Management of Ovarian Cysts

Management of Ovarian Cysts and Treatment Approaches

Ovarian cysts are fluid-filled sacs that can be seen in women of all ages and are most often detected during routine check-ups. Although a large majority of these cysts are functional and disappear on their own, some can be pathological structures requiring surgical intervention or close monitoring. Prof. Dr. Selçuk Erkılınç provides his patients with the safest treatment roadmap, meticulously differentiating these cysts from a gynecologic oncology perspective.

Why Do Ovarian Cysts Occur and What Are Their Types?

Ovarian cysts are divided into different categories depending on their developmental causes. The important thing is to accurately differentiate whether the cyst is a simple physiological process or a high-risk formation.

1. Functional Cysts

This is the most common type of cyst. They develop due to disruptions in the ovulation process. They usually shrink and disappear on their own within 1 to 3 months without requiring treatment.

2. Dermoid Cysts (Teratomas)

These are cysts containing tissues left over from the embryonic period (such as hair, fat, or teeth). They do not disappear spontaneously and generally need to be surgically removed.

3. Endometrioma (Chocolate Cysts)

These form when endometriosis settles in the ovaries. They are specialized cysts that can lead to severe pain and infertility, requiring professional expertise.

4. Cystadenomas

These are benign cysts developing from the outer surface of the ovary. While benign, they have a high tendency to grow and can sometimes reach very large sizes.

Diagnostic and Evaluation Criteria

Not every ovarian cyst requires surgery. Prof. Dr. Selçuk Erkılınç relies on the following criteria to determine the character of the cyst:

• Ultrasonography Findings: The size, internal structure (whether it is fluid or solid), and vascularity of the cyst.

• Tumor Markers: Risk analysis (ROMA index) utilizing parameters evaluated in the blood, such as CA-125 and HE4.

• Patient’s Age: The clinical approach to cysts in the premenopausal and postmenopausal periods is entirely different.

Surgical Treatment and Ovary-Preserving Approach

When a surgical decision is made, Dr. Erkılınç’s fundamental principle is to preserve the patient’s healthy ovarian tissue.

1. Laparoscopic Cystectomy (Closed Surgery)

Today, nearly all cyst surgeries are performed via the laparoscopic method. By entering through incisions of just a few millimeters, only the cyst is removed, and the ovarian tissue is preserved.

2. Oncological Approach and Safety

If a cyst is considered pathologically risky, it is of vital importance to remove it without rupturing it or allowing it to spill into the abdominal cavity during the operation. Dr. Erkılınç manages this process in the safest way possible with the discipline of oncological surgery.

3. Emergency Management (Cyst Rupture and Torsion)

In emergency situations such as a cyst twisting around itself (torsion) or bursting (rupture), rapid and experienced surgical intervention is carried out to prevent ovarian loss.

Recovery Process and Follow-Up

Thanks to laparoscopic intervention, patients are discharged on the day of surgery or the following day. Based on the pathology results obtained after the operation, a long-term follow-up plan is custom-tailored for the patient.