An ovarian cyst is a fluid-filled sac that develops on or within an ovary. The ovaries normally release an egg each month during the menstrual cycle inside a small structure called a follicle. When this follicle fails to rupture or dissolves after releasing an egg, it can swell with fluid, forming a functional cyst. These benign growths are extremely common among women of childbearing age in Nigeria and frequently resolve on their own within two to three menstrual cycles without medical intervention.
Unlike functional cysts driven by normal cycles, pathological cysts arise from abnormal cell growth. Nurses must recognize the major varieties:
Many small ovarian cysts produce no symptoms at all, discovered only during routine pelvic examinations or ultrasound scans. However, as cysts grow or undergo changes, patients may report:
Accurately diagnosing an ovarian cyst requires a combination of clinical assessment and diagnostic imaging. A pelvic examination helps the physician palpate adnexal masses. Pelvic ultrasonography, either transabdominal or transvaginal, remains the gold standard for visualizing the cyst's size, shape, and composition (whether it is fluid-filled or solid). Blood tests like CA-125 may be ordered to rule out malignancy, though elevated levels can also occur with benign conditions like endometriosis or pelvic inflammatory disease.
Management depends on the patient's age, symptom severity, and the cyst's appearance on ultrasound. Asymptomatic functional cysts often require only watchful waiting with repeat ultrasounds. Oral contraceptives may be prescribed to suppress ovulation and prevent new functional cysts from forming. When cysts are large, persistent, or suspected to be malignant, surgical intervention becomes necessary. Procedures range from a cystectomy (removing just the cyst while preserving the ovary) to an oophorectomy (removing the entire ovary).
Neglected or rapidly growing cysts can lead to life-threatening surgical emergencies. Ovarian torsion occurs when the ovary twists on its vascular pedicle, cutting off blood supply and causing sudden, agonizing lower abdominal pain, nausea, and vomiting. Another major risk is cyst rupture, which can cause internal hemorrhage or severe peritoneal irritation. Nurses must immediately report sudden severe pain, hemodynamic instability, or signs of shock, as these require emergency surgical exploration.
Comprehensive nursing care for a patient with an ovarian cyst focuses on comfort, safety, and education. Nurses monitor vital signs, assess pain using a standard scale, and administer prescribed analgesics. Before discharge, patient education should cover recognizing red flags such as severe pelvic pain, dizziness, or abnormal bleeding. Nurses also reassure patients about reproductive health, explaining that many cysts are harmless and do not impair fertility.