Dr. Guillermo Bassols,

The steps to follow to determine the nature of an ovarian cyst are as follows:

• Avoid pregnancy
• Abdominal and transvaginal Ecography. Enables the location, content and diameter of the cyst to be identified, as well as its relation with neighbouring organs
• Tumour markers. Specific blood analyses to determine the amount of CA-125 protein, which is closely related (together with other tumour markers) with the nature of the ovarian cyst
• CAT and MRI. Diagnostic methods by imaging employed to complete the pre-operative study of an ovarian cyst
• Laparoscopy. A diagnostic method that also frequently provides a surgical solution to ovarian cysts.

This will depend on age, the type of cyst and its symptoms:

• Watchful waiting. Often requires no more than a further exploration after between one to three months in order to check that the diameter of the cyst is decreasing or that the cyst is disappearing.
• Medical treatment with hormonal contraceptives. This involves a temporary suspension of ovarian activity, while at the same time reducing future risk of ovarian cancer.
• Surgery. Wherever recommendable due to the size of the cyst, whenever the cyst is not of the functional type or if the cyst is still present after some months of observation. Surgery may be confined to removal of the cyst, although on occasion it may be necessary to extirpate the ovaries themselves. The current technique consists in an operation by laparoscopy. Only on very few occasions is it necessary to carry out open surgery (laparotomy).