No, ovarian cysts do not always need surgery. They tend to be different and the reasons for them are different. Functional or false cysts occur periodically depending on the phase of the cycle and themselves disappear. They usually do not cause discomfort, and most often a woman and a gynecologist find out about them during a routine examination (ultrasonography). If a woman has no complaints, functional cysts do not need special treatment. Most likely, they will disappear on their own. Operates very rarely – only if they suddenly rupture.
Real cysts are completely different – they do not disappear. Two types of benign true cysts can develop in the ovaries: dermoid cysts (usually congenital) and endometriotic cysts (then a woman usually also has endometriosis when the inner layer of the uterine lining or endometrium expels outside the uterus). There are also mucinous cysts that tend to turn into malignancies, so they are recommended for surgery.
If the dermid cysts do not interfere, they are only about 2 cm in diameter and the annual ultrasonography shows that the cysts are standing still, nothing needs to be done. Another thing is if the dermid cyst tends to grow and has already reached 5-6 cm in diameter. Then it is better to perform a planned operation to get rid of the cyst, because as it grows and expands, it can rupture.
Endometriosis cysts should definitely be treated with hormonal tablets containing dienogest, as it can partially stop endometriosis. The second type of treatment is surgery to remove the mucous clots that have formed in the ovaries. This solution is not best for young women who want to have more children, and cysts may recur.
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