Care · By concern

Ovarian cysts: monitor, treat, operate when needed, in Paris 16th

An ovarian cyst is a fluid-filled sac that forms in or on the ovary. It is a frequent finding, most often benign, and most cysts go away on their own. At the practice, 42 avenue Mozart, Dr Chaima Gatri, OB-GYN and gynecological (gynaecological) surgeon, takes stock in a single consultation: the pelvic ultrasound is performed on site and the course of action — monitor, treat the symptoms or operate — is decided with you. When surgery is needed, she performs it herself at the Clinique de la Muette, a five-minute walk away. English-speaking practice.

Recognizing it

Functional cyst, organic cyst: two situations

Most cysts are functional: linked to the cycle, they form around ovulation and disappear on their own within a few cycles. Organic cysts — dermoid cyst, endometrioma, cystadenoma — do not depend on the cycle and persist: these are the ones that call for a decision. Often, a cyst gives no sign at all and is discovered on ultrasound. Otherwise, it shows itself through:

Sudden, intense pain low in the abdomen, with nausea or faintness, raises the fear of ovarian torsion or rupture of the cyst: call 15, the French emergency number.

Book an appointment — Dr GATRI

Assessment

Ultrasound at the practice, then the useful tests

The assessment begins with a gynecological examination and a pelvic ultrasound, performed at the practice during the consultation on the GE Voluson Expert 22 system of our equipment; the result is explained to you immediately. The ultrasound measures the cyst, describes its content — clear fluid, septa, solid areas — and in most cases distinguishes a functional cyst from an organic one. Dr Mahdhi-Basli also performs the practice's pelvic ultrasounds.

For a cyst that looks functional, we check: a repeat ultrasound a few cycles later confirms that it has gone. For a cyst that persists or whose appearance warrants it, Dr Gatri prescribes when necessary a pelvic MRI and blood tests, which refine the diagnosis. After menopause, a cyst is monitored more closely and the work-up is completed from the outset.

Treatments

From monitoring to surgery: the steps

  1. Ultrasound monitoring — the first step for most cysts: a functional cyst disappears on its own, and the follow-up ultrasound confirms it. A small organic cyst without symptoms is monitored too, at a pace set with you.
  2. Treating the symptoms — pain is treated with simple painkillers while the cyst regresses. For certain recurring functional cysts, Dr Gatri offers hormonal contraception, which puts the ovaries at rest.
  3. Laparoscopy — when the cyst persists, grows, hurts or has an appearance that requires it, Dr Gatri operates at the Clinique de la Muette, most often by laparoscopy: a few incisions of less than one centimeter and a quick recovery. Whenever possible, she removes the cyst alone and preserves the ovary (cystectomy); when preserving the ovary no longer serves a purpose, particularly after menopause, she removes the ovary (oophorectomy), together with the tube on the same side (adnexectomy) depending on the case — see Surgery — ovaries and tubes.
  4. The vaginal route (vNotes) — for an adnexectomy, when the anatomy and the indication allow, Dr Gatri operates through the natural passages, under endoscopic guidance: no abdominal scar and generally a simpler recovery. Laparotomy — open abdominal surgery — remains reserved for emergencies and complex situations.

The information sheets of the French College of Gynecologists and Obstetricians (CNGOF), translated into English, are given to you at the consultation: laparoscopy information sheet and adnexectomy by vaginal route (vNotes) information sheet. An endometrioma — the cyst of endometriosis — is managed as part of the overall care of endometriosis.

Frequently asked questions

Your questions, our answers

Is an ovarian cyst serious?

In the great majority of cases, no: most cysts are functional and benign, and disappear on their own. The ultrasound, completed when necessary by an MRI and blood tests, clarifies the nature of the cyst. Cysts that persist are monitored or operated on.

Will the cyst go away on its own?

A functional cyst, yes, within a few cycles; this is checked with a follow-up ultrasound. An organic cyst persists: it is monitored when small and silent, and operated on when it grows or hurts.

When is surgery needed?

When the cyst persists from one check to the next, when it is large, when it hurts or when its appearance on ultrasound or MRI warrants removing it — and urgently in the event of torsion or rupture. The decision is made with you, according to your age and your pregnancy plans.

Do I keep my ovary?

Whenever possible, yes: cystectomy removes the cyst alone and preserves the ovary, and with it the ovarian reserve. With a single ovary, cycles and fertility are maintained.

Cysts and fertility?

Most cysts do not prevent pregnancy. Some, such as endometrioma, are part of a condition that affects fertility, and surgery itself is weighed against the ovarian reserve. If you are planning a pregnancy, say so: it counts in every decision. The practice sees couples in an infertility consultation.

What should I do in case of sudden pain?

Sudden, intense pain with nausea or faintness raises the fear of ovarian torsion or rupture of the cyst: it is treated without delay, and it is not what the practice is for — call 15, the French emergency number. For unusual but bearable pain, choose the “Urgence gynécologique” (gynecological emergency) appointment on Doctolib or call the secretariat: depending on the degree of urgency and the schedule, you are seen the same day or in the following days.

Is it covered by health insurance?

The consultation, the ultrasound, the prescribed tests and the procedure are covered by the French health insurance (Assurance maladie) under sector 2 conditions; clinic charges and the anesthetist's fees are arranged with the clinic. The full picture is in “Fees and reimbursement”, further down.

How do I book?

On Doctolib, with Dr Gatri: “Première consultation de gynécologie” (first gynecology consultation), or “Consultation pour chirurgie des kystes de l'ovaire” (ovarian cyst surgery) if a cyst is already known; or by telephone through the secretariat. For unusual pain, choose “Urgence gynécologique”.

Fees

Fees and reimbursement

The consultation, the pelvic ultrasound and the surgical procedure are covered by the Assurance maladie under sector 2 (non-OPTAM) conditions; the practice's quotation covers Dr Gatri's fees and is provided before any procedure; clinic charges and the anesthetist's fees are arranged directly with the Clinique de la Muette. Fees are listed in the fee schedule and displayed at the practice. The information framework of this site is described on the Patient information and ethics page.

Appointments

Book an appointment

Appointments can be booked online via Doctolib or by telephone through the secretariat.

Doctolib — Dr Chaima GATRI