Ovarian Cysts - normal or dangerous? - Diagnosis and treatment

Diagnosis and treatment

The characteristic clinical picture manifested those cysts that are formed from portions of endometrioid heterotopias. This type of brush is not becomes large, the average diameter is 10 mm. In contrast to other tumor-like formations in the cavity endometrial cyst is brown contents. If you merge multiple cysts in one large cyst, then talk about the formation of "chocolate cysts", whose name is due to the color content.

The development of clinical symptoms due to the fact that in the pathological process involved in endometriosis parietal, vystseralnaya peritoneum, ie the process of spreading, and form new abnormal formation and adhesions. Involvement of the peritoneum leads to severe pain syndrome. Endometrial cysts are accompanied by the emergence of a complaint of pain in the lower abdomen that may radiate to the perineum, the area of ​​the rectum. There is a clear relationship between the intensity of pain and the day of the menstrual cycle The days of the menstrual cycle: Four phases . During menstruation celebrated maximal pain. Typically the development of pain during sexual intercourse (dyspareunia syndrome). This character is reflected in the clinical symptoms of the psycho-emotional state of women. Pronounced pain leads to a decrease in efficiency, it affects the relations not only in the team, but also in the family. The most common bilateral involvement of ovaries.

For the diagnosis of ovarian cysts need to examine the patient during the cycle several times. This is a prerequisite for the proper diagnosis, as the brush size change depending on the date of the onset of menstruation. The largest size endometriodnyh cysts reach after completion of menstruation. If the cysts are not very large, it may be difficult during the inspection. In this situation it makes instrumental examination using ultrasound scanning. The validity of this type of survey is 93%.

During laparoscopy can reliably detect endometrial cysts, assess their size, location and damage to adjacent organs and tissues (area rectouterine space). The diagnostic procedure can detect cysts in small sizes ranging from 2 mm in diameter, which are difficult to identify when viewed from a woman on the gynecological chair. Sometimes a cyst of this size is not detected by ultrasound, so laparoscopy is the most reliable method of examination.

Ovarian cysts are often detected during a standard pelvic ultrasound, which is performed under the regular medical examination or in connection with the other, in no way associated with gynecology, disease. Pelvic ultrasound can detect cysts in the early stage, before they become too large before a rupture or twisting of the cyst, ie before the onset of pain or other symptoms. If you accidentally detected a cyst doctor prescribes other tests to confirm the presumptive diagnosis.

Ovarian cyst is usually detected during a pelvic exam directly or by ultrasound. Ultrasound examination - one of the main methods of diagnosis of ovarian cysts. Furthermore, for the diagnosis of the cyst apply:

• Computed tomography
• Doppler studies
• Magnetic resonance imaging

To confirm the diagnosis and verification of malignancy neoplasms (for suspected cancer) can be assigned to the following blood tests:

• Blood CA-125 is recommended primarily for women at the age of menopause or abnormal ultrasound results to avoid the possibility of cancer
• Blood test for hormones (testosterone, estradiol, follicle-stimulating hormone)
• Blood tests for hCG (pregnancy test)

Treatment

Treatment of ovarian cysts caused by several factors, including the size and type of cyst, a woman's age and general state of health, her reproductive plans (if she plans to have children in the future), as well as the presence and severity of symptoms. In identifying cysts in the early stage treatment is reduced to a minimum.

If you notice small cyst that does not cause pain or other unpleasant symptoms the doctor is likely to recommend a delay treatment for two to three menstrual cycles to make sure that the cyst will not resolve itself. Most functional cysts disappear without any treatment within two or three months after the appearance.

In some cases, the doctor prescribes hormone therapy (for example, birth control pills) to reduce the size of the brush. Because oral contraceptives prevent ovulation Ovulation - How to determine as accurately as possible? In women taking birth control pills, functional cysts are very rare. Although the pill does not affect other types of benign cysts, they provide some protection from cancer. Oral contraceptives also reduces the likelihood of formation of new cysts, again due to prevent ovulation. The course of oral contraceptive containing synthetic hormones that have an average length of four to six weeks.

Keep in mind the possibility of combination with other forms of cysts of endometriosis, so it is important to conduct a full examination of the surgical wound. After removal of cysts cure does not end there, as the relapse of the disease. The patient should receive hormone therapy for six months, when it is necessary to strictly take into account all the possible side effects and contraindications. A promising method of therapy is considered the appointment of hormonal drugs from the group of progestogens, antigonadotropiny. If there is a need for regulation of menstrual function, we can recommend the acceptance of combined estrogen Estrogen - the key to bone health -gestagennyh drugs. Besides the course of hormone therapy is given great attention to the correction of the immune status, so for this purpose is required to prescribe immune-boosting drugs. If the course of conservative therapy is chosen correctly and promptly produced surgery, it will enhance the effectiveness of therapeutic interventions, the prognosis for this is the most favorable.

Some types of ovarian cysts are not susceptible to treatment with oral contraceptives. In this case, the cyst is removed surgically excision.

In rare cases, functional ovarian cysts require surgical treatment - usually a suspected cancer. The most likely need surgery in the following cases:

• Upon detection of complex, multiple ovarian cysts that do not disappear on their own over time
• If you find large cysts that cause distinct symptoms and do not fade with time
• Upon detection of simple ovarian cysts that are larger than five to ten centimeters in diameter
• Upon detection of ovarian cysts in women before menopause or menopause

The two main methods for surgical removal of ovarian cysts Removal of ovarian cysts before and after the procedure   - Laparotomy and laparoscopy. Laparotomy involves removing the cyst through a small incision in the skin in the abdomen, laparoscopy is considered a more invasive procedure and is used only in extreme cases. If the formation of a cyst caused by a disease - such as polycystic ovaries - may require other forms of treatment of ovarian cysts.

The choice of treatment of ovarian cysts depends on the following factors:

• Appearance and size of the cyst;
• The presence or absence of symptoms;
• Occurred if the patient menopause (after menopause risk that the cancer would cyst slightly increased).

Observation

In most cases, the detection of ovarian cysts elected monitoring strategy, in which the patient receives no treatment. It is connected with the fact that cysts usually disappear after a few months after the appearance, without any medical intervention. The patient is administered a survey to assess the possible changes in the size and shape of the brush.

Because of the increased risk of ovarian cancer for women after menopause it is recommended to undergo regular ultrasound and a blood test to do - as long as the cyst does not go away. In addition, these patients need to undergo another examination four months after the disappearance of the cyst.

Surgical intervention

If the cyst is large, and / or cause symptoms, it is usually recommended to remove. Sometimes doctors recommend removing the cyst, even if it does not cause any symptoms. This is due to the fact that it is not always possible to determine the cyst without examining it under a microscope. Cyst removal also reduces the risk that in the future it will become a malignant tumor. To remove cysts used two types of operations that are carried out under general anesthesia.

Laparoscopy

This surgical technique is usually used to remove small cysts. The surgeon makes a small incision in the lower abdomen, and thereto is blown gas to raise the abdominal wall above the internal organs. Then, the abdominal cavity is introduced laparoscope - a thin, flexible microscope with a camera and a light bulb on the end. The surgeon removes the cyst using delicate instruments, guided by an image that is displayed on the monitor. Then sew up the incision soluble surgical threads. The operation takes from half an hour to one hour, depending on the size and type of the cyst. Most patients can go home several hours later.

Laparoscopy - This operation is the first choice in the treatment of ovarian cysts, as it allows you to save fertility and quickly return to normal life, and the recovery period after it is less painful than after other types of operations.

Celiotomy

If there is a significant risk that the cyst is cancerous, it can be recommended more invasive surgery - laparotomy. During laparotomy make longer incisions, providing the surgeon better access to the cyst. Cyst removed together with the ovary, and tissue samples sent to the laboratory to test for the presence of cancer cells. Sometimes patients after such surgery has to stay in hospital for a few days.

If only one ovary is removed, the other will continue to secrete hormones and release the egg as usual, and laparotomy will not affect the patient's health and fertility. After removal of both ovaries will come early menopause (if it has not yet occurred), which may be accompanied by a number of unpleasant symptoms. However, the patient can still become pregnant by means of artificial insemination.

If the removal of the cyst would be a malignant tumor may require removal of both ovaries, uterus, and part of the surrounding tissue.