Cause of an ovarian cyst. Symptoms of an ovarian cyst in women

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For many women who are faced with a diagnosis for the first time ovarian cyst, panic is characteristic, which is most often associated with the fact that there are a lot of different and conflicting information about this disease.

Ovarian cyst, is it dangerous? That's what really worries a woman. Indeed, the ovarian cyst is different, and depending on this, such patients need an individual approach in each case. The doctor needs not only to diagnose an ovarian cyst, but also to establish the nature of this disease, to try to eliminate both the disease itself and the causes that led to it.

The fears of women are understandable, because among the patients there are many who are just about to become mothers. First of all, if there is an ovarian cyst, is it possible to get pregnant- this is the main question that worries a woman. The risk of deprivation of the possibility of motherhood frightens any woman, so fears and worries are always understandable, because they are based on objective reasons.

However, in most cases, an ovarian cyst responds well to treatment, proceeds favorably and does not lead to the development of complications. To acquaint readers with this disease, we have tried to briefly outline the basic information that is relevant to the ovarian cyst. This does not mean that having the data, you can not go to the doctor. A consultation with a gynecologist is strongly recommended in any case if there is a suspicion and signs of an ovarian cyst, since only a qualified specialist can help you. A timely visit to the doctor will also help to avoid possible complications, such as ovarian cyst rupture and others.

Concept. Definition

An ovarian cyst is a benign formation that localizes directly in the tissues of the ovary. The cyst is essentially a capsule that is filled with fluid (a secret that accumulates in the tissues of the ovary). Basically, cysts are follicular, that is, they develop from follicles that have matured in the ovary, and most often go away on their own, without any medical intervention. Only a small proportion of ovarian cysts are of a different nature and require treatment (mostly surgery). The size of the cyst can be different - from 1 to 20 centimeters.

Mechanism of ovarian cyst development

Many are interested not only in the fact of the presence of a cyst, but also in the question: how is it formed and why? Let's look at the mechanism of its origin and development. As you know, the ovaries are paired organs that are involved in such an important process as ovulation. The work of the ovaries is directly related to the production of hormones, moreover, female sex hormones are produced at different stages of the menstrual cycle in various quantities, which ensures the maturation of the follicles, ovulation, and when the egg is fertilized, the onset of pregnancy.

In cases where ovulation occurs, but the egg does not come out of the burst follicle, such a follicle undergoes changes and turns into a follicular-type cyst. If the follicle burst, then the outpouring should occur in the corpus luteum, and with normal ovarian function, the corpus luteum then undergoes changes and disappears. With impaired function, this does not happen and a corpus luteum cyst is formed.

Clinical symptoms

When a disease such as an ovarian cyst occurs, the symptoms can be varied. Most often, the first complaints are pain in the lower abdomen of a dull nature, a feeling of fullness from the inside. Menstruation is usually irregular (later than usual) and painful. Also, bloating and a slight increase in its volume are often observed. If left untreated, the cyst, depending on the variety, increases in size and can put pressure on nearby organs. In this case, the pain in the ovarian cyst becomes more pronounced and permanent, symptoms may be added, indicating a violation of the function of neighboring organs.

Also, with an ovarian cyst, the following symptoms may be observed:

• Pain during intercourse;


• Pain in the lower abdomen when performing physical exertion, overexertion;


• Frequent urination;


• Nausea and/or vomiting;


• Tachycardia;


• Increase in body weight;


• elevated temperature;


• Tension, most pronounced on the anterior abdominal wall.

Epidemiology. Statistical data

According to data provided by the statistics service, an ovarian cyst occurs in 30% of patients with a regular menstrual cycle and in 50% of cases in women whose menstrual cycle is disturbed. This disease is common in women of reproductive age, and as menopause approaches, the risk of developing an ovarian cyst is significantly reduced. It is noted that in women whose age exceeds 50 years, an ovarian cyst occurs in only 6% of cases.

Causes of the disease

Among the causes leading to the development of ovarian cysts, the most common are the following::

• Hormonal disorders in a woman's body (the occurrence of an imbalance between progesterone and estrogen);


• The onset of menstruation earlier than the average age;


• abortion.

A dermoid ovarian cyst may be associated with trauma.

Of no small importance is a number of other factors that form an unfavorable background for the development of ovarian cysts. These include Keywords: social environment, family microclimate, diet, stress, working conditions.

Classification

An ovarian cyst is classified according to various criteria.
She may be:

• Single;


• Multiple.

By localization:

• One-sided;


• Double-sided.

Also, ovarian cysts are divided according to the course of the disease into:

• uncomplicated;


• Complicated.

According to their origin, cysts are divided into:

• Follicular ovarian cyst (formed during ovulation, can be up to 5-7 centimeters in diameter);


• A cyst of the corpus luteum of the ovary (its formation is associated with the reverse development of the corpus luteum after ovulation, in size it can be no more than 6-8 centimeters);


• Parovarial ovarian cyst (formed in the area of ​​the mesentery of the fallopian tube, can reach up to 12-20 centimeters);


• Dermoid ovarian cyst (contains cartilage, hair, fat cells, etc., its capsule is thick-walled, can be up to 15 centimeters in diameter);


• Endometrioid ovarian cyst (occurs when endometrial tissue grows in the ovaries, is more often bilateral, variable in size and can be from 4-5 to 15-20 centimeters).

Complications

An ovarian cyst is rarely complicated. As a rule, the development of complications leads to untimely access to a doctor and untimely treatment. The main complications of an ovarian cyst are::

• Torsion of the cyst peduncle. In this case, the blood supply to the cyst is disrupted, due to which its necrosis gradually develops. Inflamed and partially necrotic tissues cause the development of peritonitis, which proceeds with its characteristic symptoms: body temperature rises, pain becomes very intense, and vomiting appears. In such patients, all signs of peritoneal irritation are determined. In this case, due to the risk of progression of peritonitis, care should be provided immediately.


• Rupture of the capsule of the ovarian cyst. Of all the complications, rupture of the capsule is the least common. In this situation, abdominal pain is sudden, internal bleeding develops, and there may be a state of shock (determined by the degree of blood loss). Urgent surgery is recommended as an emergency.
• Cyst suppuration. With suppuration of an ovarian cyst, pain in the abdomen is sudden and acute, the body temperature rises sharply. These patients require urgent surgical intervention.

Diagnostics

Given the possibilities of modern medicine, the diagnosis of ovarian cysts is not difficult. If an ovarian cyst is suspected, the following diagnostic measures are performed:
• Gynecological examination. Any woman should initially be examined by a gynecologist, who identifies complaints and prescribes a further examination plan. During the examination, enlarged appendages and pain in the lower abdomen are determined.


• Ultrasound of an ovarian cyst. This survey is considered quite informative. Its value increases with the use of a transvaginal transducer.


• Puncture of the posterior fornix of the vagina. This study is performed when fluid or blood is suspected in the abdominal cavity. Especially often this method is used in the presence of a cyst and a sudden complication of the course, since it allows you to determine the development of complications of an ovarian cyst.


• CT scan. This method is often used for differential diagnosis. Tomography allows you to distinguish an ovarian cyst from other possible neoplasms.


• Laparoscopy of an ovarian cyst. This is a surgical diagnostic method, since this study is carried out under general anesthesia. The advantage of this method is the ability not only to reliably diagnose an ovarian cyst, but also to remove it if, as a result of the study, the doctor concludes that this is necessary.


• General analysis of blood and urine. Laboratory diagnostics allows you to identify the presence of an inflammatory process and the degree of blood loss, if any.


• Pregnancy test. It is done to rule out an ectopic pregnancy. Regardless of whether uterine or ectopic pregnancy, if present, the test will always be positive.


• Determination of tumor markers. This study is more used for differential diagnosis in case of suspected oncological pathology. It is prescribed in the case when other methods did not reveal the nature of the disease, and also if the woman is at risk for cancer.

Differential Diagnosis

If an ovarian cyst is suspected, there is almost always a need for differential diagnosis. This is due to the fact that complaints characteristic of ovarian cysts do not differ in specificity and can accompany many other diseases. In particular, if an ovarian cyst is suspected, a differential diagnosis is carried out with such conditions and diseases as:
• Ectopic pregnancy;


• Acute appendicitis ;


• Oncological diseases of the ovaries;


• Varicose veins of the small pelvis;


• Diseases of the genitourinary system;


• Intestinal diseases.
In addition, in relation to ovarian cysts, differential diagnosis implies not only the approval of this diagnosis, but also the determination of the type of cyst, since the tactics of managing such patients and treatment will differ.

Treatment of an ovarian cyst

At the initial stage of the disease, an ovarian cyst, treatment does not always begin with the prescription of medications or recommendations for a surgical method. As a rule, a waiting tactic is chosen. Of course, not in cases where the cyst is large, the complaints are pronounced, and there is a high risk of complications. Such a tactic is acceptable if the cyst does not exceed 1 centimeter in size, the pain in the abdomen is mild, and the general condition of the patient is considered mild.

With a disease such as an ovarian cyst, surgery is one of the methods of treatment. If you have an ovarian cyst, surgery is indicated for the following types:

• dermoid ovarian cyst;


• mucinous;


• endometrioid.

Operation

It is possible to carry out the operation in two ways: by conventional incision and laparoscopic method. The latter is less traumatic, but if a complication is suspected, the first method is still preferable.

In the presence of a disease, the operation can be performed in several ways.:

• cystectomy. With this method, only the cyst is removed, while healthy ovarian tissue is completely preserved. In this case, after healing, the ovary again begins to fully perform its function. Childbearing ability is not affected. The smaller the size of the ovarian cyst, the more healthy tissue remains and, accordingly, the greater the likelihood that the ovary will cope with its function after the operation.


• Resection of an ovarian cyst. During this operation, the damaged area of ​​the ovary is excised, its healthy tissue is preserved as much as possible.


• Ovariectomy. This is an operation in which the ovary is completely removed.


• Adnexectomy. This operation consists in removing not only the ovary, but also the uterine tube. It can be done on one side or both.
  After the operation, anti-adhesion therapy is prescribed.

Conservative treatment

When the diagnosis of an ovarian cyst is established, treatment can be conservative. The main drugs that are used are oral contraceptives.

In addition, there is a large arsenal of drugs that are indicated for this disease.: vitamin preparations, ascorbic acid. The effectiveness of such a drug as Tsivilin is also noted. It has a complex anti-inflammatory effect and promotes the resorption of ovarian cysts. Alternative treatment of ovarian cysts is also used, but it is not widely used. As a rule, the use of traditional medicine cannot eliminate an existing cyst. In this case, its main goal is to eliminate inflammation, normalize hormonal levels, increase the activity of the immune system and have a sedative effect in patients with a labile nervous system.

Forecast

With follicular cysts, the prognosis is favorable, and in most cases, if a woman has a follicular cyst, surgical treatment is not required. If the dermoid ovarian cyst was removed in a timely manner, then the prognosis is favorable, including in relation to reproductive, sexual and menstrual function.

There is an unfavorable prognosis in cases where, despite the presence of an ovarian cyst, a woman does not receive adequate treatment and is not observed by a gynecologist. In such situations, the risk of complications increases significantly, and therefore the prognosis becomes unfavorable.

Preventive measures

Considering that an ovarian cyst is often the result of inflammatory processes in the genitourinary system, a woman should carefully monitor her health and consult a doctor at the first signs of inflammation and receive treatment in a timely manner. If we take into account that an ovarian cyst often occurs due to hormonal disruptions in the body, then it is important to pay attention to how regularly the menstrual cycle passes. The work of the thyroid gland is also important, since it also leads to an imbalance in the hormonal system as a whole.

Precautions if an ovarian cyst has already been diagnosed include the following::
It is impossible to take hormonal contraceptives uncontrollably. Only if they are prescribed by a doctor and selected individually, they will help to reduce some cysts (for example, ovarian follicular cyst). With the wrong intake of hormonal drugs, the cyst can even increase in size.

All kinds of thermal procedures should be avoided (taking a bath, visiting a sauna, sun tanning, visiting a solarium). The reason for this is increased blood circulation, including in the pelvic organs during thermal procedures, and this, in turn, can lead to cyst growth and increase the risk of ovarian cyst rupture. Mud procedures and applications on the lower abdomen are also contraindicated, they may increase the pain of an ovarian cyst.

If there is an ovarian cyst, what to do with physical activity? This question also worries women. You can do physical exercises, but you should avoid those exercises that contribute to the appearance of pressure in the abdominal cavity. These include lifting the torso or legs from a prone position.

Another important factor that every woman of childbearing age should consider is the prevention of unwanted pregnancy, since abortion is also one of the reasons leading to the development of ovarian cysts.

With the availability of modern medicine, it is not difficult to choose a reliable contraceptive. Contact your gynecologist or family planning center for advice on contraceptive measures.

By following our recommendations, you will partially limit yourself from the unpleasant consequences that are possible in the presence of an ovarian cyst. In addition, you will thus help to reduce the size of the ovarian cyst (in some forms of the disease).
Do not forget that a frivolous attitude towards yourself will certainly lead to problems. Stay healthy!

Cystosis is a common disease of the connective tissue of most organs of the human body. The disease appears under the influence of various factors. Despite the fact that the emerging formation is benign in nature, it accumulates fluid in itself, which can interfere with the normal functioning of the organ.

congenital cyst

A cyst is a cavity filled with fluid. Depending on the type of education and the organ on which, its nature and occurrence is determined. Each type of cyst differs in the structure and characteristics of the fluid that fills its cells.

A congenital cyst (dysontogenetic) is formed due to violations and failures in the process of tissue formation that occurred in the prenatal period. An organ that has been malformed may become covered with a cyst. For example, abnormalities in the development of the kidneys or liver are often accompanied by cystic disease. Congenital tumors contain the rudiments of various organs, tissues of embryonic origin, appearing due to problems in the formation of the nephrotic ducts. Also, syringoepitheliomas (disturbances in the structure of the sweat glands), etc., may appear. A congenital cyst can be formed both genetically and under the influence of various factors (for example, a serious hormonal failure in the mother's body).

Traumatic cyst

Traumatic arise under the influence of damage that touched the internal organ. The phenomenon occurs due to a violation of the epithelial layer, which is the majority of the organs of the human body and forms almost all glands. Among all types of traumatic cysts, cysts of the palms and fingers are most common. Such cysts can also form in the eye, liver, kidneys, and pancreas.

Retention cyst

Retention cysts occur as a result of violations in the outflow of secretions produced in the glands of the body. The outflow can be disturbed due to a disease that caused the formation of stones that prevent the normal excretion and use of the substance. Often there are cysts of the prostate, mammary and salivary glands. The released secret begins to accumulate in the duct, stretching the walls of the organ, forming a cavity covered with epithelium, on which cysts appear.

Other types of cysts

The ramolithic cyst is formed at the site of necrosis of the cells of any organ of the human body. Trying to compensate for the damage, the body forms a connective tissue that forms a benign tumor. In this case, the dead tissues are gradually absorbed and excreted from the body. For this type of tumor process, the most common are cysts in the brain, which occur mainly after a stroke.

The diagnosis of "cyst" is most often made according to the results of an ultrasound scan, less often during examination. If the cyst does not put pressure on other organs and does not cause inconvenience, they simply observe it without removing it or performing a puncture. To better understand the nature of the cyst, you need to know the causes and sequence of its formation.

The cyst is a bubble with thin walls and liquid contents. Over time, the cells of the walls produce new fluid, and the volume of the bladder increases. Cysts are removed in several cases: if they become infected, become malignant, or grow too large.

The mechanism of cyst formation in different parts of the body

Ovarian cyst

Ovarian cyst occurs mainly in young women. There are follicular, paraovarian, endometriotic, serous, dermoid, mucinous cysts, as well as cysts of the corpus luteum.

A corpus luteum cyst appears if, after ovulation, the follicle is not filled with corpus luteum cells. It enlarges and fills with a yellow liquid, sometimes with an admixture of blood. With follicular formation, the walls are created from a highly stretched shell of the corpus luteum or follicle. The reason for its appearance, as a rule, is a hormonal imbalance.

The paraovarian cyst appears at the site of the appendage, its walls are thin, transparent, with a network of small blood vessels. It is usually detected only with ultrasound, and often does not manifest itself in any way, the menstrual cycle does not change with it.

An ovarian cyst is a pathological proliferation of organ tissue in the form of a sac or bladder filled with fluid. With severe inflammation inside the sac, pus can accumulate, while the ovaries become very painful, the woman has symptoms of general intoxication. The size of the cystic formation can exceed the size of the ovary by 5-6 times and reach up to 12-15 cm (in a healthy woman, the ovaries are the size of a walnut). There are cases when cysts grew up to 20-25 cm, and the process was not accompanied by severe symptoms and signs.

Cystic proliferation of ovarian tissues is rarely an isolated disease and occurs mainly against the background of other disorders, being their complication. The cause of the pathology can be hormonal fluctuations, gynecological diseases, insufficient production of thyroid hormones by thyroid cells, abortions and miscarriages in history. Most functional cysts do not need surgical treatment, but require constant monitoring. If the formation is too large, it can rupture, dangerous with massive internal bleeding, so women should know how the pathology manifests itself and be able to distinguish it from other female diseases.

More than half of women experience the appearance of follicular cysts that form at the site of rupture of the follicle during the period of ovulation. The follicle is one of the structural components of the ovaries, consisting of an epithelial layer and connective tissue. Between them is an immature egg, the growth of which occurs during the menstrual cycle. During ovulation, the walls of the follicle burst, the mature egg enters the fallopian tube, and a corpus luteum forms at the site of damage to the epithelial layer. The corpus luteum consists of glandular tissue, which is responsible for the synthesis of progesterone (a hormone necessary for implantation and fixation of the egg in the uterus and the further development of pregnancy) and resolves on its own within 2-3 months. If this does not happen, a follicular cyst is formed.

Usually, follicular cysts respond well to medical treatment and do not require surgical intervention, but with rapid growth, a woman will be prescribed an ovarian laparoscopy. This is an operation that can be used for therapeutic and diagnostic purposes. An opening is made in the woman's abdomen through which a laparoscope is inserted into the pelvic space. If necessary, during the procedure, the doctor can remove the formation and send it for histological examination.

Less common are other types of cysts, each with its own causes and differences in the treatments used. The table shows the most common of the cystic growths diagnosed in women of reproductive age.

Type of cyst	What is it?
Dermoid	Congenital formation in the tissues of the ovary, which is formed during fetal development from epithelial cells
Mucinous	A benign tumor with thin walls, inside which is mucin - a cloudy mucous secretion. It is considered one of the most dangerous cysts that require mandatory removal, as it can degenerate into a malignant formation (ovarian cancer)
Paraovarian	Cavitary formation, which is formed from the upper part of the ovarian appendages
endometrioid	Cystic growth of the endometrium, which is a complication of endometriosis with active growth of the endometrium outside the uterus (on ovarian tissue)

Important! Hemorrhagic cysts also pose a danger to women, which occur when blood vessels are damaged and subsequently ruptured and followed by hemorrhage in the ovarian tissue. Pathology develops rapidly and is accompanied by fever and severe pain. The intensity of the pain is usually very high, the character is cutting.

Video - What is an ovarian cyst? Should it be removed?

How to identify a cyst in the early stages?

In order to prevent the rapid growth of cystic formation and to carry out the necessary therapy in time, it is important to know the initial signs and symptoms that can occur when the tumor is just beginning to grow. They are not specific and characteristic for this particular pathology, but together they should be the reason for going to the doctor and a preventive examination.

With cysts of any type, a woman's hormonal background is disturbed, which affects the appearance and leads to certain changes in the body. A woman can suddenly gain weight if she maintains the same diet and level of physical activity. Fat deposits are often accompanied by edema and are localized mainly in the abdomen and thighs.

At the same time, the activity of hair follicles increases, which leads to intensive growth of body hair. Hair can appear even in places where it has never grown before: on the back, lower abdomen, in the area above the upper lip, in the temporal part of the face. On the legs, the hairs may become coarser and turn a bright black color. An important point is that the hair grows very quickly even after the use of hardware methods of hair removal.

Changes can also affect the timbre of the voice: it becomes lower, the tonality also changes and becomes rough. Some women may develop hoarseness, but this symptom is rare. Other early symptoms (before the appearance of pain syndrome) that accompany the growth of cystic formations in the tissues of the ovaries include:

• frequent headaches;
• periodic bouts of hypotension;
• an increase in the amount of vaginal discharge between periods;
• spotting in the first half of the cycle;
• reduction in breast size.

Note! In most cases, there are no painful sensations at the initial stage, but sometimes a woman may experience slight pulling pains on one side of the abdomen, which can spread to the central part of the peritoneum, the sacrococcygeal zone and the lower back. The pains are of low intensity and are not associated with the menstrual cycle.

Typical symptoms of an ovarian cyst

The most obvious symptom indicating the possible growth of cystic cavities is a pulling, intense pain in the lower abdomen. Usually it is permanent, but its severity can vary depending on the level of physical activity and other indicators. With a cyst, the pain syndrome becomes stronger during sports, weight lifting, a few days before the onset of menstruation, with intimacy. Localization of pain can also be different: from the lower abdomen to the gluteal muscles and the coccyx area. The pain appears mainly from the side of the lesion, but with the onset of inflammation it can become diffuse.

Periodic increase in body temperature

Body temperature with an ovarian cyst is almost never at a constant level. Its fluctuations are often noted within subfebrile condition (up to 37.2 ° -37.6 °). The basal temperature also rises, but this sign cannot be reliably assessed, since a slight increase in different phases of the menstrual cycle is considered the norm for healthy women.

Severe edema

Puffiness often occurs in the subcutaneous fat located in the abdomen. The abdomen itself appears enlarged due to fluid accumulation and tumor growth, with the enlargement usually seen on only one side. If the cyst is not inflamed, the abdomen is painless and soft on palpation. Edema can also appear on the face, neck and limbs. Symptomatic therapy (the use of decongestants and herbal preparations), a salt-free diet give a result, but it is usually short-lived.

Menstrual irregularities

At an early stage, when the tumor is just starting to grow, this symptom is mild or absent altogether. Slight fluctuations are possible within 3-4 days, but such indicators are considered a variant of the norm, therefore they rarely become a reason for a comprehensive examination.

If the cyst is not treated, other cycle disorders may appear over time, which include:

• delayed menstruation for a long time (up to several weeks);
• heavy periods that last more than a week (menorrhagia);
• an increase in the amount of discharge between cycles and spotting during this period;
• pain during menstruation;
• absence of menstruation for a long time (more than six months).

Important! For any violations of the cycle, a woman should consult a doctor, as the cause may be serious hormonal disorders, in which the risk of infertility and gynecological diseases is more than 80%.

Changes in sex life

With ovarian cysts, a woman almost always experiences unpleasant and painful sensations during sexual intercourse. Their intensity may vary depending on the activity of the partner, posture and other factors. Pain can also occur within 1-2 hours after intercourse, sometimes they are accompanied by the release of a small amount of blood, dizziness and nausea. The sensitivity of erogenous zones also changes, there are difficulties in achieving orgasm. The amount of vaginal lubrication is sharply reduced, sometimes the vaginal secret is not released at all.

Video - All about the ovarian cyst

If the cyst is inflamed

If the membrane of the cystic growth is violated, microbes and bacteria that inhabit the mucous membranes of the urinary tract and pelvic organs can penetrate into the cyst cavity. After entering the liquid medium, pathogenic microorganisms begin to actively multiply and release waste products and toxins. The cavity of the cyst is filled with pus, which, if it enters the abdominal cavity, can lead to inflammation of the peritoneum and diffuse peritonitis - a deadly pathology (if the woman is not provided with surgical care in time).

To prevent this, you need to know the signs of inflammation of the ovarian cyst, which include:

• acute stabbing or cutting pain in the lower abdomen from the side of the pathological process;
• a sharp rise in temperature to 38.5 ° -39 °;
• abdominal pain on palpation;
• abdominal muscle tension and bloating;
• painful bowel movements and urination;
• vomiting and severe nausea.

Important! If a woman notes signs of an inflammatory process, it is necessary to contact a local gynecologist or a hospital. An inflamed cyst can burst at any time. This situation is dangerous with peritonitis, sepsis, abscess and other deadly complications, so pathological signs cannot be ignored. In addition, the inflamed cyst increases in size and begins to squeeze the surrounding organs, blocking the access of oxygen and nutrients.

Rupture of a cystic growth: how to recognize?

If the situation has taken a critical course, and the cyst has burst, typical signs appear that make it possible to determine the rupture or torsion of the formation. A woman develops acute pain in the lower abdomen (“acute abdomen” syndrome), a large amount of mucus is secreted from the vaginal tract, and the temperature rises to high levels. Perhaps a single discharge of vomit, bouts of dizziness. In severe cases, the woman may lose consciousness. The skin becomes pale, sometimes cyanosis of individual areas appears (mainly on the face, abdomen and hands). Blood pressure drops to critical levels.

Important! With these signs, a woman must be urgently hospitalized in the gynecological department of a surgical hospital. Treatment for rupture or torsion of an ovarian cyst is only surgical.

Cystic formations in the tissues of the ovaries is a rather dangerous phenomenon with serious consequences, which can be avoided by contacting a specialist in time. Cysts of any type need constant monitoring. If necessary, the doctor will select medication or physiotherapy or prescribe surgical removal of the formation if the tumor does not respond to conservative therapy, or there is a high risk of inflammation and rupture, as well as degeneration into malignant pathologies.

17.03.2016

A cyst is often associated with diseases requiring surgical intervention, but how correct is this understanding of the problem? Let's see why a cyst appears, and what is its nature, using the example of gynecological ailments of the female reproductive system, in particular, the ovaries.

The concept of a cyst

The cyst is a sac-like formation that is not related to the normal parts of the tissue in which it is found. Its size and shape may vary. Large formations can displace tissues and organs located nearby. The cyst is classified by size, content, time of occurrence, causes of formation. Most often, cysts appear in the ovaries and on the skin.

What are the signs of diagnosis

Cysts located directly under the skin are diagnosed by superficial examination by palpation. Under the skin or in the region of the mammary glands, tumor-like formations are easy to feel. An ovarian cyst is difficult to detect during the initial examination of women. Such pathologies in the body are detected by ultrasound, CT or X-ray.

Why does a cyst appear

As a result of disruption of normal processes in the body, a cyst may form. Such disorders can be called: infections and inflammations, tumors, chronic diseases, genetic changes, heredity, problems of embryonic development.

Classification

retention

They develop in the glands and organs of secretion and are classified as acquired. Their occurrence is preceded by a violation of the outflow of secretion due to blockages of the ducts. The accumulated secret forms a cavity that grows as the content accumulates. Retention cysts include ovarian cysts in women, cysts of the sebaceous and mammary glands, and other follicular cysts lined with a squamous epithelial layer.

Ramification

Appear as a result of necrosis of compact tissues as a result of inflammation, heart attacks and hemorrhages. Subsequently, softening and liquefaction of the "dead" tissue occurs inside the cyst. Features of this type of cyst: its walls are formed at the expense of the tissues of the donor organ, but in the future they can be replaced by connective tissue.

Ramolitic cyst can be found in the spinal cord and brain, as well as in the tumor. Special cases - cyst of the corpus luteum, cyst of the tooth on the background of fibrous osteitis or bone blasts.

Traumatic origin

They arise due to tissue damage and accumulation under the skin in the muscle or adipose tissue of particles of destroyed cells, accumulation of secretions. A sac appears under the top layer of the skin, which is a cyst.

Tumor

A progressive tumor, most often of oncological origin, provokes the appearance of cavities-cysts. Cyst tumors appear in the glands and manifest as ameloblastoma, salivary duct adenoma, and lymphangioma.

Dysontogenetic causes

They are congenital and are cyst-like formations from preserved holes and canals. They appear due to the formation of the embryo in displaced tissues, they may contain tissues of embryonic origin and even rudimentary organs - hair or teeth. Examples include cysts of the remains of the gastrointestinal system, cysts from the remains of gill openings, cysts of the prostate, kidneys, lungs, pancreas.

ovarian cyst in a woman

Its appearance usually has no obvious signs. A simple examination by a gynecologist will not give anything - you need to do an ultrasound. Throughout her life, a woman may have more than one cyst, but several. The fact is that cyst-like formations on the ovaries arise and disappear against the background of hormonal surges without any treatment. But if the cyst does not go through more than one cycle or has a malignant fullness, then surgical removal and subsequent drug therapy are necessary.

Where does an ovarian cyst come from?

The ovaries secrete hormones that promote the development of the follicle and the release of the corpus luteum from it, which is directly involved in reproductive ability. When the cycle comes to the middle, the follicle breaks down and releases the egg, promoting ovulation. If ovulation or fertilization does not occur, the empty follicle continues to develop, accumulating fluid, and the resulting void - the cavity - becomes a cyst.

Causes of a cyst

Hormonal failure as a result of exhaustion, stress, exposure to harmful factors and habits. Sometimes a cyst appears after a gynecological intervention - an unsuccessful abortion, childbirth, or too sloppy examination. The cyst is provoked by the installation or removal of the spiral, caesarean section.

Advanced or undertreated gynecological diseases can also cause a cyst.

A cyst in the ovaries usually manifests itself due to an incorrect lifestyle:

• too early sex life;
• frequent change of sexual relations;
• sex during menstruation;
• hypothermia and excessive exercise.

Other causes of ovarian cysts include malfunctions of the endocrine glands. For example, the thyroid gland. A cyst can appear without special objective reasons. If you notice abdominal pain, cycle disorder, fever, atypical vaginal discharge, contact your gynecologist immediately.

- tumor-like formation of the ovary of a benign nature. It is a pedunculated cavity filled with liquid content and tends to increase in size due to the accumulation of secretions. There are ovarian cysts (follicular, cysts of the corpus luteum, endometrioid, etc.) and supraovarian epididymis (paraovarian). Often asymptomatic, may be manifested by discomfort and pain in the lower abdomen, menstrual dysfunction, dysuric disorders (with compression of the bladder). It is complicated by torsion of the cyst stem, rupture of the capsule, leading to a picture of an acute abdomen and peritonitis.

General information

The term "cyst" (Greek "kystis" - bag, bubble) is used in medicine to refer to pathological cavities in organs, consisting of a capsule and liquid contents and increasing in size as the secret accumulates. Cysts are the most common type of benign formations and can occur in almost all tissues and organs: teeth, kidneys, liver, mammary glands, pancreas, thyroid gland, male and female genital organs, etc.

The concept of "ovarian cyst" hides a large group of tumor-like neoplasms that differ from each other in structure, causes, course and approaches to treatment. Ovarian cysts are benign neoplasms of gland tissue, usually develop for a long time, their size can vary from a few millimeters in diameter to 20 or more centimeters.

Ovarian cysts are a widespread disease and occur more often in women in the childbearing period: in 30% of cases they are diagnosed in women with a regular menstrual cycle and in 50% of women with impaired ones. During menopause, ovarian cysts occur in 6% of women.

Causes

Classification

Depending on the nature of the origin of the formation and its contents, the following types of ovarian cysts are distinguished:

• Follicular. Follicular cysts are functional formations that form in the ovarian tissue itself and are directly related to the cyclic changes taking place in it. Formed at the site of an unruptured follicle.
• Cyst of the corpus luteum. It is formed on the site of a non-regressed corpus luteum follicle. The pathological cavity in this type of ovarian cyst is formed from the shells of the corpus luteum. Like the follicular ovarian cyst, the corpus luteum cyst does not reach a significant size and can disappear on its own as the secretion dissolves in them and the cystic cavity subsides.
• Paraovarian. Paraovarian cysts originate from the supraovarian appendages without involvement of the ovarian tissue in the process. These ovarian cysts can reach gigantic sizes.
• Endometrioid. Endometrioid cysts are formed from particles of the uterine mucosa (endometrium) with its pathological focal growth on the ovaries and other organs (endometriosis). The content of endometrioid ovarian cysts is old blood.
• Dermoid. Dermoid cysts belong to congenital formations formed from embryonic rudiments. They contain fat, hair, bones, cartilage, teeth and other fragments of body tissues.
• Mucinous. Mucinous ovarian cysts are often multi-chambered, filled with thick mucus (mucin) that is produced by the inner lining of the cyst. Endometrioid and mucinous ovarian cysts are more prone to degeneration into malignant neoplasms.

Symptoms of an ovarian cyst

Most ovarian cysts do not have pronounced clinical manifestations for a long time and are often detected during preventive gynecological examinations. In some cases (increase in size, complicated course, hormonal secretion, etc.), ovarian cysts can manifest themselves with the following symptoms:

• pain in the lower abdomen

Pain may occur due to possible complications: torsion of the leg, rupture of the membrane, bleeding or suppuration of the ovarian cyst. Constant aching pain is caused by pressure on neighboring organs due to a significant increase in the size of the ovarian cyst.

• enlargement and asymmetry of the abdomen

An increase in the circumference of the abdomen or its asymmetry can be associated with both the large size of the ovarian cyst and ascites (accumulation of fluid in the abdominal cavity).

• symptoms of compression of organs and blood vessels

A growing ovarian cyst can compress the bladder or lower intestines, which is manifested by dysuric disorders and constipation. Compression of the venous vascular bundles can cause varicose veins of the lower extremities.

• menstrual irregularities

Hormonally active ovarian cysts cause menstrual irregularities - irregular, heavy or prolonged menstruation, acyclic uterine bleeding. With the secretion of male sex hormones by tumors, hyperandrogenization of the body may occur, accompanied by coarsening of the voice, male-type hair growth on the body and face (hirsutism), and an increase in the clitoris.

Complications

Some types of ovarian cysts can disappear on their own, some require a course of anti-inflammatory or hormonal treatment, and in some cases surgery is required to prevent the development of formidable complications. An ovarian cyst poses a potential risk of malignancy, especially the risk of developing ovarian cancer from mucinous and endometrioid cysts. Therefore, in order to prevent the development of oncology, priority in the treatment of ovarian cysts is given to their surgical removal.

An ovarian cyst is most often a mobile formation on a leg. Torsion of the cyst leg is accompanied by a violation of its blood supply, necrosis and peritonitis (inflammation of the peritoneum), which is clinically manifested by the picture of "acute abdomen": sharp pains in the abdomen, fever up to 39 ° C, vomiting, muscle tension of the abdominal wall. Possible torsion of the cyst along with the fallopian tube and ovary. In these cases, an emergency surgical operation is required, during which the question of the extent of the necessary surgical intervention is decided.

With some types of ovarian cysts (especially with endometrioid), there is a high probability of rupture of the capsule and outflow of contents into the abdominal cavity. Another complication of an ovarian cyst is infection and suppuration of the formation. In these cases, emergency surgical measures are also required. Ovarian cysts can cause female infertility or complicated pregnancy. Endometrioid ovarian cysts often cause the development of adhesions in the pelvis.

Diagnostics

Diagnosis of ovarian cysts is carried out on the basis of the following methods:

• collection of anamnesis and complaints of the patient
• bimanual (two-handed) gynecological examination, which allows to identify pathological formations in the ovarian region, their mobility and soreness
• transabdominal or transvaginal ultrasound diagnostics, which gives an echoscopic picture of the state of the pelvic organs. To date, ultrasound is the most reliable and safe method for diagnosing ovarian cysts and dynamic monitoring of its development.
• puncture of the posterior fornix of the vagina, which allows to detect the presence of effusion or blood in the abdominal cavity (more often with complicated ovarian cysts)
• diagnostic laparoscopy, which also allows the removal of an ovarian cyst, followed by a histological examination and the final determination of the type of tumor
• determination of the oncomarker CA-125 in the blood, the increased content of which in menopause always indicates malignancy of the ovarian cyst. In the reproductive phase, its increase is also observed with inflammation of the appendages, endometriosis, simple ovarian cysts.
• computed or magnetic resonance imaging (CT or MRI), providing information about the location, size, structure, contents of the ovarian cyst and its relation to the presenting organs
• a pregnancy test to rule out an ectopic pregnancy.

Treatment of an ovarian cyst

Conservative treatment

The choice of treatment tactics depends on the nature of the formation, the severity of clinical symptoms, the age of the patient, the need to preserve reproductive function, and the risk of developing a malignant process. Expectant management and conservative treatment are possible with a functional nature and an uncomplicated course of an ovarian cyst. In these cases, monophasic or biphasic oral contraceptives are usually prescribed for 2-3 menstrual cycles, a course of vitamins A, B1, B6, E, C, K, homeopathic treatment.

In some cases, diet therapy, therapeutic exercises, acupuncture, treatment with mineral waters (balneotherapy) are indicated. In the absence of a positive effect from conservative therapy or with an increase in the size of the ovarian cyst, surgical intervention is indicated - removal of the formation within healthy ovarian tissues and its histological examination.

Surgery

The advantages of elective surgical treatment of an ovarian cyst over the occurrence of an emergency situation are quite obvious. In addressing the issue of the scope and access of surgical intervention, operative gynecology currently adheres to organ-preserving and low-traumatic techniques. Usually, planned operations to remove an ovarian cyst are carried out by laparoscopic access and, if possible, preserve the tissues of the organ as much as possible.

Laparoscopy is usually not used if it is reliably known about the malignancy of the process in the ovaries. In this case, an extended laparotomy (abdominal operation) is performed with an emergency histological examination of the tumor. For ovarian cysts, the following types of operations are performed:

• cystectomy– removal of the cyst and preservation of healthy promising ovarian tissue. In this case, the capsule of the ovarian cyst is peeled out of its bed with a thorough hemostasis. Ovarian tissues are preserved, and after restoration, the organ continues to function normally.
• Wedge resection of the ovary- excision of the ovarian cyst along with the surrounding tissue.
• Removal of the entire ovary (oophorectomy), often together with tubectomy (i.e., complete removal of the appendages - adnexectomy).
• Biopsy of ovarian tissue. It is carried out to take ovarian tissue material for histological examination if a cancerous tumor is suspected.

Dermoid, mucinous, endometrioid ovarian cysts are subject only to surgical removal. It is also necessary to remove the ovarian cyst before the planned pregnancy due to the high risk of torsion of its legs or an increase in the size of the tumor. Early diagnosis of ovarian cysts and planned surgery can significantly reduce the amount of surgery, recovery time and avoid the terrible consequences of the disease.

With ovarian cysts at a young age, when it is necessary to preserve the reproductive function, a cystectomy or resection of the organ is performed while maintaining healthy, unchanged tissues. In the menopause, in order to prevent oncological processes, the uterus with appendages is removed - an extended hysterectomy (panhysterectomy). After surgical removal of the ovarian cyst, a course of restorative treatment is prescribed.

Forecast and prevention

Ovarian cysts of a functional nature can form repeatedly throughout life, as long as menstrual function is maintained. Properly selected hormonal therapy helps to avoid relapses. It is also possible the resumption of endometrioid ovarian cysts, however, this depends on the correct operation and further treatment. Removed dermoid ovarian cysts do not re-form. After removal or conservative treatment of an ovarian cyst, pregnancy is possible.

To avoid the risk of complications, in order to preserve the reproductive function of ovarian cysts, it is necessary to diagnose and treat them in a timely manner. This is possible only with a competent, conscious attitude to one's health and regular (2 times a year) preventive