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Ovarian Cyst
- Days In Hospital 3 days
- Outside Hospital Stay 5 days
- Success Rate 90%
Minimum Cost
$ 1500
Maximum Cost.
$ 4000
Overview of Ovarian Cyst in India
An ovarian cyst is a small piece of tissue that grows in an ovary. Ovarian cysts can be made up of liquid, pus, or solid tissue, and can range in size from very small to large. The diagnosis of an ovarian cyst will require that a physician use one or more tests to establish the type of cyst(s) that exist and to develop a treatment plan, if necessary. In some cases, ovarian cysts may be malignant, so it is essential to consult with a qualified physician about any concerns regarding ovarian cysts. The type of treatment given for ovarian cysts is determined by the patient's age and the types and sizes of the individual cysts.
The way the symptoms are presented to an individual patient may also indicate the need for surgical removal of ovarian cysts. There are two methods for performing surgery on the cyst: the traditional method and a minimally invasive technique in which small cuts (incisions) are made to allow access for removal of the cyst, resulting in faster recovery and fewer scars. Although this type of surgery has many benefits, it also has risks which can be minimized by following guidelines to maintain a healthy diet and to exercise regularly. Recovery from surgery will generally take several weeks and will be determined primarily by the quality of post-operative care received by the patient.
What is Ovarian Cystectomy?
A surgical procedure called Ovarian Cystectomy removes cysts from an ovary that have formed and filled with fluid. Surgery may be required for women whose ovary cyst symptoms, such as pain or discomfort, are severe enough to require intervention. Additionally, cysts may pose risks to a woman's health due to complications.
The surgeon will create an incision in the abdomen above the vagina and below the belly button to reach the ovaries and remove the cyst, while preserving as much of the surrounding tissue as possible. There are many ways to perform ovarian cystectomies, including open surgery, laparoscopic surgery, and robotic surgery. Alleviating the patient's symptoms associated with the ovarian cyst is the prime objective of the procedure and addressing any potential health concerns that arise from the cyst.
Types of Ovarian Cyst:
Functional Cysts: These are cysts that form during a woman’s menstrual cycle, for example, follicular or corpus luteum cysts and usually disappear by themselves.
Dermoid Cysts (Mature Cystic Teratomas): have tissue in them such as hair and fat and will require surgical removal of the cyst.
Endometriomas are due to endometriosis and are filled with old blood. They can prevent a woman from becoming pregnant.
Cystadenomas are a type of ovarian cyst that grow from the ovarian tissue and can be very huge.
Hemorrhagic Cysts are cysts that have blood in them due to bleeding from the inside of the cyst.
Procedure:
Before The Procedure
Patients will take part in a series of steps, before having an ovarian cystectomy, to prepare for the procedure and address any concerns associated with the operation.
Preoperative Assessment: The first step in preparing for an ovarian cystectomy is to conduct a comprehensive evaluation of the patient's overall health. This evaluation will include a review of the patient's medical history, current medical condition, and any prior surgeries or conditions. The assessment will consist of imaging such as pelvic ultrasound and/or CT scan to determine the size, location, and type of cyst as well as the health of the ovaries and adjacent tissues.
Preoperative Instructions: Once the assessment is completed, patients will be provided specific preoperative instructions and dietary restrictions. In general, patients should not eat or drink anything for a specified amount of time prior to the procedure (for example, fasting for the evening before the surgery). Patients will also receive detailed preoperative instructions on any do or don’t items.
Medicine: Your healthcare provider will assess all of your medications and determine if any should be stopped or altered (primarily if the drug interacts with anaesthesia or has an impact on your bleeding tendency). You must heed your provider’s advice regarding your medication(s) and discuss any concerns with your provider. Alternative medications may also be prescribed if necessary.
Consultation Regarding Anaesthesia: An anaesthetist will meet with you to go over the types of anaesthetics available, as well as discuss any potential side effects of the anaesthetic. The anaesthetist will review your medical history to develop a safe anaesthetic plan, as well as answer any questions you may have.
To Prepare for Your Day Of Surgery: It is best to have someone available to drive you to and from the hospital, since you will be unable to drive yourself while under the influence of anaesthesia. It’s also advisable to set up a support system for yourself at home during your initial recovery period.
During The Procedure
The following are the steps that occur during an Ovarian Cystectomy:
Anaesthesia: The procedure requires general anaesthesia, meaning the patient will be completely unconscious and not feel any pain during the operation.
Incisions: Depending on the type of surgical procedure used, the Surgeon will either create a small incision (for Laparoscopic Surgery) or a larger incision (for Open Surgery). For Laparoscopic Surgery, the Surgeon inserts a Camera (called a Laparoscope) that allows them to see into the patient's abdomen while removing the cyst.
Removal of Cysts: During the operation, the Surgeon will carefully remove the cyst from the patient's body while attempting to protect and conserve as much healthy ovarian tissue as possible. If there are multiple cysts on the same ovary or both ovaries, all of the cysts can potentially be removed during the same operation.
Frozen Section Analysis: In some instances, particularly if the cysts appear to be abnormal or unusual during surgery, the Surgeon may send a portion of the removed tissue to the Pathology Department for Frozen Section Analysis. A Frozen Section biopsy of the tissue will provide rapid analysis to help determine whether the cyst is benign or malignant, which may assist the Surgeon in providing immediate recommendations for future surgical management.
Cyst Examination: The laboratory will also perform an extensive pathological analysis of the cyst sample to confirm the nature of the cyst and to help rule out malignancy.
Wound Closure: After the Surgeon has successfully removed all of the cysts, they will close the incisions with stitches or surgical adhesive. In the event that open surgery is performed, the larger incision will be closed with stitches.
After The Procedure
Following a cyst removal from the ovaries, patients can expect the following:
Recovery Room: Patients will be taken to a recovery room immediately after surgery and monitored by medical staff as they come out of anesthesia.
Postoperative Pain & Discomfort: Patients will experience some level of discomfort or pain (especially at the incision site). Such discomfort is normal and, as such, patients will be given pain medication to help mitigate the discomfort.
Hospitalisation: Most patients will have undergone laparoscopic surgery, which means that they will be able to leave the same day. In the situations that involve open surgery, patients will generally need to remain hospitalised for a brief period (between 1-2 days) for observation and recovery.
Activity Limitations: Following surgery, patients will be expected to refrain from strenuous activity, heavy lifting, etc., for several weeks, after laparoscopic surgery and more so for open surgery. Gentle walking is encouraged to assist patients in their recovery.
Follow-Up Appointments: Patients will return to see their surgeon to check on their healing and review any laboratory results associated with the cyst. If a patient is developing any signs of infection, such as fever or increased pain, they should notify the surgeon immediately.
Returning to Normal Activity: Within 1-2 weeks of laparoscopic surgery and 4-6 weeks of open surgery, most patients who underwent laparoscopic surgery will have resumed their normal activity and, in cases of open surgery, returned to their normal level of activity.
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Cost of Ovarian Cyst in India
In India, the price range for removing an ovarian cyst is between $1300 and $1800. Depending on the kind of operation used to remove the cyst from the ovary, the cost may change. Additionally, the cost may change based on each patient's complications.
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Indications of Ovarian Cyst:
When something causes symptoms that would indicate the presence of problematic ovarian cysts, then generally, a doctor will recommend that an individual undergo surgery to remove the ovarian cysts. Common reasons for performing surgery to remove an ovarian cyst may include:
Pelvic Pain: In most cases, women will have continuous or sharp pelvic pain from pressure or irritation caused by cysts.
Bloating or Fullness: Women often feel like they are either too full or experiencing bloating. This may be uncomfortable and prevent them from functioning normally.
Irregular Menstrual Cycles: Hormones associated with irregular periods or changes in menstrual flow can be disrupted by the presence of an ovarian cyst.
Pain with Intercourse: Pain during intercourse may result from cystic ultimatums.
Problems with Urination or Bowel Movements: A large cyst may place pressure on the bladder and/or rectum, leading to an increase in frequency of urination or difficulty voiding.
Cysts that are diagnosed via imaging studies (ultrasounds) are evaluated for their size and complexity, and if there is any suspicion that the cyst may actually be malignant. This surgical procedure serves two purposes (treatment and diagnosis) as the cystic tissue is further examined in the laboratory.
Indications for Ovarian Cyst Removal
There are several clinical indicators and diagnostic criteria that may indicate a woman should undergo surgery for ovarian cyst removal. These include:
Cyst Size: Generally, larger cysts (>5-10cm) are more likely to produce symptoms, and therefore, they may need to be surgically removed if they are not resolved with time and during subsequent monthly cycles.
Complexity of Cyst: Complex cysts seen on imaging films (for example, a cyst containing both solid material and fluid) are viewed as more suspicious than simple cysts (which typically contain only fluid) and are often operated upon to exclude the possibility of cancer.
Persistent Symptoms: If your doctor has a suspicion your cysts are likely to cause persistent symptoms such as pelvic pain and discomfort and this has not improved after conservative treatment options, your doctor may recommend surgical intervention.
Rupture of Cyst: The rupture of a cyst, which can occur very suddenly, will cause excruciating pain (and the possibility of internal bleeding) and require immediate surgical intervention.
Cysts Related to Hormonal Imbalances: If a cyst is suspected to be associated with a hormonal imbalance (such as in women with polycystic ovary syndrome), it may be removed to bring the ovaries back into their normal state of activity.
Having a Family History of Ovarian Cancer: A family history of ovarian or breast cancer may prompt medical professionals to suggest the removal of a cyst, if the patient has one.
Age and Whether or not in Menopause: While young women may be monitored closely, it is usually recommended that post-menopausal patients with a cyst have the cyst removed because of an increased potential for malignancy.
Risk Factors:
Ovarian cystectomy is associated with certain complications and hazards that must be examined by the attending physician before this surgery can be carried out. Some of these potential problems are:
Risk of Infection: Like all surgeries, ovarian cystectomy carries the possibility of an infection occurring either externally at the incision site or internally within the abdominal cavity. The signs of an infection include redness, swelling, fever, and discharge from either the external incision or internally from the abdominal cavity. While antibiotics usually treat infections associated with this procedure, they sometimes require additional treatment such as surgery if the disease is more serious than anticipated.
Significant Bleeding: Although all blood loss is controlled during the actual surgical medicine procedure, some patients experience excessive blood loss either during the original surgical procedure or afterwards when the surgical site is healing. Very rarely do patients suffer enough blood loss that they require a transfusion or further surgery to compensate for that blood loss.
Risk of Injury to Nearby Organs: Because the ovaries are situated closely to other organs, such as the bladder, ureters, intestines, and blood vessels, there is some risk that nearby organs may be unintentionally injured during the surgery. The likelihood of injuries to other organs is higher in patients with large cysts and/or complicated ovarian cysts. If any other organ is damaged during the procedure, a second surgery might be required to fix that injured organ.
Loss/Damage of Ovaries: The surgical goal is always to conserve as much of the ovarian tissue as possible. However, in certain circumstances where the cyst is substantially impacting the ovarian tissue or in cases involving large cysts, that will not be possible. In cases where a significant amount of ovarian tissue is affected, that may also require the ovary to be removed entirely, which would most likely lead to an alteration in a woman's hormone levels and an elimination of her ability to become pregnant subsequently.
Scarring and Adhesions Resulting in Chronic Pelvic Pain: Following surgery, there is potential for development of scar tissue or adhesion in the pelvis resulting in chronic pelvic pain and problems with subsequent surgeries and also possibilities of infertility if scar tissue impedes the fallopian tubes or reproductive organs; which is more frequent with open surgeries.
Recurring Ovarian Cysts: The cyst that was surgically removed will not return, but it is likely that new ovarian cyst will develop in the future (especially in people who have had previous recurrent ovarian cysts).
General Anaesthesia Complications: There are possible complications of general anaesthesia such as respiratory and cardiovascular complications (high risk patients) and allergic reactions; Nausea and vomiting following surgery is a common side effect of anaesthesia and should be expected to resolve quickly.
Deep vein thrombosis (DVT) is a condition that develops from clotting of blood in the leg when there is limited movement after surgery; this is most often seen immediately after an accident or during an extended hospital stay due to the fact that patients have restricted mobility on account of their injuries. A clot can also break free from its former location and travel to the lung, which is considered a serious complication. Long-term (months) or short-term (days) mobility after surgery is critical in preventing DVT.
Menstrual cycle changes will vary from woman to woman, and while most women will not see significant changes in their menstrual cycles, some may experience shorter or longer menstrual cycles attributable to an effect from ovarian surgery.
Fertility is a significant concern because in many cases, there will be multiple surgeries to the ovaries, each of which can result in diminished fertility. Before any procedure, consult with the surgeon regarding fertility options if future pregnancy is an important consideration.