Ovarian cyst

Developing from epithelial tissue layers and growing by multiplication of cells by division, the true neoplasm, affecting the ovary is the ovarian cyst.

Primarily, its development is asymptomatic and only with time a woman begins to feel pathological discomfort. Mostly this pathology is transformed from a previously formed cyst and can be a single-chamber and multi-chambered neoplasm, which is located on the so-called anatomical leg (a set of blood and lymph vessels, nerves), the second end of which grows into the affected ovary.

ICD-10 code

According to the International Classification of Diseases of the 10th revision (μb 10), the ovarian cyst has its own individual code - N83, whose name sounds like "Noninflammatory lesions of the ovary, the uterine tube and the broad ligament of the uterus."

Causes of Ovarian Cystoma

Categorically and unequivocally to sound all sources provoking development of the considered pathology, for today it is impossible. But a certain range of women who are prone to this disease can be delineated. Diagnosis of ovarian cyst, the reasons for its occurrence:

• Ovary failure.
• In the anamnesis chronic disease of female genital organs.
• If close relatives of the female line were diagnosed with ovarian cancer or other female genital organs.
• In the anamnesis an operative measure affecting the ovaries.
• If a woman is a carrier of HPV (human papilloma virus).
• Abortions. The more of them, the higher the risk of injury.
• In a woman's history, herpes of the second type, that is genital herpes, was diagnosed.
• Amenorrhea is the absence of menstruation for six months or more.
• Irregular menstrual cycle.
• A woman was diagnosed with breast cancer.
• The woman had an ectopic or frozen pregnancy.
• The age of the woman when she approaches the period of onset of premenopause or menopause.

[1], [2]

Causes of cystoma of the right ovary

If the cystoma of the right ovary is diagnosed, the reasons for its appearance by a gynecologist can not always be established. But if you consider the anamnesis is painful, it is possible to guess the source of the problem in most cases. Causes of pathology in the development of cystoma of the right ovary are similar to those that were voiced above. But you can definitely say, whatever the impetus that triggered the mechanism of the disease, the root cause of the immediate origin of cystoma is the hormonal failure and viral damage of the female genital organs (endometritis, colpitis, oophoritis).

[3], [4], [5]

Symptoms of ovarian cystoma

Neoplasm of a small size usually does not affect the course of the menstrual cycle and does not cause a woman discomfort. At this stage, pathology can only be detected by accident during a preventive examination. With a further increase in the size of the ovarian cyst, the symptoms of this pathology gradually begin to manifest, intensifying their intensity.

To such it is possible to carry:

• Drawing pain symptoms in the area of the uterus, giving in the lumbar and inguinal area.
• Bloating, the appearance of a feeling of bursting.
• Infertility.
• Malfunctions of the menstrual cycle.
• Frequent urge to go to the toilet "on a small".
• Stool disorder: constipation or, conversely, diarrhea (less often).
• Edema of the lower extremities.
• In the serous nature of formation - the accumulation in the fallopian tube of a liquid substance of a pale yellow hue, as well as liquid can accumulate in other parts of the body.
• In case of torsion of the leg, the pain becomes unbearable, the body temperature rises, there is an increased tone of the abdominal muscles, tachycardia.

Injury or increased physical activity can lead to rupture of the cystoma.

As a rule, a small size cyst does not appear in any way: the woman feels quite normal, there are no malfunctions in the menstrual cycle. To diagnose it at this stage of development is possible only with preventive gynecological examination, or undergoing an examination of the suspicion of infertility.

Only having reached certain sizes it can be assumed that a woman has an ovarian cyst, the signs gradually begin to manifest and gain intensity. The first thing that draws attention to a woman is the pulling, constant pain in the area of the uterus, which begins to give back and the groin area. 

Neoplasm increases and begins to infringe on neighboring organs. So pressure on the bladder is manifested by frequent urge to urinate, and the intestines can react with constipation (less often diarrhea). Vessel compression leads to swelling of the lower extremities.

In serous cysts, ascites or hydrosalpinks (abnormalities of the fallopian tubes) are sometimes observed. If the capsule's leg is twisted, there is a sharp pain, the body temperature rises, there is an increased tone of the abdominal muscles, tachycardia. If you do not provide the necessary medical assistance in time, there may be a break in the cystoma, intoxication, sepsis and death.

Serous ovarian cyst

Based on the substance with which the capsule is filled, the gynecologists are divided into mucinous and serous formation. Serous cyst of the ovary is filled with an ultrafiltrate of plasma, which is constantly reabsorbed and produced. The inner layer of the cystoma is covered by cells of the surface or tubular epithelium. Pathology, mainly represented by a single chamber, which can reach a size of 30 cm in diameter.

Approximately 10 to 15% of women diagnosed with serous ovarian cyst, if timely measures are not taken, subsequently receive a change in the diagnosis of ovarian cancer. Risk group - women from 40 to 45 years.

Mucinous cystoma of the ovary

Advantageously, specialists in the field of gynecology have to establish a diagnosis - mucinous cystoma of the ovary. This disease has another name - pseudomucinous cystoma of the ovary. This tumor has an epithelial lining filled with a mucus secret. Mostly, such cysts have several chambers. This pathology has no age differentiation, although this pathology is still more common in postmenopausal women. Mucinous cyst of the ovary shows insignificant, only 3 - 5, percent of degenerations into cancer tumors.

Multi-chamber ovarian cyst

Multicameral ovarian cystoma practically does not differ from a capsule with one chamber. Basically, all the difference is reduced to the presence of dividing partitions, which divide the inner space of the cystoma into several compartments filled with slime-like or liquid secret. The envelope of the neoplasm develops by dividing the epithelial cells of the ovary.

The predominantly multi-chambered ovarian cyst is a pseudomucinous cyst.

There are cases when the septa arise due to the fusion of several cysts of various types. The main reason for the formation of multi-chamber capsules is the violation of hormonal balance in the body of a woman.

Cystoma of the right ovary

This new formation on the genesis of the appearance of physicians is divided into the primary cystoma - proliferating from the tissue cells of the ovary and the secondary one - developed from cancer metastases.

Cystoma of the right ovary refers to benign neoplasms susceptible to high proliferation rates. And in the case of ignoring the symptoms, the disease turns into a category of "neglected pathologies," which provokes the tissue of the cystoma to degenerate into a malignant tumor. That is, a healthy cell in this situation can go from a benign tumor, through proliferating to malignant.

The cystoma itself is a capsule with a limited contour, the cavity of which is filled with a substance of a liquid or somewhat viscous consistency. The inner lining of the formation is covered with a thin layer of epithelium. Cystomas of the right ovary are most often observed in girls during puberty, as well as in women of adulthood, when it enters the period of onset of menopause. This is the peak period when the body of women and girls is most affected by the imbalance of the hormonal background.

Gynecologists distinguish cystomas of the right ovary of several species. These are follicular and luteal cysts, functional genesis, endometrioid, dermoid, as well as pseudomucinous and serous, belonging to epithelial cystomas. Dermoid neoplasms can be observed in any age category of women, even in newly born babies, as their occurrence is caused by failure of embryonic histogenesis.

The cyst of the right ovary does not arise from scratch, but is a consequence of a cyst that has grown in the ovary somewhat earlier.

[6]

Left ovarian cyst

Among tumor tumors affecting female genital organs, most often obstetricians - gynecologists diagnose exactly cystomas. The cystoma of the left ovary, as well as the right ovary, is a benign neoplasm, which is distinguished by a sufficiently high rate of proliferation. This education distinguishes from other benign tumors with a greater risk of malignancy. The development of pathology starts from the epithelial cells of the ovary. In this case, the cystoma of the left ovary can reach a threatening size.

The connecting link with the affected organ is an anatomical leg. This small connecting thread includes a system of arteries, lymphatic vessels and nerve ligaments.

Ovarian cyst during pregnancy

The ovary cyst is considered a true benign tumor, but because of the likelihood of degeneration into cancer, it is subject to removal, especially for young women who wish to become a mother.

After the conception has occurred, the woman's organism begins to be rebuilt for a new status, hormonal restructuring takes place, which also affects such a working chain: pituitary-hypothalamus-neuronal system-endocrine system-ovaries. Against the background of reduced immunity, the appearance of neoplasms is quite realistic. And if ovarian cystoma was diagnosed during pregnancy, first of all the pregnant woman should be under the constant supervision of doctors.

In order not to provoke a miscarriage, it is impossible to excrete a cyst in the first trimester of bearing. The operation can be performed only when the pregnancy passes into the second trimester. If the resection was performed by an experienced surgeon, the fetus does not threaten anything.

Ovarian cystoma size

Getting acquainted with the cases of diagnosing the disease in question, it is evident that the ovarian cyst, whose dimensions are diagnosed from several millimeters to 10-15 cm, can grow and represent quite impressive sizes. This pathology is mainly observed in women older than 30 years. This disease is much less common among the fairer sex, who have already crossed the line in 60 years.

Large ovarian cyst

As soon as the conditions that triggered the mechanism of proliferation of pathological neoplasms have developed, the tumor sizes begin to increase rapidly. It takes not much time, and on the computer screen, when a woman passes an ultrasound examination, the uzist can observe a clearly discernable capsule, with a content of less density than its shell. If previously an experienced gynecologist could, using the palpation technique, state that a large ovarian cyst is being determined, then modern medical equipment makes it possible to diagnose this disease even in the embryo, when the capsule development only begins and has a small size.

One of the distinctive characteristics of the pathology in question is the rapid proliferative growth of the newly formed tumor. It takes very little time and this capsule, with the next study, can show a size of 10 - 15 cm. But, probably, any gynecologist had to deal with a particular pathology at least once in his practice when ovarian cysts of large sizes were diagnosed. And these are not isolated cases.

A person by nature is lazy and begins to take retaliatory measures only when uncomfortable discomfort symptomatics begins to pester him strongly enough. And if this characteristic is superimposed on the Russian "maybe, too," the doctor sometimes has to observe cystomes that have reached a diameter of 30 cm. Having imagined a ball of this size, an unprepared person is capable of experiencing a real shock.

But the problem of such neoplasms is not only in their horrible size, but also that the more time it grows, the greater the probability that sooner or later it will malign in a cancerous tumor. But the problem is not only in the risk of degeneration, the ovarian cyst of large sizes takes more and more places inside the woman's body. This leads to the fact that the neoplasm begins to weigh its weight on neighboring organs. Therefore, the clinical picture of ovarian cystoma with large dimensional characteristics is usually accompanied by a symptomatology that speaks of malfunctions in the functioning, for example, of organs such as the intestine, stomach or bladder, and the female genital organs, as well as the vascular system.

The size of the cystoma of the right ovary

This disease refers to polymerizing pathologies. At the same time, their growth rate can be quite substantial. If the tumor was not detected in time, then at the appearance of obvious symptomatology and diagnosis - cystoma of the right ovary - the size of the capsule can reach a diameter of up to 30 cm. Such sizes of cystic education can not but affect the work of neighboring organs.

But such parameters are more an exception than the norm. Mostly, the cystoma begins to manifest itself much earlier, reaching a much smaller size.

Cysts and cysts of the ovaries

To understand what is the difference between cysts and ovarian cysts, it is worthwhile to understand what a cyst is, and what pathological abnormality is called a cystoma.

The cyst is a retentive or tumor-like neoplasm of one of the ovaries, filled with fluid or blood. The main impetus to the growth of the cyst is the failure of the hormonal balance of a woman, as well as the consequence of a chronic inflammatory process taking place in the organs of the peritoneum and small pelvis. The growth of the neoplasm is due to the accumulation of internal secretion.

Kistoma is a true benign ovarian formation that is capable of rapid growth, that is, the growth of dimensional parameters passes not through the accumulation of more secrets, but due to the true division of the tumor cells themselves. Kistomas are potentially malignant formations.

[7], [8], [9],

Differential diagnosis of ovarian cystoma

If a gynecologist suspected a woman of a tumor in the history of a woman with a suspicion of infertility or in the light of a prophylactic examination, and specifically that it is an ovarian cyst, the differential diagnosis includes:

• Inspection of a woman by an obstetrician - gynecologist on the chair.
• Collection of her anamnesis.
• An analysis of the patient's complaints.

To confirm or refute the suspicions of the doctor is carried out:

• CT scan.
• Ultrasound examination of the uterus and ovaries.
• Ultrasound examination of mammary glands.
• Magnetic resonance imaging (MRI).
• A blood test for a cancer marker is also under way.
• Take a puncture of the abdominal cavity.
• If necessary, an endometrial biopsy is performed.

When determining the ovarian cyst, it should be differentiated from other gynecological diseases with similar symptoms. Therefore, the doctor may additionally designate:

• Roentgenogram of the stomach.
• Gastroscopy.
• Consultation with doctors: urologist, proctologist or gastroenterologist.
• In case of doubt, a laparoscopy with ovarian biopsy is assigned, which, if necessary, from the diagnostic procedure can develop into a therapeutic one.

The final diagnosis is obtained only after excision of the neoplasm and the results of the histology of its tissues.

[10], [11], [12], [13], [14]

The difference between a cyst and an ovarian cyst

Very often women who are far from medicine do not understand whether the cyst and ovarian cystoma have a difference? These two neoplasms, nevertheless vary.

Cyst is a shell filled with liquid. Its growth is due to an increase in the volume of content (liquid). Whereas cystoma is a true tumor that grows by directly dividing cells. The percentage of cyst degeneration into cancers is close to zero, whereas in cystoma this probability is much higher.

When diagnosing proliferative epithelial cystoma, a gynecologist in a woman's diagnosis indicates a precancerous condition.

Treatment of ovarian cystoma

This pathology can affect both one and two ovaries at once. The probability of degeneration of the cells of the formed capsule into a malignant tumor is high enough. In this case, the statistics of clinical observations indicate that, for example, mucinous cystoma shows a percentage of malignancy of 5%, while a serotype neoplasm shows a malignancy level of 15%.

Proceeding from the above, if ovarian cyst is diagnosed, treatment of this pathology is reduced to the only possible method - removal of the cystoma by surgical means. If pathology is found in a young woman, she is given a cystectomy. This is an operative, highly unpredictable intervention in which the obstetrician-gynecologist removes only the cyst, the healthy ovarian tissue of the ovary remains intact, and within the healthy tissue the germinated cells of the capsule are carefully harvested.

After carrying out this operation, the specialist necessarily appoints a study on oncomarkers, the so-called specific substances that are the products of the life of cancer tissues or are the compounds produced by healthy cells in response to the invasion of malignant elements. To conduct this study, the patient is taken for analysis of blood and urine.

But there are clinical indications, in which the surgeon has to excise not only the pathological outgrowth, but also the affected ovary. Advantageously, this procedure is performed laparotomically (operative opening of the abdominal cavity, a cut is performed along the lower abdominal line) or laparoscopically (a low-traumatic method of performing surgical operations performed using a loparoscope).

If the study on tumor markers gave a positive result or the observation of the cyst in the dynamics shows its very active growth, in such a situation the doctor can prescribe radiation or chemotherapy. This will prevent or treat the development of cancer in the bud.

In general, if a woman has had a timely cystectomy, her prognosis for the future is quite favorable, up to full recovery. However, such patients should be regularly shown for examination to a gynecologist - an oncologist. This preventive operation is much more sparing for the woman's body than for those that need to be applied in case of need to stop the results of the complication of the disease.

The preventive measures include properly selected contraceptives, regular visits to a gynecologist and periodic ultrasound examination.

Removal of the ovarian cyst

Regardless of the clinical picture and dimensions of the neoplasm, a woman with a diagnosis of ovarian cyst is clearly shown to remove pathological formation, possibly together with the affected ovary. The main reason for this radical treatment is the high risk of malignancy of the cystoma, as well as its rapid growth, which negatively affects the functioning of other pelvic organs.

After setting the diagnosis of ovarian cyst, removal and accompanying studies are performed by a gynecologist - an oncologist. After excision, the received material is poisoned into the laboratory for further examination, during which the nature of the capsule is clarified and the presence or absence of cancer cells in the excised tissues is answered.

The volume of the intervention is determined by the size of the capsule, its physico-chemical parameters, which are ascertained by intraoperative histological examination, as well as the age of the patient and the plans of the woman to have or not have a child later. Mostly, a woman is prescribed laparotomy or laparoscopy. The question of the appointment of this or that method of surgical intervention is decided by the surgeon-gynecologist individually in each case.

In the clinical picture, when a young woman is diagnosed with a smooth-walled serous cystoma that is not burdened by a factor of on-care, the doctor usually appoints a cystectomy, a sparing method of surgery, which makes it possible to rehabilitate the pathology while preserving the ovarian tissue.

If a woman of reproductive age is diagnosed as mucinous, papillary - serous cystoma, the treating doctor will have to prescribe a laparotomy to the patient with complete removal of the affected ovary. If a woman has already left the reproductive period, then, most likely, she will be prescribed pangysterectomy (an operation in which the uterus with appendages is removed). Such a radical method of treatment will save a woman in the present and further from cancer of the genitals.

The obstetrician-gynecologist can resort to emergency surgery if ultrasound showed that the leg of the cystoma is twisted, as well as when the cyst capsule has burst, and its contents have leaked inward. Procrastination is unacceptable. Any delay can lead to intoxication, sepsis and death.

When the cancer cells are found in the tumor, or at its borderline characteristics, the doctor has the right to prescribe radiation, hormonal or chemotherapy.

Operation to remove ovarian cyst

Primarily, the operation to remove the ovarian cyst is performed by the endoscopic method. The essence of the method is that on the front surface of the abdomen in certain places the doctor makes three holes through which the pathological flesh is excised through the laser. The positive characteristics of this technique include the absence of scars and malaise in the postoperative period, a low level of trauma, a small recovery period. To negative - not every medical institution has equipment for carrying out this procedure. Therefore, the most commonly used method of electrocoagulation (electric soft tissue cauterization).

Often used laparoscopic excision of the flesh - it is akin to the endoscopic method and is performed under general anesthesia. The first stage of this operation is filling the abdominal cavity with gases, after which the capsules are removed through one of the punctures. Due to the use of high-precision optical equipment, it is possible to avoid the standard complications provided by classical laparotomy, for example, colloid scars, which is significant if the woman is still planning to become a mother.

There are indications when one can not do without a laparotomy or a cavitary operation. Then the incision on the abdomen is significant, the scar is formed, and the recovery period takes a longer time.

The main parameters on the basis of which the doctor makes a choice of the technique of excision of the cystoma is the type and size of the tumor, the state of the woman's health, the availability of the medical institution and the level of qualification of its personnel, as well as the risk of various complications.

The preoperative period includes refusing to eat, smoke and drink on the day when surgery is planned. Immediately before the procedure, the patient is given a drug that must prevent the formation of blood clots.

Treatment of cystoma of the right ovary

For such a pathology as the right ovary cyst, there is only one treatment - surgical intervention with the removal of a pathological tumor. And the sooner this procedure is carried out, the less complications and pathological changes the woman will get. But the methods of excision are somewhat different. And what method to apply in this or that case is decided by the attending physician-gynecologist. To do this, he can only after the general picture of the disease is obtained.

For example, with a serous cyst, only the capsules are resected, whereas in a mucinous tumor, the capsule is removed together with the affected ovary. After that, the cut off tissues are subjected to a thorough examination for the detection of the cancer cells themselves or antibodies to them. In the case of a positive response, the gynecologist-oncologist ascribes laser and chemotherapy to the patient.

But even if the result of the biochemical analysis on the oncomarkers turned out to be negative, the patient should preferably undergo an examination with an oncologist-gynecologist twice a year, since a woman who undergoes such an operation automatically falls into a risk group for oncology.

Operation with right ovary cyst

If during the planned or emergency examination the cystoma of the right ovary was diagnosed, the operation is unambiguous. The immediate method and extent of the intervention is determined by the attending physician-gynecologist or gynecologist-oncologist, individually, based on the factors that constitute the complete clinical picture of the disease, which were described above.

With a right ovary cyst, the operation is appointed without delay, as complication of this pathology is hemorrhage, malignancy, perforation of pathological neoplasm, tissue necrosis, pressure on neighboring organs and body systems, twisting the capsule's legs. The prognosis is evaluated based on the results of the histological structure of the formation.

Treatment of cystoma of the left ovary

For such a pathology as cystoma of the left ovary, treatment, as in the case of a lesion of the right ovary, there is only one - surgical intervention with the removal of a pathological tumor. The faster the operation is performed, the less complications and pathological changes the woman will get.

All methods of removal of neoplasms and the factors influencing their choice are similar to those already stipulated in the case of therapy in diagnosing cystoma on the right ovary of a woman.

The main purpose of the operation:

• Confirmation of the disease.
• Definition of the nature of the cystoma.
• Exclusion of cancer pathology.
• Excision of a neoplasm.
• Gentle attitude to healthy neighboring tissues.

Operation with cystoma of the left ovary

In the overwhelming majority of cases, when establishing the diagnosis of left ovarian cystoma, surgery is the only way to carry out therapy, which is considered by a gynecologist. Before him is only the question of determining the technique by which the neoplasm is removed. Primarily the choice is between laparotomy or laparoscopy. The main factors that tilt the scales to one or the other method are similar to the choice when operating the right ovary cyst.

The volume of excision depends on the size of the formation, the nature of the tumor, which is determined by the histological examination, as well as the age of the patient and her desire to become a mother in the future.

Laparoscopy of the ovarian cystoma

It is enough part of the surgical procedure that laparoscopy of the ovarian cystoma is prescribed. The preparatory stage for this procedure is similar to the period before preparation for other endoscopic procedures. The very "operation" is carried out using general anesthesia. On average, the whole procedure takes from half to one and a half hours.

The surgeon produces one small incision below the navel, through which a video tube is fed in. Slightly lower and divorced by different stools are produced two more incisions. Through them a special instrument is provided to the resection site, which is necessary for excision. Controlling his work in the eyepiece of the videocope, he makes an incision on the cyst and with it he gradually removes it.

The procedure is not complicated, but effective.

Treatment of ovarian cystoma by alternative means

Kistoma is a benign tumor that can later degenerate into cancer. If the formation is small, then there is a chance to get rid of it by grandmother methods. It is possible in the treatment of ovarian cystoma by alternative means to introduce one of the following suggested recipes.

1. A tablespoon of dry herb cauliflower goose infusion on boiled milk or water for a couple of hours. Drink half an hour before meals three times a day.
2. A decoction from this plant will do. Just the grass should be boiled for a quarter of an hour on a small fire, then let it brew for two hours, drain it. It is necessary to drink three to four times a day for a quarter of a glass.
3. Perfectly recommended by the daisy, taken in the same proportions with melissa. This mixture should be poured with freshly boiled water and let it stand for four hours. Drink must be hot.
4. Pour three tablespoons of corn stigmas with a glass of boiling water and boil for 10 minutes on a small flame. Strain, drink 50 g three times a day.
5. Take one tablespoon takes calendula, celandine and chamomile. This collection is poured in half liters of boiling water, and the container is well wrapped in a warm blanket for the whole night. The resulting infusion is to drink three times a day for half an hour before meals with a half-glass dose.
6. As a syringing suit decoction, made on grape wine.

Treatment with alternative means our great-grandfathers advised to begin in the first phase of the lunar calendar. They believed that in this case the therapy would be more effective.

Treatment of ovarian cystoma without surgery

Predominantly, when the diagnosis of ovarian cyst is diagnosed, it is almost impossible to dispense with surgery. Only if such a neoplasm was detected at an early stage of development and has a small size, you can try to carry out resorptive drug therapy or take the recipes of alternative medicine.

It is only necessary to remember that during the passage of such treatment the patient must constantly be under the control of a doctor, undergoing periodic diagnosis to determine the size of the capsule. If the recourse does not happen and the cystoma continues to grow, it will not be possible to avoid surgical intervention.

Summarizing the above, it can be stated that ovarian cyst is a disease not only uncomfortable, but also dangerous. Therefore, to avoid this pathology or to get out of the fight against the disease with the least loss for one's health, a woman can only visit a gynecologist on a regular basis, without ignoring his preventive examinations and ultrasound examinations. It is worth a woman to take care of her health and in terms of eliminating abortions, injuries, preventing infectious and inflammatory diseases.

It is only necessary to be more attentive to the signals of your body and in time to seek help from a specialist!