An ovarian cyst is an accumulation of fluid in the ovary that is limited by a thin membrane. Any follicle that is larger than 2 cm is an ovarian cyst. There are cysts the size of a grain or more, which can be compared in size to an orange. most cysts are benign. Most cysts develop in women of reproductive age (when a woman can give birth to a child, mostly from 15-44 years). If the diameter of the cyst is more than 5 cm, then it must be treated surgically. There are two types of ovarian cysts:
Functional cysts are the most common. They are part of the menstrual cycle and disappear quickly.
Pathological cysts can be either benign or malignant.
What are the signs and symptoms of an ovarian cyst?
An ovarian cyst often exists without symptoms and is discovered incidentally. In the case when it manifests itself with certain symptoms, it is impossible to say firmly that these symptoms developed due to the cyst. Similar symptoms are seen in pelvic inflammatory disease, endometriosis, cancer, appendicitis, diverticulitis, etc.
The following signs and symptoms are more characteristic of an ovarian cyst:
- Irregular and/or painful and/or strong and weak menstruation;
- Pain in the pelvic cavity, may be constant or intermittently dull and may radiate to the lower back and thighs;
- Pain before and after menstruation;
- Dyspareunia – pain during coition (sexual intercourse) or after it;
- Pain during bowel movements (stomach);
- Bloating, swelling, or a feeling of heaviness;
- problems with emptying the bladder;
- Pressure on the bladder or on the rectum – frequent stools;
- Hormonal disorders – sometimes the body produces an increased amount of hormones, due to which breast changes begin and increase hairiness
Symptoms and complications of an ovarian cyst:
- Torsion – if the cyst grows on a stalk, that is, it is connected to the ovary by a thin trunk, then it can twist, as a result, the blood supply to the ovary is disrupted, which causes severe pain in the lower abdomen;
- Rupture – when the ovarian cyst ruptures, the patient experiences severe pain. In case of infection, the pain intensifies. The rupture may be accompanied by bleeding;
- Cancer is very often an ovarian cyst the initial form of cancer.
Functional ovarian cysts are of two types:
A follicular cyst is a common form of ovarian cyst. Every month, a woman’s ovary releases one egg, which travels to the uterus and, if fertilized, it settles in the inner lining of the uterus (endometrium). The egg is first located in the follicle, which is filled with fluid. When maturing, as a rule, the follicle should burst, but sometimes it does not burst and does not release the egg, or when the egg is released, it does not pour out the contents, and follicular ovarian cyst forms. These cysts dissolve on their own.
Luteal cysts are extremely rare. Sometimes, after a rupture of the follicle, blood accumulates in the remaining luteal body (the so-called postovulatory corpus luteum). This type of cyst disappears on its own after a few months but may burst and cause sudden pain.
Ovarian cyst – Pathological cyst:
- A dermoid cyst (teratoma) is usually a benign cyst that develops from stem cells (primary oocyte), cells of this type have the potential to form any tissue, so hair, skin, teeth, and bones can be found in a dermoid cyst. the treatment of such a cyst is surgical;
- Cystadenoma – develops from cells that cover the outside of the ovary. They may contain a dense slimy substance or a watery mass. It is attached to the ovary from the outside and can grow without dimension, therefore, despite the fact that its nature is benign, its surgical treatment is mandatory;
- An endometrioid cyst is the same as endometriosis/endometrioma. Endometriosis is a disease in which the internal tissue of the uterus (endometrium) occurs outside the uterus, at the same time it can also occur on the ovary in the form of an endometrioid cyst, which, like the uterus, is characterized by monthly bleeding and detachment, therefore, the existence of this cyst is accompanied by painful menstruation and dyspareunia (painful sexual contact);
- Polycystic ovary syndrome is the result of a hormonal imbalance, against which a lot of follicles form in the ovary, which do not burst and remain in the form of cysts.
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Diagnosis of an ovarian cyst
Ultrasound examination (echoscopy) – with the help of an ultrasonograph sensor (research apparatus), we find out the shape, size, position, content (contains liquid, dense or mixed) cysts.
Blood tests – cancer markers such as A-125 may be altered, an increase in marker levels indicates cancer. The definition of hormones allows you to establish whether or not a hormonal imbalance is the cause of the cyst.
A pregnancy test can give a false positive result, especially if a luteal cyst has formed.
Laparoscopy is a diagnostic method and at the same time a treatment method, although this method is used mainly if the size of the cyst is large echoscopically or due to other reasons it needs to be cut out.
Treatment Methods
Waiting tactics. If you have a cyst, you may be asked to wait and repeat the echoscopy in 1-3 months to recheck the change in the size of the cyst. This tactic is mainly offered to women who:
- Reproductive age;
- Have no symptoms;
- Their cyst is filled with fluid;
- The diameter of the cyst is from 2 to 5 cm.
Birth control pills
reduce the chance of developing a new cyst and the growth of an existing one.
Surgical treatment is an elective method for menopausal women and if:
- The cyst has not disappeared after several cycles;
- Growing in size;
- Looks suspicious on ultrasound.
There are two types of surgical treatment:
laparoscopy – two small holes are made in the lower abdomen and one at the navel, a thin instrument (laparoscope) is inserted into the abdominal cavity and the uterus and its appendages are examined, the cyst is removed and, if necessary, the ovary can also be removed. Removal of an ovary does not cause infertility if one ovary is healthy.
Laparotomy – a large incision is made in the lower abdomen, this method is called open surgery. The procedure is performed if there is a suspicion of ovarian cancer and a large cyst. In any case, the surgical material is sent to the laboratory for a histomorphological study, on the basis of which an analysis of the processes and anomalies occurring in the reproductive organs is made. After applying the laparoscopic method, the patient goes home on the same day or the second day and the postoperative period is much shorter than with laparotomy. The average stay in the hospital is 2 days.
Prevention
Cyst prevention is not possible. If nothing bothers you and you just want to insure yourself, you can periodically check with echoscopy every 6-8 months and detect a cyst at an early stage, which will save you from surgery if it is small in size and of such a structure that it can be treated with medication.
