Fibroids, cysts and polyps: what a pelvic ultrasound finds

Mikhail Derebenchenko — GP, obstetrician-gynecologist

Functional ovarian cysts

The commonest finding and the most benign. A follicular cyst or a corpus luteum cyst is not a disease but a normal stage of the cycle that has gone slightly further than usual. These resolve on their own within one to three menstrual cycles in most cases. The correct approach is a repeat scan after menstruation, not immediate treatment. Surgery here is not merely unnecessary but harmful: any operation on an ovary reduces ovarian reserve.

Attention is warranted for cysts with a solid component, large cysts, those persisting on follow-up, and any cyst accompanied by pain and signs of torsion — which is an emergency.

Uterine fibroids

A benign tumour of the muscle layer, and very common. The key question is not size but location and symptoms. A fibroid that does not distort the uterine cavity and causes no symptoms usually needs only monitoring. Treatment is considered with heavy periods and anaemia, pain and pressure on adjacent organs, distortion of the cavity affecting fertility, or rapid growth. There are many treatment options today, and hysterectomy has long since stopped being the only one.

Endometrial polyp

An overgrowth of the lining of the uterine cavity. It may cause bleeding between periods, heavy periods or postmenopausal bleeding, or no symptoms at all. Unlike functional cysts, a polyp does not disappear by itself. Management depends on age, symptoms and size; after menopause polyps are treated more strictly.

Endometriomas and adenomyosis

These deserve a separate conversation, because they often come with pain, affect fertility and are managed long term. A characteristic situation: years of painful periods that a woman assumed were normal — they are not, and they are worth investigating.

Why comparison over time matters

The same image means different things depending on the trajectory. A 4 cm cyst seen for the first time and a 4 cm cyst stable over two years are different clinical situations. It is therefore worth bringing previous reports and, where possible, being followed in one place.

How the appointment works

Examination and ultrasound happen in a single visit and the findings are discussed immediately — no "come back for the report next week". Where needed, tests are taken and colposcopy performed on the spot.

Where to go

At GMS an obstetrician-gynecologist consultation is AED 600 and a specialist consultation AED 750; standard pelvic ultrasound AED 800, expert-level AED 1,000, Pap test AED 300, basic colposcopy AED 2,000 and extended colposcopy AED 3,500.

Guidelines referenced

• ACOG. Uterine Fibroids
• ACOG. Ovarian Cysts

FAQ

Does a functional ovarian cyst need surgery?

No. In most cases these cysts resolve within one to three menstrual cycles, and a repeat scan after menstruation is the correct approach. Surgery here is harmful: any operation on an ovary reduces ovarian reserve.

When does a cyst need attention?

When it has a solid component, is large or persists on follow-up. Any cyst with pain and signs of torsion is an emergency.

When does a fibroid need treatment?

Treatment is considered with heavy periods and anaemia, pain and pressure on adjacent organs, distortion of the cavity affecting fertility, or rapid growth. There are many treatment options today, and hysterectomy is not the only one.

This article is for information only and does not replace a consultation. If you have symptoms, see a doctor.

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