Ovarian cysts are fluid-filled sacs near or around the ovaries. Most ovarian cysts are common, but others can cause painful symptoms for patients.   

Kathryn C. Stambough, M.D., service chief for the Arkansas Children’s Hospital pediatric and adolescent gynecology clinic in Little Rock, said about 15 percent of patients are seen daily for ovarian cyst concerns. Stambough is one of only two fellowship-trained pediatric and adolescent gynecologists in the state. She is also an assistant professor in the division of pediatric and adolescent gynecology in the department of obstetrics and gynecology at the University of Arkansas for Medical Sciences.    

Stambough shared the following five questions parents should ask regarding ovarian cysts:   

1. Are ovarian cysts normal?   

Any girl of reproductive age, meaning after their first period, can have ovarian cysts. Common ovarian cysts are physiological, created as part of the body’s normal process.   

2. What are the types of ovarian cysts?   

There are two categories of ovarian cysts: physiologic and pathologic.   

Physiologic cysts are produced with ovulation. They come and go, depending on a person’s cycle. Typically, physiologic cysts are found when patients receive medical imaging for another reason.  

Pathologic cysts are abnormal cell growths not tied to a menstrual cycle. These cysts are unlikely to be reabsorbed by the body. However, most are benign or not harmful in pediatric patients. It is extremely rare for a pediatric patient to have a malignant or diseased ovarian cyst.   
3. What can cause ovarian cysts?   

Besides the menstrual cycle, sometimes ovarian cysts can be caused by underlying conditions, including endometriosis and polycystic ovarian syndrome (PCOS).   
4. How are they treated?   

Physiologic cysts generally do not have symptoms and can be observed without treatment. A body typically reabsorbs a physiologic cyst in four to six weeks. A gynecologist may want to repeat imaging or pelvic ultrasound to ensure the cyst is reabsorbed.   

However, if a physiologic cyst is large, has ruptured or twists and blocks blood flow to the ovaries, called ovarian torsion, physiologic cysts can cause pelvic or lower abdomen pain ranging from a heavy feeling to severe sharp pain. Symptoms can be treated with nonsteroidal anti-inflammatory drugs (NSAIDs).  

With a suspected pathologic cyst, a gynecologist, parent and patient can discuss options. Observation may be recommended if the pathological cyst is small and not symptomatic. If the cyst is painful or large, laparoscopic surgery may be recommended to remove it.  
5. How concerned should parents be about their child having an ovarian cyst?   

Most ovarian cysts are benign. If a patient develops symptoms like nausea, vomiting, abdominal pain or avoids eating and drinking, they should be seen by a gynecologist to check for ovarian torsion. 


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