The diagnosis of an "ovarian cyst" sounds frightening to many women. The first things that come to mind are major surgery, general anesthesia, scars, and a long recovery period. However, modern medicine has made significant advancements in minimally invasive techniques, allowing patients to get rid of these formations without any incisions or punctures to the abdominal wall.
In this article, we will discuss in detail which types of cysts qualify for non-surgical treatment, what methods are available today, and why sclerotherapy is becoming the gold standard for preserving women's health.
Types of Ovarian Cysts
Before choosing a treatment method, a doctor always determines the nature and type of the cyst using ultrasound, MRI, and laboratory tests. All cysts can be divided into two large groups:
- Functional Cysts (Temporary)
These form due to a temporary hormonal imbalance and, in most cases, resolve on their own within 2–3 menstrual cycles. They include:
Follicular cyst: Occurs when a dominant follicle fails to rupture during ovulation and continues to grow.
Corpus luteum cyst (luteal cyst): Forms at the site of a ruptured follicle if fluid accumulates inside it.
- True Cysts (Organic)
These formations will not disappear on their own and require mandatory monitoring or removal:
Endometrioma (chocolate cyst): Filled with thick, dark brown blood; forms as a result of endometriosis.
Serous cyst (cystadenoma): Filled with clear, watery fluid; can grow to large sizes.
Dermoid cyst: A congenital formation containing elements of embryonic tissues (fat, hair, cartilage). Due to its thick, pasty content, this type of cyst can only be removed surgically.
Malignant formations: Tumors that require immediate gynecological oncological treatment.
Methods of Ovarian Cyst Removal
In modern gynecology, three main approaches are used to address ovarian cysts:
Conservative (medical): Applied only to functional cysts and involves hormonal and anti-inflammatory therapy.
Surgical (operative): Laparoscopy (via small punctures) or laparotomy (open surgery via an incision).
Non-surgical (minimally invasive): Transvaginal aspiration and sclerotherapy under ultrasound guidance.
Disadvantages of Surgical Cyst Removal
Although laparoscopy is considered a minimally invasive operation, it remains a fully invasive surgical intervention with the following drawbacks:
Reduction of ovarian reserve (the main disadvantage): When stripping the cyst wall, the surgeon is forced to use electrocoagulation to stop bleeding. This inevitably damages the adjacent healthy ovarian tissue and permanently destroys the egg supply, which is highly critical for women planning a future pregnancy.
General anesthesia: The operation requires endotracheal intubation and deep general anesthesia, which places a heavy burden on the cardiovascular and nervous systems.
Adhesion formation: Any intervention inside the pelvic cavity can trigger the formation of adhesions, which can later cause chronic pelvic pain or tubal infertility.
Long rehabilitation period: Requires hospitalization, wearing compression stockings, dealing with puncture wound pain, and restricting physical activity for up to 1 month.
Sclerotherapy at Trinity Women's Clinic: How is the Procedure Performed?
Ovarian cyst sclerotherapy is a high-tech, non-surgical alternative to laparoscopy. The procedure is performed on an outpatient basis in a sterile minor operating room and takes only 20–30 minutes.
Step-by-Step Procedure:
Pain Management (Anesthesia): A light intravenous sedation ("twilight sleep") is combined with local anesthesia. The patient feels no pain or discomfort.
Cyst Puncture: Under the guidance of a high-precision ultrasound probe, the gynecologist inserts a very thin needle through the vaginal fornix directly into the cyst cavity. No incisions or punctures are made on the abdominal skin.
Fluid Evacuation: The doctor completely aspirates the liquid content of the cyst, which is immediately sent for mandatory cytological (pathology) evaluation.
Sclerosing: A special sclerosing agent (usually sterile 96% ethyl alcohol) is injected into the emptied cyst cavity. The solution acts on the inner lining of the capsule, destroying the cells that produced the fluid. After a few minutes, the sclerosing agent is completely removed.
Completion: The needle is withdrawn. The walls of the cyst stick together, and over the course of several weeks, a tiny, unnoticeable fibrous tissue forms where the cyst used to be.
Advantages of Sclerotherapy
Maximum preservation of fertility: The procedure does not affect healthy ovarian tissue or its vascular network. The ovarian reserve and follicular apparatus remain completely intact, making sclerotherapy the ideal choice for women planning a pregnancy.
No scars or blemishes: Access is gained transvaginally, so absolutely no marks or scars are left on the body.
Safety and gentle anesthesia: Using short-term sedation instead of heavy general anesthesia minimizes risks to the body and eliminates toxic effects on the liver and heart.
Rapid recovery: Within 2–3 hours after the procedure, the patient can leave the [Clinic Name] on her own and return to her daily routine. There is no need for extended sick leave.
Minimal risk of adhesions: Since the pelvic cavity is not opened and does not come into contact with air or surgical instruments, the risk of developing pelvic adhesions is virtually zero.
Important: Sclerotherapy is a highly precise technique that has strict indications and contraindications. It is perfectly suited for unilocular serous cysts and endometriomas, but cannot be used if malignancy is suspected or for dermoid cysts.
Schedule a consultation with a gynecologist at Trinity Women's Clinic to undergo an expert ultrasound assessment and find out if sclerotherapy is the right option for you. Protect your reproductive health safely and without surgery!