Exams and Tests

A healthcare provider may perform the following tests to determine if a woman has an ovarian cyst or to help characterize the type of cyst that is present:

• Endovaginal ultrasound: This type of imaging test is a special form of ultrasound developed to examine the pelvic organs and is the best test for diagnosing an ovarian cyst. A cyst can be diagnosed based on its appearance on the ultrasound.
  
  
  • An endovaginal ultrasound is a painless procedure that resembles a pelvic exam. A thin, covered wand or probe is placed into the vagina, and the examiner directs the probe toward the uterus and ovaries.
    
    
  • This type of ultrasound produces a better image than a scan through the abdominal wall can because the probe can be positioned closer to the ovaries.
    
    
  • Using an endovaginal ultrasound, the internal cystic structure may be categorized as simple (just fluid filled), complex (with areas of fluid mixed with solid material), or completely solid (with no obvious fluid).
  
  
• Other imaging: CT scanning aids in assessing the extent of the condition. MRI scanning may also be used to clarify results of an ultrasound.
  
  
• Laparoscopic surgery: The surgeon fills a woman's abdomen with a gas and makes small incisions through which a thin scope (laparoscope) can pass into the abdomen. The surgeon identifies the cyst through the scope and may remove the cyst or take a biopsy from it.
  
  
• Serum CA-125 assay: This blood test checks for a substance called CA-125, which is associated with ovarian cancer (the CA stands for cancer antigen). This test is used in the assessment of epithelial ovarian cancer and may help determine if an ovarian mass is harmless or cancerous. However, sometimes benign conditions may result in the elevated levels of CA-125 in the blood, so the test does not positively establish the diagnosis of ovarian cancer.
  
  
• Hormone levels: A blood test to check LH, FSH, estradiol, and testosterone levels may indicate potential problems concerning these hormone levels.
  
  
• Pregnancy testing: The treatment of ovarian cysts is different for a pregnant woman than it is for a nonpregnant woman. An ectopic pregnancy (pregnancy outside the uterus) must be ruled out because some of the symptoms of ectopic pregnancy may be similar to those of ovarian cysts.
  
  
• Culdocentesis: This test involves taking a fluid sample from the pelvis with a needle inserted through the vaginal wall behind the uterine cervix.

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Ovarian Cysts - Symptoms at Onset of Disease

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