Treatment of ovarian cysts

Treatment of ovarian cysts depends on its type and diagnostic measures.

An ovarian cyst is a fairly common disease that occurs in almost 50% of all women suffering from amenorrhea, dysmenorrhea and other menstrual cycle disorders.

Before therapy is prescribed, a full range of studies is mandatory, which includes:

• Visual examination on a gynecological chair.
• Colposcopy.
• Abdominal and transvaginal ultrasound examination.
• A comprehensive blood and urine test.

An ovarian cyst, the treatment of which varies from medication to surgery, is directly related to the normal functioning of the hormonal system. The type of cyst, its size and stage of development determine the method by which it can be eliminated.

Cysts can be functional and organic. Treatment of a functional ovarian cyst involves conservative measures, in addition, if certain simple rules are followed, such cysts can go away on their own, especially if they do not exceed 3 centimeters. They are also successfully neutralized by properly administered hormonal therapy, which allows you to get rid of neoplasms in a few months.

Types of surgery for ovarian cysts

• Cystectomy is the removal of the tumor by enucleating the capsule, while healthy ovarian tissue is preserved. The incision eventually regenerates, and the ovary regains its ability to function normally.
• Wedge resection - the cyst is excised with a wedge-shaped incision, the ovarian tissue remains intact, and functions are restored after several months.
• Ovariectomy is the complete removal of the ovary. Often, adnexectomy is also performed during this operation – a complete ectomy of the appendages. This type of operation is considered radical and is performed in case of the risk of developing an oncological process.
• Women in the climacteric period are recommended to undergo ovariectomy or hysterectomy – removal of the uterus and appendages.

In order to avoid surgical intervention, even such a gentle one as laparoscopy, it is necessary to regularly undergo preventive gynecological examinations, including a full range of examinations (abdominal and intravaginal ultrasound, colposcopy).

Types of functional neoplasms and methods of their treatment

A follicular neoplasm that develops from the largest follicle that has not undergone the rupture stage (without the release of an egg). The cyst cavities are smooth, rather thin, such cysts are always single-chambered. If a small ovarian cyst is diagnosed, treatment can be conservative, usually oral drug therapy is prescribed. If the cystic formation exceeds 7-8 centimeters in size, it is enucleated or resected, either partially or completely. If the cyst is detected in a timely manner, the operation is performed laparoscopically, that is, with minimal trauma to the abdominal cavity. If the cystic formation of the ovary is accompanied by torsion of the pedicle, a full-fledged abdominal operation is indicated.

A corpus luteum cyst or corpus luteum cyst can form when ovulation occurs and the follicle is filled with fluid, not with what it should be - corpus luteum cells. This type of cyst is diagnosed quite rarely, and the cystic formation often resolves (involutions) on its own. Treatment consists of dynamic observation using ultrasound monitoring for 2-3 months. In the case of development, increase in size and risk of torsion of the pedicle, ovarian cyst treatment involves surgery.

Hemorrhagic neoplasm is a cystic formation that is formed due to the penetration of blood during menstruation into the cavity of the follicular cyst. Most often, this type of neoplasm involution (resolves) by the end of menstruation, in the case of strong enlargement and filling with blood, laparoscopic surgery is indicated.

There are other types of cysts that are diagnosed as organic.

Types of organic cysts and possible methods of their treatment

A dermoid cyst develops slowly, often asymptomatically. It is a fibroepithelial neoplasm or, in other words, a cluster of undeveloped embryonic tissues – hair follicles, cartilage tissue, fat or skin. Such an ovarian cyst is treated only by surgery. The dermoid can become purulent, then during surgery the cystic formation is opened, the purulent contents are removed and a cavity drainage is installed. Complete removal of the capsule is mandatory, otherwise the dermoid can recur and provoke complications in the form of malignant formations (oncoprocess).

An endometrioid cyst develops due to the growth of tissue from the mucous epithelium of the uterus into the ovaries. Such a cystic formation is often filled with bloody fluid and quickly grows to large sizes. This type of neoplasm is also called "chocolate" because the contents of the cavity in the form of coagulated blood resembles a chocolate shade in color. The standard method of treatment is a gentle laparoscopic surgery, during which the formation is completely excised.

Epithelial neoplasm is a mucinous cystic formation, in the cavity of which there is mucin - a secretory fluid of mucus-like consistency. These multi-chamber cysts often grow to large sizes and are removed only by surgery, since they can become malignant (develop into a tumor).

A serous neoplasm is a cyst with liquid, clear contents, capable of transforming into a malignant tumor. Therefore, its treatment is only surgical. The scope of the surgical operation is determined by the woman's age and the results of the examination. As a rule, women under forty years of age have one ovary removed, during the operation a histological analysis of the formation is performed. If the histology shows the norm, then the resection is carried out within the boundaries of healthy tissue. Older women undergo abdominal radical surgery to remove both ovaries to eliminate the risk of malignancy.

Ovarian Cyst Treatment Schemes

The treatment regimen is directly related to the following factors:

• Clinically manifested symptoms.
• Age of the woman.
• Risk of malignancy (development into a malignant process).
• The need to preserve reproductive function.
• Possible concomitant diseases.

Small functional cystic formations that do not have complications such as suppuration or capsule rupture are treated most often with conservative methods. The use of single-phase or two-phase contraceptives that normalize the functions of the hormonal system is indicated - Janine, Yarina, Novinet and others. Oral medications are prescribed in combination with B vitamins, vitamins A, E, C and K. Homeopathy, physiotherapy procedures, and a strict diet are prescribed as additional therapy. The dynamics of changes in the cyst condition is monitored using ultrasound scanning. In complex cases with suppuration and an increase in size, a functional ovarian cyst is treated only by surgical methods.

All organic cystic formations are subject to surgical removal, primarily laparoscopic. Laparoscopy is indicated in cases where there is no risk of malignancy, i.e., an oncological process is excluded. If cysts develop into malignant, oncological formations, a full laparotomy with histology during surgery is indicated.