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Most bilateral oophorectomies (63%) are performed without any medical indication, and most (87%) are performed together with a hysterectomy. [10] Conversely, unilateral oophorectomy is commonly performed for a medical indication (73%; cyst, endometriosis, benign tumor, inflammation, etc.) and less commonly in conjunction with hysterectomy (61%).
The mainstay of treatment is surgery to remove the residual ovarian tissue. Women with ORS with a pelvic mass should have appropriate evaluation for malignancy . Hormonal therapy to suppress ovarian function is an alternative treatment for those who refuse surgery, or those who are not candidates for surgery. [3]
Ovarian cysts may be classified according to whether they are a variant of the normal menstrual cycle, referred to as a functional or follicular cyst. [6] Ovarian cysts are considered large when they are over 5 cm and giant when they are over 15 cm. In children, ovarian cysts reaching above the level of the umbilicus are considered giant.
It is common for many women to develop a cyst in their lifetime. [4] At times, these can go unnoticed without pain or visible symptoms. A cyst may develop in either of the ovaries that are responsible for producing hormones and carrying eggs. Ovarian cysts can be of various types, such as dermoid cysts, endometrioma cysts, and the functional cyst.
Theca lutein cyst is a type of bilateral functional ovarian cyst filled with clear, straw-colored fluid. These cysts result from exaggerated physiological stimulation (hyperreactio luteinalis) due to elevated levels of beta- human chorionic gonadotropin (beta-hCG) or hypersensitivity to beta-hCG.
The removal of healthy ovarian tissue or compromising blood flow to the ovary are both risk factors of the surgery that could lead to detrimental affects on the ovarian reserve. However, despite the fact that there is a risk of loss of ovarian function, studies have shown the recurrence rate of endometrioma is reduced.
Large cysts can lead to torsion of the adnexa inflicting acute pain. [3] [4] Prior to surgery, PTCs are usually seen on ultrasonography. However, because of the proximity of the ovary that may display follicle cysts, it may be a challenge to identify a cyst as paratubal or paraovarian. [5]
This type can form when ovulation doesn't occur, and a follicle doesn't rupture or release its egg but instead grows until it becomes a cyst, or when a mature follicle involutes (collapses on itself). It usually forms during ovulation, and can grow to about 7 cm in diameter.