Ovarian cysts are sacs filled with fluid that form on or inside an ovary. They are usually harmless and go away by themselves, but in some cases, a ruptured ovarian cyst can result in severe complications that require surgery.  

Others write off severe symptoms because they believe the pain they're feeling are simply the natural reaction to changes in the body of a woman. However, neglecting important warning signs can endanger your health. To better guide you on what could be the telltales that you require ruptured ovarian cyst surgery, keep reading.  

Ovarian Cysts and Rupture Facts You Need to Know  

Ovarian cysts occur in approximately 7% of women at some point in their lives, based on a 2014 study by Farghaly SA. And though most believe menopaused women are safe, they are actually more vulnerable at 18% probability, cited the above-mentioned study.  

Functional cysts, like follicular cysts or corpus luteum cysts, usually develop during the menstrual cycle and usually resolve on their own without treatment. However, when rupture occurs, it can discharge fluid or blood, giving rise to complications like intraperitoneal bleeding or pelvic infection.  

While most ruptures can be treated with watchful waiting, some symptoms indicate the need for immediate attention with an ovarian cyst specialist in Singapore or other specialists near you, for proper assessment.  

Surgical intervention is usually determined by symptom severity and potential for complications. Here's a breakdown of the most common telltale signs:  

1. Severe or Persistent Pelvic Pain  

One of the strongest indicators of an ovarian cyst rupture is severe pelvic or abdominal pain that is not easily resolved. In contrast to the dull ache that a developing cyst will cause, rupturing tends to produce stabbing, immediate pain on one side of the lower abdomen. The pain might also extend to the back or thighs and become worse with movement.  

If the pain lasts a few hours or is too severe to cause distraction from normal activities, then it may be indicative of complications such as internal bleeding or a hemorrhagic cyst. 

For instance, a ruptured corpus luteum cyst can lead to profuse bleeding, resulting in a decrease in blood pressure or a rise in heart rate. A pelvic examination or ultrasound scan can be advised if you have such discomfort.  

2. Dizziness and Fainting Caused by Internal Bleeding  

Internal bleeding is a grave result of a ruptured ovarian cyst, especially with haemorrhagic ovarian cysts. Note that this haemorrhagic ovarian cysts are more prevalent in those who have not yet reached menopausal phase, based on the study published by Ahmed M. Abbas.  

Symptoms include dizziness, fainting, or light-headedness, especially upon standing. You may also experience tachycardia or hypotension, which are indicators of excessive blood loss. In certain situations, periumbilical ecchymosis, or bruising near the belly button, occurs. This indicates that the blood is accumulating in the abdominal cavity.  

In case these symptoms appear, urgent assessment via CT scanning or pelvic ultrasound is essential. Surgical intervention, frequently through minimally invasive procedures such as laparoscopy, can be necessary to prevent further bleeding and excise the cyst.  

3. Pelvic Infection Causing Fever and Chills 

A ruptured cyst may occasionally result in a pelvic infection or chemical peritonitis when the contents of the cyst irritate the lining of the abdomen.

Symptoms may involve fever, chills, or foul vaginal discharge, and these can indicate an infection for which a woman needs to seek immediate treatment.

A vaginal culture or blood test can help diagnose the infection, and fluid accumulation or an adnexal mass may be detected through a pelvic ultrasound.  

If infection is bad or spreading, surgery may be required to drain the infected area or take out the infected cyst. This is especially so if the rupture can cause pelvic inflammatory disease, which can affect reproductive health if not treated. 

4. Ovarian Torsion or Other Complications  

Ovarian torsion, in which the ovary rotates and interrupts its own blood supply, is an uncommon but dangerous complication sometimes caused by a ruptured cyst. Ovarian torsion results in acute, intense pelvic pain, usually with nausea or vomiting. Torsion calls for immediate medical attention, as prolonged deprivation of blood circulation can destroy the ovary.  

Obstetrics & Gynecology highlighted that ovarian torsion is a 2-3% cause of gynaecological emergencies and the fifth most frequent reason that usually requires surgery. Medical treatment could involve laparoscopic surgery to facilitate untwisting of the ovary or the cyst removal. 

 Other conditions, such as an ectopic pregnancy or even ovarian cancer in the early stages masquerading as cyst rupture, can also be treated by surgery. As an example, a dermoid cyst or malignant tumor could be found while undergoing tests such as a computed tomography scan or frozen pathology sections and should then be surgically removed to avoid further danger.  

5. Conservative Measures Not Working Anymore 

In others, a ruptured ovarian cyst may be treated initially with conservative therapy such as pain medication, a heating pad, or a warm water bottle to alleviate pain.  

Yet, if symptoms linger after these attempts, or in cases of heavy vaginal bleeding or increasing pain, surgery could be the course of action. Laparoscopic surgery, utilizing small cuts and surgical instruments such as retrieval bags, is usually preferred for its quicker recovery time compared to open surgery.  

For women in menopausal stage or with a history of polycystic ovary syndrome, the risk of developing complications is higher, requiring more frequent monitoring. If conservative measures fail to alleviate symptoms, a laparoscopic ovarian cystectomy or, in exceptional cases, open surgery can be performed to promote long-term health.   

Taking Action  

While all the symptoms above are clear telltale signs, you don't have to panic once you feel a slight pain in your pelvic area. Yes, your body may go through a lot of changes as you age, and while that is a beautiful thing, you must also listen to your body if it says otherwise.  

At the end of the day, the decision to undergo surgery or not will depend on your symptoms, history, and test results. So, once you feel something's not right, it may be time to ring your doctor.