Management of Ruptured Ovarian Cyst
What is management of a ruptured ovarian cyst?
An ovarian cyst is a fluid-filled sac that forms on or inside an ovary. In some cases, the cyst can break open (rupture). A ruptured cyst may be managed in several ways. You may just need to keep track of your symptoms. You may need to take pain medication. In other cases, a cyst may need surgery.
The ovaries are a pair of small, oval-shaped organs in the lower part of a woman’s belly (abdomen). About once a month, one of the ovaries releases an egg. The ovaries also make the hormones estrogen and progesterone. These play roles in pregnancy, the menstrual cycle, and breast growth.
An ovarian cyst can develop due to different reasons. Most ovarian cysts are harmless. A cyst that ruptures may cause no symptoms, or only mild symptoms. Ruptured cysts that cause mild symptoms can often be managed with pain medicines. The cyst may be looked at with an imaging test.
In some cases, a ruptured cyst can cause more severe symptoms. These can include pain in the lower belly (abdomen) and bleeding. Symptoms like these need treatment right away.
You may need care in the hospital if you have severe symptoms from a ruptured cyst. You may be given intravenous (IV) pain medicines through a needle inserted into your vein. You may need to have fluids or blood replaced due to internal bleeding. In rare cases, a ruptured ovarian cyst may need surgery.
If you need surgery because of internal bleeding, a surgeon will make a cut in your abdomen while you are under anesthesia. The doctor controls the bleeding and removes any blood clots or fluid. He or she may then remove the cyst or your entire ovary.
Why might I need management of a ruptured ovarian cyst?
Some ruptured ovarian cysts can cause a lot of bleeding. These need medical treatment right away. In severe cases, the blood loss can cause less blood flow to your organs. In rare cases, this can cause death.
Many ovarian cysts do not rupture. Doctors do not know why some cysts break open and some do not. A cyst is more likely to rupture during strenuous exercise or sexual activity. If you have a health condition that makes you bleed easily, you will likely need surgery for a ruptured cyst.
There are different types of ovarian cysts. Functional cysts are the most common type. These only occur in women who have not gone through menopause. They often happen when an egg doesn’t release from the ovary during ovulation. These cysts are the most common type to rupture.
How do I prepare for management of a ruptured ovarian cyst?
A doctor diagnoses a ruptured ovarian cyst. If you have sudden, sharp belly pain, see a doctor right away. If you know that you have an ovarian cyst, be aware that it can rupture and need treatment.
Your primary care doctor or an obstetrics and gynecology (OB/GYN) doctor will diagnose the condition. Your doctor will ask about your medical history and your symptoms. Be sure to tell the doctor if you know that you have an ovarian cyst. You will also have a physical exam. This will likely include a pelvic exam.
If your doctor thinks you may have a ruptured cyst, you may need tests. These tests can help rule out other possible causes of your symptoms, such as an ectopic pregnancy, appendicitis, or a kidney stone. Some of these tests may include:
- This test uses sound waves to view the size, shape, and location of the cyst.
- Pregnancy test. This is done to check if pregnancy may be the cause of the cyst
- Blood tests. These check for anemia (low iron in the blood). They also check for infection.
- Urine test. This looks for other possible causes of your pain.
- Vaginal culture. This is done to check for a pelvic infection.
- Computed tomography (CT) scan. This uses a series of x-rays and a computer to create a detailed picture of the area.
You may need more tests to rule out other possible causes of your symptoms.
If you need surgery for your cyst, your doctor will tell you how to prepare. For example, you shouldn’t eat or drink after midnight before your surgery.
What happens during management of a ruptured ovarian cyst?
Management of a ruptured ovarian cyst depends on whether it is complex. A regular cyst is a simple fluid-filled sac. A complex cyst may have solid areas, bumps on the surface, or several areas filled with fluid.
Many women have functional ovarian cysts. Most of these are not complex. A ruptured cyst that is not complex can be treated with pain medication. You may be told to watch your symptoms over time. In some cases, you may need to have follow-up ultrasound tests. You may not need any other treatment.
If the cyst is complex, you may need different care. This type of cyst may cause:
- Blood loss that causes low blood pressure or fast heart rate
- Signs of possible cancer
If you have a complex ruptured ovarian cyst, you may need care in the hospital. Your treatment may include:
- Intravenous (IV) fluids to replace lost fluid
- Careful monitoring of your heart rate and other vital signs
- Monitoring of your red blood cell level (hematocrit) to check the blood’s ability to carry oxygen
- Repeated ultrasounds to check for bleeding into your abdomen
- Surgery for a worsening medical condition or to check for cancer
If you need surgery, your doctor may use a minimally invasive method. This is also known as laparoscopy. The doctor makes small incisions in your abdomen while you are under anesthesia. A tiny lighted camera and other small tools are put through these incisions. The doctor controls the bleeding and removes any blood clots or fluid. He or she may then remove the cyst or your entire ovary. The tools are then removed. The incisions are closed and bandaged. If the doctor does not use laparoscopy, the surgery will be done with larger incisions.
Talk with your doctor about what type of treatment will work best for you.
What happens after management of a ruptured ovarian cyst?
You and your medical team will make a follow-up plan that makes the most sense for you.
If your ruptured ovarian cyst is not complex, you will likely continue your care at home. You can use pain medications as needed. Your pain should go away in a few days. Let your doctor know right away if you your pain gets worse, if you feel dizzy, or have new symptoms. Follow up with your doctor if you need imaging or blood tests.
If you have a complex ruptured ovarian cyst, you may need to stay in the hospital for one or more days. If your cyst is no longer bleeding, you may be able to go home. You can use pain medications as needed. You may need follow-up imaging tests to make sure that your bleeding has stopped.
If you had surgery, you will be told how to care for your wound and bandage. You may need to limit your physical activity for a while. Your medical team will give you more information.
In rare cases, a ruptured ovarian cyst is caused by cancer. This will need careful follow-up treatment from a doctor who specializes in cancer care. You may need surgery and other therapies.
Some women have more than one ovarian cyst. You can work with your doctor to plan treatment for multiple cysts. A cyst that has not ruptured may need to be watched over time. In other cases, you may need surgical removal of the cyst.
Before you agree to the test or the procedure make sure you know:
- The name of the test or procedure
- The reason you are having the test or procedure
- The risks and benefits of the test or procedure
- When and where you are to have the test or procedure and who will do it
- When and how will you get the results
- How much will you have to pay for the test or procedure