Ovarian cyst
The content of the article:
- Ovarian cyst: what is it
- Causes of pathology
- Varieties of pathology
- Ovarian cyst: symptoms in women
- Diagnostic methods
- Consequences and possible complications
-
Ovarian cyst: treatment
- Expectant tactics: to be treated or not
- Drug treatment
- Operative intervention
- Video
Irregular periods, pain in the lower abdomen - these symptoms can be an ovarian cyst. At the same time, it can be asymptomatic without causing any discomfort. In this case, the pathology is detected by chance when visiting a gynecologist and performing an ultrasound scan for other indications. Ovarian cyst refers to hormonal diseases of the female genital organs. Mostly women of reproductive age are ill, less often after menopause. Pathology can pass without consequences, but the large size of the formation, high mobility or the duration of the existence of the neoplasm are often associated with the development of serious complications.
What an ovarian cyst looks like can be seen in the photo.
The ovarian cyst in the photo looks like a rounded neoplasm
Ovarian cyst: what is it
A cyst is a benign tumor-like formation, which is a cavity with liquid contents. A neoplasm occurs in the structure of the ovary and can increase its size several times.
Ovarian cysts have the following features:
- The size can range from a few mm to 5-8 cm (no more).
- More often they are formed on one side - in the right or left ovary. A bilateral process, when both ovaries are affected, is less common.
- They have a thin capsule.
- Most neoplasms disappear spontaneously within two months.
They do not belong to true tumors, as they increase in size due to the accumulation of fluid. True tumors grow due to cell division, their growth is unlimited.
Causes of pathology
There is no single cause that would lead to an ovarian cyst. In the mechanism of the development of the disease, hormonal disorders play the main role.
Factors that increase the risk of cystic lesions include:
- Endocrine system diseases. These are mainly violations of the production of gonadotropic hormones of the pituitary and hypothalamus, estrogens and progesterone. But the onset of the disease is also influenced by diabetes mellitus, thyroid disease, hyperprolactinemia.
- Obesity and metabolic syndrome.
- Failure to comply with the regimen of hormonal drugs.
- Chronic inflammation of the pelvic organs.
- Lack of pregnancy at reproductive age.
- Abortion.
Genetic predisposition also plays a role in the development of the disease. Smoking, unhealthy lifestyle, unfavorable environmental conditions have a lesser impact.
Varieties of pathology
There are several types of cysts. It is necessary to determine the type of neoplasm for the correct selection of therapy. There are functional cysts (follicular, luteal), serous and endometrioid.
| Varieties | Explanation |
| Follicular |
Follicular cysts are functional formations. They are formed from the ovarian follicle and are the result of unsuccessful ovulation. They often exist for a short time and disappear spontaneously. Treatment is not required in most cases. |
| Luteal |
Also, like follicular, they belong to functional formations. Formed from the corpus luteum of the ovary. In most cases, such formations regress on their own without requiring surgical treatment. |
| Serous (simple) | Formed from the tissue that covers the outside of the ovaries. |
| Endometrioid (endometriomas) |
Endometriomas occur with endometriosis. Endometriosis is a condition in which endometrial cells grow outside of this layer (for example, in the ovaries). Monthly bleeding from the focus of endometriosis leads to the formation of a cavity in the ovary, which is filled with blood. The blood thickens over time, darkens and becomes like liquid chocolate. In this regard, such cysts are also called "chocolate". |
Ovarian cyst: symptoms in women
In many cases, this pathology is asymptomatic and is discovered by chance during routine examinations. Less often, the disease manifests itself as a violation of the menstrual cycle, pain and discomfort in the abdomen. Often, the disease does not manifest itself in any way for several months, and the first symptoms appear acutely with the development of complications.
So, the signs of an ovarian cyst depend on its type, size and the presence of complications:
| Symptom | Explanation |
| Abdominal pain |
Lower abdominal pain is the most characteristic symptom of the disease. Pain in an uncomplicated course has the following characteristics: · In most cases, one-sided (left or right); Localized in the lower abdomen; · Is aching or pulling; • not intense, more like a feeling of heaviness; · The severity of pain depends on the menstrual cycle. With the development of complications, the painful sensations become intense, difficult to bear. The pain can radiate to the rectum, external genitals. Such intense pain is characteristic of a ruptured cyst or torsion of its legs. |
| Menstrual irregularities |
Another common symptom of the disease. May have the following manifestations: · Increase in menstrual intervals; · Shortening the cycle; • irregularity of menstruation; · Long delays; Painful periods; Dysfunctional uterine bleeding. |
| Dyspareunia | In some cases, dyspareunia may occur - pain and discomfort during intercourse. |
| Infertility | Functional cysts (formed from follicles or corpus luteum) inhibit the growth of other follicles. Accordingly, while a functional cyst persists in the ovary, there will be no normal growth of subsequent follicles, which means there will be no ovulation (that is, conception is impossible). |
Diagnostic methods
It is rather difficult to suspect pathology only by clinical manifestations, since the symptoms are not specific, that is, they can occur with various diseases.
To make the correct diagnosis, you need to contact your gynecologist. The doctor will examine the girl, and, if necessary, prescribe an additional examination - an ultrasound scan (ultrasound) of the pelvic organs.
| Diagnostic method | Indication for conducting | Description |
| Gynecological examination | In all cases | With the help of a gynecological examination, it is possible to determine the volumetric formation in the area of the uterine appendages. It is impossible to determine the type of tumor formation; for this, an ultrasound scan is prescribed. |
| Ultrasound of the pelvic organs | In all cases |
Ultrasound can be performed through the anterior abdominal wall, as well as transvaginally. Ultrasound is the main and often the only research method. With the help of ultrasound, you can determine: · The size of education - usually no more than 8 cm; Localization - left or right ovary; · Content - the secret that fills the cavity can be homogeneous and heterogeneous; · Wall thickness; · Number of cameras - one or several. With the help of ultrasound, the type of cyst can be suspected, but it cannot be definitively determined whether the formation is benign or malignant. |
| Tumor marker test CA-125 | If you suspect a malignant tumor |
A tumor marker test is performed to rule out ovarian cancer. Indications for the study: · On ultrasound, parietal dense structures are determined; Ascites (accumulation of fluid in the abdominal cavity); · General signs of malignant formation - a sharp weight loss, loss of appetite, severe weakness. This method has insufficient specificity - the content of the CA-125 marker in the blood can be increased in inflammatory diseases, as well as during pregnancy. |
| Laparoscopy followed by histological examination of the cyst | If you suspect a malignant tumor | If you suspect ovarian cancer, your doctor may order a diagnostic laparoscopy. During the procedure, the formation is removed and sent for histological examination. During the histological examination, the type of cystic formation is finally determined. |
Consequences and possible complications
The consequences of the disease largely depend on the type of education and the presence of complications. Functional cysts (follicular, luteal) in most cases go away on their own without any consequences.
With large sizes of education, as well as with its prolonged existence, complications can develop - rupture of a cyst, torsion of its legs, hemorrhage.
| Complication | Explanation |
| The gap |
Cyst rupture is one of the most serious complications. The gap is facilitated by the rapid growth of education, significant physical activity. When ruptured, the integrity of the wall of the cystic formation is violated, and its contents enter the abdominal cavity. The complication develops suddenly and is accompanied by the following symptoms: · Sharp pain in the lower abdomen; Dizziness, general weakness; · nausea, vomiting. In this case, an emergency operation is required. |
| Twisting the legs |
Torsion of the cyst pedicle is also a serious complication. A complication occurs under certain conditions: · Great mobility of education; · A sharp change in intra-abdominal pressure (physical activity, sexual intercourse); · Small size of the neoplasm; · Asymmetric shape. With the development of a complication, a sharp pain in the lower abdomen appears. The pain is not associated with the menstrual cycle, more often it is provoked by physical exertion or sexual activity. |
| Hemorrhage | A frequent complication of a corpus luteum cyst is hemorrhage in its cavity. With other types of cystic formation, this complication rarely develops. |
If they are not eliminated in time, the consequences will be unfavorable. Peritonitis (acute inflammation of the peritoneum) may develop, which is often fatal.
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Ovarian cyst: treatment
Treatment tactics depend on several factors - the nature and size of the education, the woman's age. Treatment of disease in women of reproductive age usually begins with expectant management or drug therapy.
Expectant tactics: to be treated or not
Small formations often resolve on their own; medical intervention is not required. In this case, expectant tactics are shown - observation during 3 menstrual cycles (including ultrasound control). When a wait and see tactic is indicated:
- functional cysts (follicular, luteal);
- education size up to 6 cm;
- asymptomatic course.
In most cases, such formations dissolve in several cycles. If this does not happen, surgery is indicated.
Drug treatment
As an alternative to expectant tactics, drug treatment is used, which consists in taking combined oral contraceptives (COCs). Drug treatment is aimed at preventing the growth of education, reducing its size, as well as preventing the formation of new cysts.
Oral contraceptives suppress the stimulating effect of gonadotropic hormones on the female genital organs, mainly on the ovaries.
Taking oral contraceptives prevents ovulation during the menstrual cycle, therefore, there are no changes associated with ovulation in the ovaries.
Operative intervention
The main method of treating pathology is surgery.
Indications for elective surgery:
- the formation did not regress within 3 menstrual cycles of observation or drug treatment;
- the woman's age is over 55;
- the size of education is more than 8 cm (at any age);
- signs of a malignant formation.
An urgent operation is indicated for the development of complications - rupture, torsion of the leg, peritonitis.
There are two main types of surgery to remove a mass - laparoscopy and laparotomy.
- Laparoscopic surgery is less traumatic. Punctures are made on the anterior abdominal wall, through which special instruments are inserted inside. Tissue trauma and postoperative trace are significantly less than with laparotomy. In this regard, the recovery period is faster, easier and less painful.
- Laparotomy surgery is more traumatic. To gain access to the ovary, an incision is made along the anterior abdominal wall. The main indication for laparotomy is the development of complications (rupture, torsion of the leg, peritonitis), since in these cases extensive access is required. Recovery after laparotomy takes longer.
In the reproductive age, the scope of the operation consists in excising the neoplasm within healthy tissues. During the postmenopausal period, the appendages are completely removed.
Video
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Anna Kozlova Medical journalist About the author
Education: Rostov State Medical University, specialty "General Medicine".
The information is generalized and provided for informational purposes only. At the first sign of illness, see your doctor. Self-medication is hazardous to health!
