Cyst of the left ovary

Under the ovarian cyst is understood as a benign tumor type in the form of a cavity of liquid contents, resulting from the tumor process. Most often, this diagnosis of a cyst of the left ovary is given to women of childbearing age, less often such pathology is detected in women over fifty.

Every month a small vial is formed in the ovary of a healthy woman, called the dominant follicle or Count's follicle.

[1], [2]

Causes of the cysts of the left ovary

Based on medical practice, a cyst of the left ovary is formed due to little-studied factors. For example, the formation of a dermoid cyst on the left occurs in violation of embryonic tissue development, as a result of hormonal alteration of the organism during puberty, with the onset of menopause or after a stomach injury.

The phenomenon of polycystic belongs to the problems of the hormonal type. Along with insulin resistance (insulin sensitivity is absent), insulin production is activated by the pancreas. As you know, insulin is a hubbub that is responsible for digestibility and glucose content in the blood. As a result of an overabundance of insulin in the ovaries, the level of male hormones (androgens) increases, preventing the maturation of the egg and its release.

Common causes of cysts of the left ovary: 

• early onset of the first menstruation (up to 11 years); 
• pathologies relating to follicular maturation; 
• endocrine problems (hormonal imbalance, hypothyroidism); 
• previous abortions; 
• menstruation disorders (cycle irregularity, etc.); 
• history of previous cystic forms; 
• use of tamoxifen in the fight against breast cancer; 
• infectious diseases of the genital organs; 
• inflammation of the ovaries / fallopian tubes; 
• previous operations on the pelvic organs.

[3], [4]

Pathogenesis

Every month a small vial is formed in the ovary of a healthy woman, called the dominant follicle or Count's follicle.

This natural cyst serves as an environment for the maturation of the egg. By the middle of the monthly cycle, the dominant follicle bursts, giving the egg cell access to the fallopian tube for possible fertilization. In place of the follicle, a yellow body is formed, the main task of which is to maintain the hormonal background for full nourishing.

The reasons for which the follicle does not rupture and gradually increases with the accumulation of fluid are not fully revealed. This process is called a follicular / retention cyst. In some cases, the yellow body itself is converted into a cyst. Two data pathologies occupy 90% of clinical practice and are included in the group of functional (physiological) formations. Such cysts are found on one of the ovaries, can reach a diameter of five or more centimeters. After a few weeks or months, a benign neoplasm can disappear on its own.

A cyst of the left ovary or the right ovary is formed in parallel with the pathological conditions of the ovaries: 

• the cause of hemorrhagic formation is a hemorrhage in a functional cyst, which is accompanied by a blunt, pulling pain of the lower abdomen (the corresponding side); 
• Dermoid processes are characterized by the presence of hair, cartilage, bone structures, predominantly one of the ovaries. This is due to the fact that the cells that serve for the formation of other organs, penetrate into the cavity of the ovary. This pathology often requires surgical treatment; 
• Endometriotic cysts contain blood that penetrates the ovary during the damaging effects of endometriosis. The disease manifests itself with menstrual pains, as well as ineffectual attempts to conceive a baby; 
• cystadenomas - reach gigantic sizes (up to 30 cm), do not manifest themselves; 
• polycystic ovary syndrome (PCOS) is the most common disease that manifests itself as an overgrowth of multiple cysts of different diameters. Accompanied by a cycle failure, an increase in the number of male sex hormones, infertility; 
• cancer damage - manifested by slow growth of cystic formations.

[5], [6], [7], [8], [9], [10], [11], [12]

Symptoms of the cysts of the left ovary

Often, cystic formations develop asymptomatically. The presence of a functional cyst (based on practice, they occupy 90% of all clinical cases), the woman learns at a scheduled examination or other studies. Discomfort occurs in situations where a functional cyst grows to an impressive size.

The following symptoms of a cyst of the left ovary are distinguished: 

• nagging pain, mostly on the left lower abdomen; 
• the appearance of scant discharge from the vagina, not related to menstruation; 
• acute pain syndrome in the middle of menstruation, lower abdomen (often left), followed by spotting vaginal discharge; •
• pain in the lower abdomen, the peak of which is observed after physical loading or sexual intercourse; 
• nausea; 
• irregular periods; 
• the appearance of the need for frequent false urge to urinate and defecate; 
• constipation; 
• weight gain; 
• temperature increase up to 39 С; 
• feeling of pressure from the inside, tension in the abdominal region; 
• tachycardia.

A cyst of the left ovary can manifest itself as abdominal distention / enlargement, a feeling of fullness or distension. Polycystic ovary syndrome is often accompanied by excessive hair on the face, copious sebum, acne, cardiovascular problems.

[13]

Forms

[14]

Cyst of the yellow body of the left ovary

A luteal cystic neoplasm or cyst of the yellow body of the left ovary is formed from the yellow body in the cortical layer of the ovary.

The corpus luteum is endocrine cells left over from a bursting follicle, producing progesterone and dying off as the new ovulation approaches.

If the corpus luteum does not regress in a timely manner, blood circulation is disturbed, resulting in a cystic cavity. According to the general clinical practice, such a neoplasm occurs in 2-5% of cases.

What is the cyst of the yellow body of the left ovary and what are the reasons for its appearance? The luteal cyst grows up to 8 cm, is filled with reddish-yellowish liquid, characterized by a smooth rounded surface. Factors affecting the growth of education are little studied. Among the main reasons, doctors distinguish hormonal instability, problems with blood circulation. Moreover, a cyst of the left ovary can form both during pregnancy and without it.

To provoke the formation of cysts can: 

• medicinal substances that simulate the release of the egg from the follicle; 
• the use of drugs to prepare in vitro fertilization (for example, clomiphene citrate); 
• use of pharmacological emergency contraception; 
• excessive mental or physical exhaustion; 
• fad diets, unhealthy diet; 
• the presence of frequent or chronic diseases of the fallopian tubes, ovaries; 
• frequent abortion.

Clinically, the corpus luteum cyst has no manifestations. Often she passes by itself, leaving the woman in complete ignorance.

Luteal type cysts, as a rule, do not develop into malignant tumors.

[15]

Endometrioid cyst of the left ovary

Endometriosis is the germination of the tissue that makes up the uterine lining, to nearby organs. The size of an endometrial cyst ranges from 0.6 to 10 cm. By its structure, this type of cyst resembles a solid capsule 0.2-1.5 cm thick with adhesions on the surface. The cavity of the cyst is filled with the contents of the brown color, which represents blood residues secreted during menstruation, as in the uterine cavity.

The reasons for the development of an endometrioid cyst of the left ovary have not been fully studied and come down to a number of theories, among which are: 

• the mechanism of the return of uterine cavity cells into the fallopian tubes during menstruation; 
• "Skidding" of uterine cells in the ovary during surgical manipulation; 
• penetration of the epithelium into the area of the ovary by means of lymph / blood; 
• hormonal disorders, ovarian dysfunction, hypothalamus, pituitary; 
• immune type problems.

The symptomatology of the disease is characterized by acute pain of the aching type, which increases periodically, extending into the lumbar area and rectum, aggravating during menstruation.

Endometrioid cyst of the left ovary and right ovary are classified into stages: 

• first, new growths appear in the form of single points; 
• the second - the cyst grows to a small / medium size, adhesions of the pelvic area are detected (without affecting the rectum); 
• the third - cystic formations up to 6 cm. Are formed on two ovaries (both on the left and on the right). Endometrial processes are manifested in the uterus and fallopian tubes, the walls of the pelvic region. Adhesions cover the intestinal zone; 
• the fourth, endometriotic cysts reach maximum sizes, the pathological focus is transferred to nearby organs.

This type of cyst may not be symptomatic. Patients with a similar pathology turn to a specialist only if it is impossible to conceive a child. At the same time, it is necessary to get rid of the cyst initially, and then plan the birth of a new life.

[16], [17], [18], [19]

Follicular cyst of the left ovary

Follicular cyst is nothing but an enlarged follicle with a thin wall of a capsule filled with fluid. The size of this neoplasm is no more than 8 cm. This type of cystic mass is most often found in girls of puberty.

Follicular cyst of the left ovary occurs with the same frequency as the right. The size of these cysts is not more than 6 cm. When they are formed, no symptoms can be observed. In rare cases, there is an increase in the female hormone - estrogen. The clinical picture is complemented by irregular menstruation, acyclic type bleeding, aching pain is noted in the lower abdomen.

If the follicular cyst has a size of more than 7 cm, then there is a danger of torsion of the legs with the vessels and nerve endings. The process is accompanied by acute pain in the abdomen, and the patient's condition is deteriorating sharply, which requires immediate hospitalization.

With ovulation (in the middle of the cycle) a rupture of a cyst is possible, which is characterized by severe pain. Such a neoplasm does not prevent possible pregnancy. It should be noted that in the process of hormonal adjustment of the follicular type, the formation proceeds independently closer to the 20th week of gestation. However, the situation requires continuous gynecological monitoring.

Treatment is based on the use of hormonal drugs (estrogen or gestagen) for up to two months. If conservative therapy does not produce results, this is the reason for the operation.

Cyst of the left ovary during pregnancy

For a long time, a woman with endometriotic education in the cavity of the ovary cannot conceive, which is the only reason to see a specialist, since this cyst does not reveal itself at all. To think about pregnancy is desirable after the removal of cystic formation.

Endometriotic cyst of the left ovary during pregnancy is not a contraindication to childbirth only in cases when it is small and does not squeeze nearby organs. Endometrioid heterotopies, on the other hand, pose a threat to abortion, and therefore require constant medical supervision.

Follicular cyst during the period of gestation can pass on their own, but also requires increased control.

Serous formation on the ovary up to 3 cm does not affect the development of the fetus and the course of pregnancy, which cannot be said of large cystomas. Already from the 12th week of gestation, when the uterus actively grows and rises in the abdominal area, there is a danger of a twisted cystic leg. The pathological condition is eliminated surgically, which often provokes a miscarriage.

A small-sized mucinous cyst of the left ovary increases the risk of miscarriage and emergency situations leading to surgery. A woman should remove the mucinous neoplasm, undergo a two-month rehabilitation, and only then plan conception.

Luteal formation or yellow body cyst during pregnancy is a necessary source for maintaining normal levels of hormones that are responsible for the preservation of pregnancy and atrophy by the 18th week of gestation. But the absence of this neoplasm is a cause for concern and threatens spontaneous abortion.

[20], [21]

Functional cyst of the left ovary

The process of ovulation is accompanied by the formation of a cavity with a ripened egg cell on the surface of the ovary. After the release of the egg cavity disappears independently. For reasons not clear to medicine, the egg is not released or fluid is injected into the cavity. This is how a benign tumor forms - a functional cyst of the left ovary / right ovary. The very name of cystic formation indicates the main factors provocateurs pathology - ovarian dysfunction and failure of the hormonal sphere.

Predisposing causes of the disease include frequent inflammation of the genital area, prolonged stressful conditions and physical exhaustion, overheating or overcooling of the body.

Functional cyst differs in type of impairment and phase of the cycle on: 

• follicular - the follicle does not break, the egg does not come out. The cavity is filled with liquid contents, not the cells of the corpus luteum. The follicle turns into a 60 mm cyst; 
• luteal - is formed immediately after ovulation (the follicle has burst, the egg has left) when a cyst of the corpus luteum is formed with fluid inside or mixed with blood.

The functional type of a tumor does not belong to malignant and does not have severe symptoms, if it does not reach a huge size. The main complaints include failures of the menstrual cycle (prolonged menstruation or their delay), a lightening type of mid-cycle discharge. Pain in the left lower abdomen manifests itself with a significant increase in the functional cyst of the left ovary.

Common complications include: 

• cystic leg torsion; 
• neoplasm rupture during sexual intercourse / exercise; 
• hemorrhage into the cystic cavity.

Cysts of a functional type usually pass by themselves, but may require surgery.

[22], [23]

Dual chamber cyst of the left ovary

A neoplasm with two chambers is called a two-chamber cyst of the left ovary. A similar pathology occurs in the process of hormonal disorders, due to stresses and excessive physical and mental overloads.

The disease is dangerously high likelihood of cystic leg torsion, rupture of education with the outpouring of its contents into the abdominal area, which entails an inflammatory process (peritonitis).

A two-chamber cyst of the left ovary often develops with mild or absent symptoms. The characteristic complaints of patients with a two-chamber cyst include: 

• weakness; 
• sharp pain in lower abdomen; 
• menstrual problems; 
• no way to get pregnant.

A cyst of any type can consist of 2, 3, sometimes more cameras. Medicine still cannot give an exact explanation of the reasons for the appearance of these formations. Two-chamber cysts are found in women of any age, different lifestyles.

Gynecologists consider as the best method of prophylaxis routine examinations, which make it possible to detect a cystic neoplasm at an early stage and apply gentle treatment without the use of surgical means.

[24]

Retention cyst of the left ovary

A true or retention cyst of the left ovary is formed as a result of accumulation of secretory fluid in the capsule / organ duct. Depending on the structure, such formations are divided into follicular, endometrioid, paraovarial, and cysts of the corpus luteum. The main distinguishing characteristic of this neoplasm is the absence of proliferation, i.e. Increase due to cell multiplication of tissue.

This disease occurs in patients of any age group, often represents a congenital defect of the period of intrauterine development, when the walls of the ducts merge.

Severe symptoms retention cyst of the left ovary has not. Complaints are reduced to different intensity of pain and delay of menstruation. Complications in the form of hemorrhage, torsion of the legs are accompanied by a strong pain syndrome.

Retention type of education can dissolve over a period of two menses. Patients are observed for up to three months, and with the further development of cysts, conservative therapy or surgery can be recommended.

[25], [26], [27], [28]

Dermoid cyst of the left ovary

Benign education is considered a dermoid or dermoid cyst of the left ovary. In clinical practice, such cysts are found in 20% of total cases of cysts.

These tumors are round, oval in shape with a smooth outer surface, and inside contain various tissues (muscle, nervous, fat, connective, cartilage structures). Dermoid includes hair, sweat and sebaceous glands. The internal cavity of this cyst is filled with a jelly-like medium.

Dermoid cyst affects only one of the ovaries, usually the right one. The neoplasm is characterized by slow growth, cases of developing into malignant tumors occupy no more than 3%.

Factors affecting the appearance of dermoid are not fully defined. It is believed that such cysts develop with embryonic disorders of tissue formation, hormonal disruptions of puberty, during menopause. The pathological focus is detected with the same frequency in adolescence, adulthood and childhood.

Like any benign tumor, the dermoid cyst of the left ovary does not have severe symptoms until it reaches a significant (15 cm or more) size. Characteristic signs of dermoid are: 

• feeling of heaviness, distended abdomen; 
• pain at the level of the lower abdomen; 
• visual protrusion of the abdomen due to accumulation of fluid or the size of the cyst itself; 
• disorders of stool as a result of compression of the intestinal tumor.

Sharp pain and an increase in body temperature may indicate a twist of the cystic leg, which is the reason for immediate hospitalization.

[29], [30], [31], [32], [33], [34]

Paraovarian cyst of the left ovary

Ten cases out of one hundred are occupied by a paraovarial cyst of the left ovary, which is formed as a result of embryonic disorders. Pathologies that develop from the appendage are subject to the fair sex from 20 to 40 years. The paraovarial neoplasm occupies the space between the fallopian tube and the ovary. Cyst overgrowth occurs due to overstretching of the walls, filling the tumor, and not through cell division.

Cystic formations of this type are among the most unpredictable, not passing on their own or after the use of medicines. The increase in paraoviral cysts can occur under the influence of harmless factors - taking a hot bath, visiting a tanning salon or getting a natural tan.

The culprits in the formation of such a formation are viral infections in the course of girl's bearing, the effect of chemical factors on the fetus, stress conditions, poor ecology, the use of drugs, etc.

The presence of a paraovarial cyst does not affect the possibility of conception. However, pregnancy increases the risk of torsion of the leg and rupture of a cystic tumor.

The first harbingers of a growing paraovarial neoplasm include the aching pains of the lower abdomen, which are gaining strength during physical exertion and following them. Small cysts are formed without severe symptoms. Reached a diameter of 15 cm, cystic tumors exert pressure on neighboring organs, increasing the stomach in size.

When this type of neoplasm is detected, physical exercise that promotes a change in the position of the body is not allowed - somersaults, turns, jumps, etc. It is possible to get rid of the disease only by surgery.

[35], [36]

Serous cyst of the left ovary

A mobile, practically painless neoplasm of a benign species is a serous cyst of the left ovary. The main complaints include: 

• soreness of a dull, aching type of the zone of the lower abdomen, extending to the lower back and groin area. The pain may cover the left limb; 
• changes in the monthly cycle in most cases do not occur, violations relate to the amount of bleeding that become abundant or scarce.

A benign tumor of a serous type or ovarian cystadenoma is a blister with a clear liquid. This pathology is found in 70% of clinical practice and is divided into: 

• simple cystic formation with a smooth and even surface; 
• papillary (papillary) neoplasm (has growths that look like warts).

Papillary cystadenomas can affect both ovaries, often consist of several chambers, and tend to transform into malignant forms of formations.

Serous formation of small size is found most often on a gynecological examination, and quite unexpectedly for the patient herself. Serous cyst of the left ovary of a small size is often mistakenly identified as a functional neoplasm, which requires constant monitoring for up to six months.

Cysts with a size of 15 cm and more are characterized by a complicated clinical course. Large cysts can compress nearby organs, which is an indication for surgical treatment. Large tumors accompany stool disorders and urinary problems, and increased pain is noted. Often the abdomen increases due to fluid accumulation in the peritoneal zone. Therapeutic tactics are based on the results of a comprehensive examination.

[37], [38], [39], [40]

Regression of cysts of the left ovary

Regression of a cyst of the left ovary is a reduction of the neoplasm in size or its complete disappearance on its own or through therapeutic tactics.

The most likely resorption are functional cysts: follicular and corpus luteum cyst. They disappear in 2-3 months independently or under the influence of monophasic hormonal contraceptives, accelerating the healing process.

According to clinical practice, the most common follicular, endometrioid, paraovarian and tekalyuteinovye neoplasms, as well as cysts of the corpus luteum. If benign ovarian tumors do not have acute symptoms, and their size is relatively small, then the doctor can choose a waiting tactic. In cases when the cyst of the left ovary does not pass on its own, oral-contraceptives with progesterone are used in combination. A feature of these contraceptives is the ability to suppress the gonadotropic function of the pituitary gland, which is most important for the corpus luteum cyst. At the first stage of therapy in order to achieve the effect of hormonal curettage take 1-2 tablets for 15 days. Starting from the fifth day of the cycle - 1 tablet each under the supervision of an ultrasound scan, echography is prolonged, up to regression of the cyst of the left ovary.

[41], [42], [43], [44], [45], [46]

Complications and consequences

By the nature of cystic formation can judge the consequences of the disease in the event of adverse circumstances.

Common effects of left ovarian cyst: 

• torsion of the legs leads to tissue death as a result of impaired blood circulation, which is fraught with inflammation of the abdominal zone; 
• neoplasm growth squeezes / displaces adjacent organs, the process is accompanied by pain syndrome and organ dysfunction. Against this background, infertility can develop; 
• rupture of the cystic capsule threatens with internal hemorrhage; 
• the ability to transform into a malignant tumor.

Removal of the tumor also has adverse effects in the form of: 

• the inability to conceive a child in the future; 
• adhesions in the fallopian tubes - a frequent complication of laparoscopy despite the fact that the procedure is carried out with minimal intervention in the female reproductive system.

The presence of severe consequences is influenced by: patient's age, general state of health, plans for conception, lifestyle.

[47], [48], [49], [50]

Rupture cyst of the left ovary

The most dangerous complication is the rupture of a cyst of the left ovary due to the development of peritonitis, which threatens the health and, in some cases, the life of the patient.

Unfortunately, not a single woman is insured against the onset of cystic formation. As for the loss of integrity with the outpouring of cyst contents into the peritoneum, this pathological process does not occur in all types of cysts. For example, a functional type of neoplasm on the ovary arises and resolves imperceptibly for a woman.

Factors leading to ovarian cyst rupture: 

• inflammatory process, leading to thinning of the wall of the follicle; 
• hormonal disorders; 
• pathology in the process of blood clotting; 
• severe physical overload; 
• active sex.

The following symptoms should alert: 

• piercing type continuous pain, concentrated in the lower abdomen;
• temperature not reduced with antipyretic drugs; 
• poor general condition; 
• a strange form of discharge from the vagina; 
• bleeding; 
• signs of intoxication (nausea, vomiting); 
• pallor; 
• fainting; 
• problems with defecation and gas release; 
• sharp decrease in pressure.

The presence of the slightest signs of a cyst rupture is a reason to call an emergency room. In a hospital setting, after confirming the diagnosis, medication is prescribed (in uncomplicated situations) or laparoscopic intervention to remove the damaged follicle.

[51]

Torsion of cysts of the left ovary

Another complication is considered torsion of the cyst of the left ovary, which is divided into: 

• full - turn from 360 ° to 720 °; 
• partial - deviation from the original position is up to 180 °.

As a result of incomplete torsion, the veins that carry blood into the ovary are squeezed, but the uterine and ovarian arteries continue to function. In this case, the neoplasm grows in size, fibrin appears on the surface of the tumor, provoking the adhesive process. The cyst of the left ovary loses mobility. Complete type overturn is characterized by the absence of blood supply in the arteries and veins, which causes ischemia and necrotic manifestations.

The phenomenon of recut is accompanied by such symptoms: 

• acute abdominal pain syndrome; 
• the muscles of the anterior wall of the peritoneum are overstrained; 
• Shchetkin-Blumberg symptom will be positive; 
• signs of intoxication - nausea, vomiting; 
• increased heart rate; 
• a cold sweat comes on; 
• body temperature increases; 
• the skin becomes pale.

Cyst rejection requires immediate medical attention, treatment is most often prescribed surgically.

Diagnostics of the cysts of the left ovary

The main diagnostic method for detecting a cyst of the left ovary is an ultrasound scan that detects a dark round bubble. Ultrasound examination gives an idea of the structure of cystic formation. In order to determine the cause of the pathology and monitor the dynamics of changes in the cyst, a series of ultrasound examinations can be recommended.

Doppler ultrasound diagnosis is an ultrasound method for assessing blood flow in the vascular bed. For example, there is no blood circulation in the luteal cyst, and it is found in other ovarian tumors.

In view of the fact that functional cysts are capable of self-resorption, and cases of self-healing are not characteristic of dermoid and cancer tumors, when a cyst is found, they often choose a wait-and-see treatment strategy. Dermoid, cancerous tumors can change their size or remain unchanged, and the processes of endometriosis cause a significant increase in cystic formations during menstruation and their decrease after the end of menstruation. All these factors help professionals to establish the correct diagnosis in the research process.

If the gynecologist suspected that the cyst is not functional, then an additional diagnosis of the cyst of the left ovary is indicated: 

• laparoscopic method - refers to the category of diagnostic surgery, in which the doctor through the camera and a special tool conducts an examination, and also takes the material for analysis; 
• a blood test for the quantitative content of the marker CA-125 - used in cases of suspected cancer. It should be understood that a high level of tumor marker does not always indicate the presence of ovarian cancer, as an increase in CA-125 occurs as a result of other pathological processes; 
• blood test for the level of sex hormones - indicates hormonal changes that have resulted in the formation of a cyst; 
• blood biochemistry - to determine the content of cholesterol and glucose.

A complete blood count is done to identify an endometrioid cyst. In patients with this pathology, the erythrocyte sedimentation rate increases significantly, which is often confused with the inflammatory process. Modern techniques - CT, MRI with high accuracy allow to evaluate the internal structure of cystic formation.

[52], [53]

Echo signs of cyst of the left ovary

Ultrasound examination of the ovary is a safe, reliable diagnostic method that determines the structure of the organ. Ultrasound scanning is performed using an abdominal sensor through the peritoneal wall or in a transvaginal way. Transvaginal examination is considered more informative, since the sensor is inserted into the vagina and as close as possible to the organ being examined.

The left ovary is normally located in the left uterine rib, contains up to 12 follicles, is characterized by an average echogenicity compared to the color of the uterus, consists of a moderate number of blood vessels. The size of the follicle in the normal range - 1-30mm. A size greater than 30mm indicates a functional cyst.

The cyst of the left ovary on the monitor is a rounded vesicle of different color and structure. As a result of ultrasound scanning is determined by the type of cystic formation.

Ultrasound is recommended to hold on the fifth or sixth day of the menstrual cycle, as the ovaries change their structure and appearance during one cycle. To clarify the diagnosis, it is necessary to undergo several ultrasounds.

The following echoal signs of cyst of the left ovary are distinguished: 

• serous type of cyst of smooth-wall structure - on the scan image are anechoic liquid formations, often with septa approximately 1 mm thick. The calcification of the capsule is manifested by an increase in echogenicity and local wall thickening; 
• papillary cystadenomas resemble cauliflower inflorescences with viscous and muddy contents. On the monitor, such neoplasms have a round or oval shape, a dense capsule with multiple parietal seals (papillae), characterized by increased echogenicity; 
• mucinous cyst - wall thickness is 1-2mm, most often have partitions resembling honeycombs. A distinctive feature of this neoplasm is the presence of a medium or highly echogenic fine suspension inside the capsule, which is typical for cysts more than 6 cm. Formations of small size - homogeneous and anechoic.

For a proper differentiation of a cyst from a specialist, a great deal of experience is required, since some pathological structures have a similar internal structure. Here it is important to consider the location of the tumor with respect to the uterus, its appearance, size, the presence of septa and suspension.

[54], [55], [56]

Treatment of the cysts of the left ovary

Making a diagnosis of a cyst of the left ovary is not a reason for despair. To clarify the type of neoplasm, it is necessary to undergo additional examination, discuss with your doctor the options for optimal therapeutic effects and possible side effects. The patient should constantly monitor the slightest state changes, and in the event of alarming symptoms, immediately call for urgent help.

Some types of cysts, such as functional or yellow body, are capable of self-resorption. Such patients are under the control of the dynamics of tumor formation by ultrasound and Doppler methods up to 3 months.

Successfully proven conservative methods of treatment: 

• hormone therapy;
• balneological procedures - irrigation with medicinal solutions of the vagina, bathing;
• peloidotherapy (scarring);
• Forez SMT-currents, in which the maximum absorption of drugs through the skin;
• electrophoresis - the penetration of therapeutic liquid media through the skin due to the low frequency current;
• ultraphonophoresis - physiological effects are provided by ultrasound irradiation;
• magnetotherapy.

Treatment of a cyst of the left ovary is prescribed on the basis of the patient's age, the individual characteristics of her body, the reasons for the formation of cystic formation, based on the size and speed of tumor growth.

In the treatment of functional and endometrioid cysts, oral hormonal contraceptives are used, blocking the work of the ovary, inhibiting the growth of an existing cystic formation, as well as preventing the emergence of new tumors.

In the treatment of polycystic ovary syndrome, in addition to receiving hormone-containing drugs, special attention is paid to the normalization of body weight and carbohydrate metabolism.

Menopausal women with cysts up to five cm and normal CA-125 are not prescribed treatment, but re-ultrasound is recommended to track the growth of education.

Operations are indicated for patients with cysts greater than 10 cm and in cases when other methods of treatment have failed. Laparoscopy is widely used to remove tumors (several openings are made in the abdomen), less frequently laparotomy is used - excision of cysts by an incision in the abdominal wall.

Surgical intervention is inevitable in case of exacerbation of the disease, when bleeding occurs, there is a torsion of the cystic leg or the death of the ovary.

Surgery for a cyst of the left ovary

Surgical intervention in the diagnosis of a cyst of the left ovary is used not only to remove the neoplasm, but also to determine the causes of its formation, establish the type of cyst and exclude cancer.

When choosing a surgical treatment technique, the fundamental factors will be: 

• general condition of the patient; 
• possible complications; 
• type and size of cystic formation; 
• instrumental equipment of the clinic.

Surgery for a cyst of the left ovary is possible using laparotomy (make an incision) or laparoscopy (through a puncture). The basic factors in the choice of treatment tactics will be the age and condition of the patient, as well as the characteristics of the tumor.

Laparoscopic excision is considered less traumatic, leads to a minimum of complications, has a shorter rehabilitation period. Surgical intervention is performed under general anesthesia. In the abdominal wall do several punctures-cuts, through which endoscopic instruments are introduced. Culdoscopy is a special case of laparoscopy, when an endoscope is inserted through the vagina.

A variant of surgical treatment to get rid of polycystic ovary syndrome is electrocoagulation. The essence of the technique consists in cauterization of the ovarian sites (pointwise) with cells that produce male hormones, in particular testosterone. The operation is characterized by speed, minimum recovery period, low level of trauma.

[57], [58]

Treatment pills cyst of the left ovary

Drug treatment is primarily selected based on the type of cystic formation. Conservative therapy of a cyst of the left ovary of the follicular type consists of preparations based on estrogen and progestogen. The duration of medication varies from one month to two.

Treatment with pills cyst of the left ovary of the endometrioid type includes: 

• hormone therapy; 
• taking vitamins; 
• immunomodulatory program; 
• anti-inflammatory and analgesic scheme.

In the treatment of endometriosis with hormones, the following groups of drugs are prescribed: 

• synthetic estrogen / progestogen - "Diane-35", "Marvelone", "Femoden", "Ovidone", etc.; 
• progestogen containing agents - duphaston, gestrinon, medroxyprogesterone, etc.; 
• drugs antiestrogenic properties - "tamoxifen";
• androgenic drugs - “Sustanon-250”, “Testenat”, etc.; 
• antigonadotropic substances - "danazol", "danoval" (reduce the activity of the pituitary gland); 
• anabolics - "methylandrostendiol", "nerobol", etc.

Hormones are prescribed only by the attending physician, the duration of treatment reaches nine months.

Patients as a tonic therapy and ovarian activation are recommended to take vitamins C, E.

Anti-inflammatory drugs (tablets or suppositories) are used exclusively by medical prescription. As for anesthesia, the most commonly used is “analgin”, “baralgin”.

In order to correct the immunity prescribe: 

• the course of "levamisole" ("decaris") - three days with a single dose of 18mg; 
• intramuscular injections of “spelenin” - up to 20 injections of 2 ml every other day or every day; 
• & Quot; cyclocherol & quot;, & quot; thymogen & quot;, & quot; pentaglobin & quot;.

Drug treatment of polycystic ovary syndrome necessarily includes: 

• the course of "metformin" up to six months - to normalize the metabolism of carbohydrates, triggered by a decrease in the sensitivity of tissues to insulin; 
• taking hormones in the fight against infertility - taking "clomiphene-citrate" is carried out from the fifth to the tenth day after the onset of menstruation, normalizes the ability of the egg to exit the ovary in 50% of cases. If the desired effect is not observed, the drug is replaced by “pergonal” / “Humegon” with the active substance gonadotropin; 
• hormone therapy if pregnancy is not planned - “Diane-35”, “Yarin”, “Jess”, “Verohspiron” with antiandrogenic properties.

A small size of the cyst of the left ovary can be treated with contraceptive homeopathic remedies (for example, “Lachesis 6”, 5 granules twice a day). If drug therapy does not produce results or complications arise, surgical intervention is prescribed.

Prevention

The use of monophasic combined contraceptive drugs is the best prevention of a cyst of the left ovary. Medical practice has proven to reduce the risk of ovarian tumors six times a year when taking combined contraceptives. Protective effect lasts up to 15 years.

For girls at puberty, for preventive purposes, “jess” is shown for up to six months, if there is no need to prevent unwanted pregnancy.

Reproductive age, women require long-term use of hormone-containing drugs with a minimum content of estrogen. The most convenient is the ring “NovaRing”, which releases into the body ethinyl estradiol (15 μg) and etonogestrel (120 μg). Vaginal contraceptive introduction provides a stable concentration of hormones in the blood, control of the menstrual cycle and the exclusion of a reduction in the contraceptive effect when interacting with food or other pharmacological drugs, as with oral administration.

If estrogen is contraindicated, then resort to progestogen therapy. Initially, it is recommended to take “Norcolute” twice a day for 5 mg, the second stage includes a “charosetta”.

Prevention of a cyst of the left ovary also includes: 

• maintaining a stable emotional state, developing a positive attitude towards life; 
• use of homeopathy / herbal remedies for the normalization of hormonal levels; 
• adherence to a low-calorie diet, the use of more plant fiber, vitamin A and selenium; 
• exercise, activating blood circulation in the pelvic organs; 
• moderation during sunbathing and tanning; 
• performance of the day regimen; 
• do not abuse hot water baths; 
• regular visits to the gynecologist.

[59], [60], [61], [62]

Forecast

Benign ovarian tumors are slow to grow, do not cause metastasis, and are able to push or squeeze nearby organs and tissues.

The prognosis of a cyst of the left ovary is made on the basis of the type of neoplasm, the treatment applied, the individual characteristics of the patient’s body and its age.

After treating serous cystadenoma of the ovary, the prognosis is usually favorable for the woman’s body and future pregnancy. Conception was recommended not earlier than full recovery, which corresponds to two months after surgery.

Conclusions about the need to continue the treatment of seropapillary cystadenoma after surgical removal depend on the histological picture. It is desirable to plan a pregnancy in two months from the moment of surgery.

For the most part, the prognosis of cysts of the left ovary of the mucinous and dermoid type is favorable for health and pregnancy, the onset of which should be postponed for two months after the exfoliation / removal of the neoplasm.

The recurrence of endometrial formations depends on the quality of the surgery and the treatment chosen.

A functional cyst of the left ovary can be detected repeatedly throughout the patient’s life before the onset of menopause.

[63]