Ovarian Cysts

Most ovarian cysts are entirely normal and resolve on their own — a smaller number need careful assessment, and occasionally surgery, with a strong focus on preserving healthy ovarian tissue.

Most Cysts are benign and resolve without treatment

Often Detected incidentally — no symptoms at all

Ovary-first Preserving healthy tissue is always the priority

Ovarian cysts are fluid-filled or partially solid sacs that develop on or within an ovary. They are extremely common and most do not require any intervention. However, persistent, large, painful or complex cysts may need closer evaluation to determine the right course of action.

Types of ovarian cyst

Not all ovarian cysts are the same. Understanding the type helps guide monitoring and treatment decisions.

Functional cysts Follicular and corpus luteum cysts form as part of the normal menstrual cycle and almost always resolve on their own.

Endometriomas Cysts related to endometriosis, sometimes called "chocolate cysts," which may require surgical management.

Dermoid cysts Mature cystic teratomas containing tissue such as hair or fat — benign but often require removal.

Cystadenomas Cysts arising from the outer surface of the ovary, which can grow large and typically need surgical removal.

Polycystic ovaries Multiple small follicles related to PMOS (previously known as PCOS) — distinct from isolated ovarian cysts.

Ovarian cancer Rarely, a cyst may be malignant. Prompt specialist assessment helps identify features that require urgent referral.

Symptoms

Many ovarian cysts cause no symptoms and are found incidentally on ultrasound. When symptoms do occur, they may include:

Pelvic ache or pressure A dull, persistent discomfort or feeling of heaviness in the pelvis

Bloating A sensation of fullness or visible abdominal swelling

Pain with intercourse Discomfort or deep pain during sexual activity

Menstrual changes Irregular, heavier or more painful periods than usual

Sudden severe pelvic pain May indicate ovarian torsion, rupture or bleeding — requires urgent assessment

How ovarian cysts are diagnosed

Pelvic ultrasound

The primary investigation. The appearance, size and blood flow within a cyst help determine whether it is benign and can be safely monitored, or whether further evaluation is needed.

Tumour markers

Blood tests such as CA-125 are sometimes used alongside imaging to help assess the nature of a cyst, particularly if features are complex or concerning.

MRI (where indicated)

Provides additional detail on cyst characteristics when ultrasound findings are uncertain or when surgical planning requires more precise mapping.

Treatment approach

Treatment depends on cyst type, size, symptoms, and your fertility and hormonal health goals. Many cysts require no intervention at all.

Conservative monitoring

Simple cysts that are likely to resolve are safely managed with regular ultrasound monitoring.

Hormonal management

May be considered in some cases to reduce the formation of new functional cysts.

Laparoscopic cystectomy

Minimally invasive removal of the cyst while carefully preserving the surrounding healthy ovarian tissue.

Laparoscopic oophorectomy

Removal of the ovary where preservation is not possible or appropriate — discussed carefully with each patient.

Urgent surgery

Required for suspected ovarian torsion or rupture — these are time-sensitive surgical emergencies.

Oncology referral

Where imaging or blood test features raise concern for malignancy, prompt referral to gynaecological oncology is arranged.

Dr Krones' Approach

Ovary-preserving laparoscopic surgery

Dr Krones' advanced laparoscopic training emphasises ovary-preserving surgery wherever it is safe to do so. This is particularly important for women of reproductive age and for long-term hormonal and bone health.

Decisions are made with thorough explanation of the imaging findings, the realistic options, and the risks and benefits of each approach — so you can make an informed choice about your care.

When to see a specialist

Seek specialist assessment in any of these situations:

A cyst has been identified on imaging and you want to understand your options
Persistent pelvic pain, pressure or bloating
Pain with intercourse or menstrual irregularities
Sudden severe pelvic pain — seek urgent assessment immediately

Book a consultation

Dr Krones consults at Suite 3A, North Shore Private Hospital, St Leonards, with operating privileges at North Shore Private Hospital and The Mater Hospital.

A valid GP or specialist referral is required for all new appointments.

02 9053 1245