis, or follicle abnormalities during ovulation. Polycystic ovary syndrome (PCOS) is also a common cause of ovarian cysts, where multiple small cysts form on the ovaries due to hormonal disturbances.
How are ovarian cysts diagnosed?
To diagnose ovarian cysts, doctors may perform a pelvic examination and order imaging tests such as ultrasound or MRI. These tests help visualise the cysts’ size, shape, and location.
Types of ovarian cysts
Ovarian cysts can manifest in various forms, each with distinct characteristics. Common types include:
1
Follicular cysts
These develop when a follicle fails to rupture and release an egg during the menstrual cycle, causing fluid accumulation.
2
Corpus luteum cysts
These form when the follicle ruptures and releases an egg but fails to shrink afterwards, leading to fluid accumulation.
3
Endometriomas
These cysts develop when endometrial tissue grows within the ovaries, often due to endometriosis.
4
Dermoid cysts
These cysts contain tissue such as hair, skin, and even teeth, originating from embryonic cells. They are typically benign.
5
Cystadenomas
Cystadenomas develop from ovarian tissue and can be filled with mucous or fluid. They can grow quite large but are usually benign.
Symptoms of ovarian cysts
Pelvic pain: The most common symptom associated with ovarian cysts is pain. The pain may occur on one pelvis side and can radiate to the lower back or thighs.
Bloating: Bloating or feeling fullness in the lower abdomen may be due to a cyst pressing on surrounding organs.
Changes in menstrual cycle: Ovarian cysts can cause irregularities in the menstrual cycle, including heavier or lighter bleeding than usual and spotting between periods.
Pain during intercourse: Large ovarian cysts may cause discomfort or pain during sexual intercourse, especially if they put pressure on the pelvic organs.
Urinary symptoms: Ovarian cysts that press on the bladder may cause more frequent urination or difficulty emptying the bladder.
Painful bowel movements: Large cysts can exert pressure on the rectum, causing pain or discomfort during bowel movements.
After evaluating the results of these diagnostic tests, your healthcare provider can definitively diagnose adenomyosis and discuss appropriate treatment options based on your circumstances and preferences.
Can ovarian cysts lead to cancer?
Benign ovarian cysts may resolve on their own. However, some types, such as dermoid cysts or cystadenomas, may have the potential to become cancerous. Therefore, it is essential to monitor ovarian cysts regularly and follow up with an ovarian cyst specialist to detect any concerning changes.
What treatment options are available for
ovarian cysts in Singapore?
Ovarian cyst removal surgery
In cases where ovarian cysts are large, causing symptoms, or suspected of being cancerous, surgical removal, known as cystectomy, may be recommended. A cystectomy can be performed with a minimally invasive laparoscopy or a traditional open surgery (laparotomy).
Laparoscopic ovarian cyst removal involves making small incisions in the abdomen through which a laparoscope (a thin, flexible tube with a camera and light) and surgical instruments are inserted.
The surgeon then uses the laparoscope to visualise the cyst and surrounding structures and carefully removes the cyst from the ovary. Laparoscopic ovarian cyst surgery offers a shorter recovery time, less postoperative pain, and reduced risk of complications compared to traditional open surgery.
Non-surgical alternatives
In some instances, hormonal medications may be prescribed to help shrink ovarian cysts or prevent new ones from forming. These medicines regulate hormone levels and can be an alternative to surgery for some women. Your doctor may also give pain relief medication to alleviate pelvic pain or discomfort associated with ovarian cysts.
What are the possible risks of the ovarian cyst removal procedure?
Every surgical procedure carries potential risks, likewise with ovarian cyst removal. The risks, however, are typically minimal, especially with minimally invasive techniques. Some risks include:
- infection
- bleeding
- damage to surrounding organ
- adverse reactions to anaesthesia
Getting an experienced doctor’s help can ensure that these risks are managed, minimised or avoided.
When should you see an ovarian cyst specialist?
Consult an ovarian cyst specialist if you experience the following:
- Severe or sudden onset of pelvic pain
- Fever or signs of infection
- Difficulty breathing
- Sudden changes in urinary or bowel habits
- Unexplained weight loss
- Family history of ovarian cancer
Additionally, if you have a history of ovarian cysts or are at higher risk due to conditions like PCOS, regular check-ups are recommended to monitor for any changes.
What are uterine fibroids?
Fibroids are another reproductive health condition, although they are often confused with ovarian cysts. Uterine fibroids form within the uterus. Varying in size, these benign growths can lead to symptoms like heavy menstrual bleeding, pelvic discomfort, and pressure on nearby organs such as the bladder or rectum.
What causes fibroids in the uterus?
Hormonal factors, genetic predisposition, and oestrogen levels are believed to play a role in the development of uterine fibroids. Fibroids usually grow during reproductive years when oestrogen levels are high and often shrink after menopause when oestrogen levels decline.
What are the risk factors for uterine fibroids?
Risk factors for uterine fibroids include:
- Age (30-40s)
- Family history
- Hormonal factors
- Obesity
- African descent
- Early menstruation
- Use of hormonal contraceptives
- Certain lifestyle factors
How are uterine fibroids diagnosed?
Types of uterine fibroids
Uterine fibroids can be classified into several types based on their location within the uterus:
- Intramural fibroids: The most common type of fibroids that develop in the wall of the uterus.
- Subserosal fibroids: These fibroids grow on the surface of the uterus and may protrude outward, causing pressure on surrounding organs.
- Submucosal fibroids: These form just underneath the inner lining of the uterus (endometrium) and may protrude into the uterine cavity, potentially affecting fertility or causing heavy menstrual bleeding.
- Pedunculated fibroids: These fibroids grow on a stalk-like structure (peduncle) inside or outside the uterus.
What are treatment options for fibroids in the uterus?
Myomectomy
Myomectomy involves removing fibroids while retaining the uterus. This procedure can be conducted via open surgery, laparoscopic surgery, or hysteroscopy, selected based on fibroid size and placement.
Hysterectomy
Hysterectomy is the complete removal of the uterus and is considered a definitive treatment for uterine fibroids, especially for women who have completed childbearing or have symptoms that fail to respond to other treatments.
Medications
Hormonal medications such as progestin-releasing intrauterine devices (IUDs), or oral contraceptives may help alleviate symptoms like heavy menstrual bleeding and pelvic pain.
Uterine Artery Embolization (UAE)
UAE is performed to block the blood supply to the fibroids, causing them to shrink and relieve symptoms.
MRI-guided Focused Ultrasound Surgery (MRgFUS)
This procedure uses high-intensity ultrasound waves to heat and destroy fibroid tissue while sparing surrounding healthy tissue.
When should you see a gynaecologist in Singapore?
You should seek medical attention for uterine fibroids if you experience:
- Heavy menstrual bleeding that affects your quality of life or leads to anaemia.
- Pelvic pain or pressure that doesn’t improve with over-the-counter pain relievers.
- Difficulty emptying your bladder or frequent urination.
- Pain during sexual intercourse.
- Swelling or enlargement of the abdomen.
- Difficulty conceiving or recurrent miscarriages.
- Concerns about your reproductive health or if you have a family history of uterine fibroids.
Uterine fibroids and ovarian cyst removal specialist in Singapore
Understanding the complexities of ovarian cysts and uterine fibroids is crucial for women’s reproductive health. With proper diagnosis, treatment, and care from qualified specialists like Dr Chang TC, women can effectively manage these conditions and improve their overall well-being.
Using a patient-centred approach and minimally invasive surgical techniques, Dr Chang provides personalised care to women seeking relief from reproductive health conditions.
Frequently Asked Questions
Can ovarian cysts affect fertility?
While most ovarian cysts do not significantly impact fertility, certain types of cysts, such as endometriomas, may affect egg quality or interfere with ovulation, potentially affecting fertility.
What is the cost of an ovarian cyst removal surgery?
The cost of ovarian cyst removal surgery in Singapore will depend on the type of procedure, hospital fees, and insurance coverage. It’s advisable to consult with your doctor for specific pricing information.
Which surgery is best for ovarian cysts?
The choice of surgery for ovarian cysts depends on the size and type of cyst, the patient’s overall health, and reproductive goals. Minimally invasive techniques are often preferred for smaller cysts, while open surgery may be necessary for more extensive or complex cysts.
What size of ovarian cyst is dangerous?
While there is no definitive size threshold for determining the risk of ovarian cysts, large cysts (over 5 centimetres) or those that cause symptoms such as persistent pain or bloating may warrant further evaluation and treatment.
Can ovarian cysts resolve on their own?
Many ovarian cysts resolve independently without treatment, especially if they are small and asymptomatic. However, larger cysts or those causing symptoms may require medical intervention or surgical removal.
Are uterine fibroids cancerous?
The majority of uterine fibroids are benign (non-cancerous) growths. However, in rare cases, a fibroid may be cancerous or be associated with an increased risk of uterine cancer. Prioritise regular monitoring and follow-up with a doctor to detect any concerning changes.
Can uterine fibroids affect fertility?
Uterine fibroids can affect fertility depending on their size, number, and location within the uterus. Fibroids that distort the uterine cavity or interfere with the implantation of a fertilised egg may reduce the chances of conception or increase the risk of miscarriage.
How enlarged do uterine fibroids need to be before being surgically removed?
Determining whether to surgically remove enlarged uterine fibroids relies on factors such as fibroid size and location, symptom intensity, and the patient’s reproductive objectives.
What happens if fibroids go untreated?
Untreated uterine fibroids can worsen symptoms such as heavy menstrual bleeding, pelvic pain, or pressure on nearby organs. In some cases, fibroids may grow larger or cause complications such as infertility or anaemia due to excessive bleeding.
Can I get pregnant if I have uterine fibroids?
Many women with uterine fibroids have successfully conceived and birthed. However, fibroids may increase the risk of pregnancy complications such as miscarriage, preterm birth, or fetal malpresentation. It would be best if you discussed any concerns with a healthcare provider to optimise pregnancy outcomes.