Medical Management

 Oral contraceptives: Birth control pills may be helpful to regulate the menstrual cycle,
prevent the formation of follicles that can turn into cysts, and possibly reduce the size
of an existing cyst.

 Pain relievers: Anti-inflammatories such as ibuprofen (for example, Advil) may help
reduce pelvic pain. Narcotic pain medications by prescription may relieve severe pain
caused by ovarian cysts.

 * pain relievers, including acetaminophen (Tylenol), nonsteroidal anti-inflammatory

drugs such as ibuprofen (Motrin, Advil), or narcotic pain medicine (by prescription)
may help reduce pelvic pain.NSAIDs usually work best when taken at the first signs of
the pain.
 * a warm bath, or heating pad, or hot water bottle applied to the lower abdomen
near the ovaries can relax tense muscles and relieve cramping, lessen discomfort,
and stimulate circulation and healing in the ovaries. Bags of ice covered with towels
can be used alternately as cold treatments to increase local circulation.
 * combined methods of hormonal contraception such as the combined oral
contraceptive pill -- the hormones in the pills may regulate the menstrual cycle,
prevent the formation of follicles that can turn into cysts, and possibly shrink an
existing cyst. (American College of Obstetricians and Gynecologists, 1999c; Mayo
Clinic, 2002e)
 Also, limiting strenuous activity may reduce the risk of cyst rupture or torsion.
 Cysts that persist beyond two or three menstrual cycles, or occur in post-menopausal
women, may indicate more serious disease and should be investigated through
ultrasonography and laparoscopy, especially in cases where family members have
had ovarian cancer. Such cysts may require surgical biopsy. Additionally, a blood test
may be taken before surgery to check for elevated CA-125, a tumor marker, which is
often found in increased levels in ovarian cancer, although it can also be elevated by
other conditions resulting in a large number of false positives.[18]
 For more serious cases where cysts are large and persisting, doctors may suggest
surgery. Some surgeries can be performed to successfully remove the cyst(s) without
hurting the ovaries, while others may require removal of one or both ovaries.

Surgical Management

 * Laparoscopic surgery: The surgeon fills a woman's abdomen with a gas and makes
small incisions through which a thin scope (laparoscope) can pass into the abdomen.
The surgeon identifies the cyst through the scope and may remove the cyst or take a
sample from it.

 * Laparotomy: This is a more invasive surgery in which an incision is made through

the abdominal wall in order to remove a cyst.
• Surgery for ovarian torsion: An ovarian cyst may twist and cause severe abdominal
pain as well as nausea and vomiting. This is an emergency, surgery is necessary to
correct it.

• *Salpingectomy is the surgical removal of one or both fallopian tubes. The fallopian
tubes serve as a passageway for an ovum to travel from the ovary to the uterus. In a
unilateral salpingectomy, only one fallopian tube is removed; in a bilateral
salpingectomy, both fallopian tubes are removed. A salpingectomy can be performed
for a number of reasons, including treatment of ectopic pregnancies and infections in
the fallopian tubes (salpingitis). Women afflicted with the sexually transmitted diseases
gonorrhea, syphilis, and chlamydia are prime candidates for salpingectomy. These
conditions are the most common causes of infection of the fallopian tubes. Childbirth,
abortion, and insertion of intrauterine devices (IUDs) have also been associated with
salpingitis and the salpingectomy procedure. Women who have only one fallopian tube
are still able to conceive.
• *Salpingo-oophorectomy is a surgical procedure involving the removal of one or both of
the fallopian tubes (salpingectomy) and one or both ovaries (oophorectomy). In a
unilateral salpingo-oophorectomy procedure, only one fallopian tube and one ovary are
removed. In the bilateral procedure, both fallopian tubes and both ovaries are removed.
In women under the age of 40, an attempt is made whenever possible to preserve
ovarian function by removing only one ovary or a part of one ovary. A salpingo-
oophorectomy may be performed to remove fluid-filled sacs (cysts), benign tumors
(fibromas or teratomas), or abscesses. It is also done to treat chronic inflammation of
the fallopian tubes (chronic salpingitis or tuberculous salpingitis), pelvic inflammatory
disease, endometrial cells in the pelvic cavity (endometriosis), and breast and ovarian
cancer. The procedure is used to remove the results of a pregnancy that develops in a
fallopian tube rather than the uterus (ectopic pregnancy). Salpingo-oophorectomy may
also be performed with a hysterectomy as a part of the treatment for uterine cancer or
for treatment of a cancerous tumor derived from placental tissue (choriocarcinoma).
Salpingo-oophorectomy is used in breast cancer cases when the physician considers
that a reduction in the amount of hormones produced by the ovaries (estrogens) may
slow the growth of the cancer. Besides treating existing ovarian cancer, the procedure
is sometimes used to remove healthy ovaries as a preventive (prophylactic) measure in
reducing the risk of ovarian cancer in high-risk women.