Cyst of the right ovary in women: causes, signs, what to do

An ovarian cyst is a benign neoplasm, a cavity containing fluid of different consistency and structure, depending on the cause of the formation and the type of cyst. If the secretory fluid accumulates in the cyst, its size increases and causes clinical symptoms, while small tumors do not provoke discomfort and may remain asymptomatic in the tissues of the ovary for many years.

The ovaries are a paired organ that performs many functions, among which the main and extremely important ones are reproductive and hormonal. Laterality, asymmetry of the ovaries is still being studied and gives grounds for numerous discussions between gynecologists, practitioners and theorists. Some experts are convinced that the right ovary is more active in the sense of follicular activity than the left, therefore it is more vulnerable and susceptible to the development of tumors and cysts of various kinds in it. However, such a statement does not have a scientifically substantiated evidence base, hence the cyst of the right ovary and the left cyst have the same reasons, the pathogenetic mechanism of development, symptoms and methods of treatment.

[1], [2]

Causes of cyst of the right ovary

The etiology, causes of cyst of the right ovary can be varied and depend on many external and internal factors. It should be noted that even with the presence of modern methods, technologies and a fairly large statistical base, the etiology of the formation of mildew (benign ovarian formations) is still not clear. There are several hypotheses generally accepted by the world medical community, among which the theory of hormonal changes is the most popular. According to this version, the causes of cyst of the right ovary, including the left one, are in violation of the balance of LH (luteinizing peptide hormone), FSH (follicle-stimulating hormone), that is, pituitary hormones. Accordingly, a possible cause of cystic formations can be chronic stress, nervous tension or exhaustion.

It is believed that functional cysts are formed due to abnormal ovulation, and other types of tumors may be the result of chronic hormonal disruption and ovarian dysfunction.

In addition, it is customary to distinguish the following factors provoking a cyst: 

• Inflammatory processes in the uterus, fallopian tubes.
• Sexually transmitted diseases, STDs (sexually transmitted diseases).
• 35-40% of cysts are formed after abortion.
• Causes of a cyst of the right ovary may be associated with a malfunction of the thyroid gland (hypothyroidism).
• Disorders of the menstrual cycle.
• Disruption of metabolism, overweight (obesity) or underweight (anorexia).

Symptoms of cyst of the right ovary

Signs and symptoms of a cyst of the right ovary may not appear if the tumor is functional in nature and does not exceed 2–3 centimeters in size. In the case of persistent hormonal disorders, gynecological diseases, inflammations and other pathological factors, the cyst may increase, suppress and provoke the following symptoms:

Uncomplicated cyst:

• Transient pain in the lower abdomen.
• Feeling of heaviness in the abdomen.
• Disruption of the menstrual cycle - a delay, absence, a long or too short cycle.
• Lower abdominal pain with intense physical exertion.
• Pain in the lower abdomen or in the right side during sexual contact, after it.
• Pain after urination.
• Low-grade body temperature without any other objective reasons.
• Periodic discharge with blood.

Complications, aggravations of the cyst formation process: 

• Sudden increase in body temperature.
• Sharp pain in the abdomen.
• Nausea, vomiting.
• Dizziness, weakness.
• Atypical vaginal discharge.
• Tense abdominal muscles.
• An increase in the abdomen without objective reasons.
• Drop in blood pressure, tachycardia.
• Disturbed urination (frequent urge, poor emptying).
• Constipation.
• Asymmetry of the abdomen.

It should be noted that hormone-dependent cysts provoke irregularities in the menstrual regimen, a cycle in which menstruation can go in violation of the schedule and be scarce, excessively abundant or completely absent.

Cyst of the right ovary: if there is no menstruation?

Disruption of the menstrual cycle can trigger hormone-dependent cysts - these are follicular and cysts of the corpus luteum.

If the gynecologist suspects that a woman develops a cyst of the right ovary, no periods, according to the complaints, then the possibility of luteal education, which often develops in early pregnancy, should be excluded. In the process of carrying a fetus, the hormonal system in the female body begins to work differently, estrogen is produced in a smaller amount, and progesterone requires much more to consolidate and maintain the pregnancy. The active ovary from which the dominant follicle is released must function more intensively, which often leads to the development of a cyst on it. The luteal cyst of the right ovary is considered functional and, as a rule, is self-absorbed at the 12-14th week of pregnancy. This is due to the fact that the necessary progesterone begins to produce no longer an ovary, it accumulates in the placenta. If another cyst of the right ovary is diagnosed, there is no menstruation, that is, pregnancy has begun, but without a preserved yellow body, then there is a threat of interruption of gestation, spontaneous miscarriage. In addition, a cyst of another type, non-functional, in a pregnant woman can be a serious danger to both the development of the fetus and the health of the mother herself.

Also, a corpus luteum cyst can cause other menstrual disorders. In addition to the absence, menstruation causes minor pain in the lower abdomen, and may lose the rhythm. For an accurate diagnosis, to exclude an ectopic pregnancy or more serious pathologies of the pelvic organs, in addition to ultrasound, blood tests for chorionic gonadotropin are required.

Cyst of the right ovary during pregnancy

Most often, pregnant women are diagnosed with a corpus luteum cyst, if a follicular cyst appears to be in custody, this is most likely an annoying mistake, since this type of neoplasm cannot develop in principle when conception has already taken place. Both prolactin and the fertilization mechanism of the active follicle interfere with this.

A cyst of the right ovary during pregnancy is explained by the fact that the duration of the activity of the corpus luteum increases from two weeks to three months, right up until the formation of the placenta. A woman needs much more progesterone to fix and preserve the fetus, this function is assumed by the yellow body, working more intensively and more actively. In such a situation, the corpus luteum can transform into a cyst-shaped cavity, which in the second trimester is resolved independently and does not cause discomfort for the expectant mother.

All other types of neoplasms, such as a dermoid cyst of the right ovary during pregnancy, endometriosis or paraovarial, are subject to systematic observation. If the cyst does not interfere with the course of pregnancy and does not provoke functional disturbances in the woman’s body, it is not touched, but removal in any case is necessary, after delivery or during them during caesarean section.

A large cyst or neoplasm due to the proliferation of endometrial tissue - an endometrioid cyst, a more serious tumor - cystadenoma require frequent ultrasound tests as complications are possible - torsion of the cyst legs, rupture of its capsules, hemorrhage into the peritoneum.. In addition, a large cyst of the right ovary is often causes symptoms similar to signs of appendicitis, therefore, at the earliest opportunity, the neoplasm is removed by the laparoscopic method. The optimal time for a planned cyst surgery for a pregnant woman is the second trimester.

Cyst of the corpus luteum of the right ovary

Cystic corpus luteum or luteal cyst is considered a functional neoplasm, which is formed from a bursting, ovulated follicle. When the follicle is ruptured, blood is resorbed (resolved) and loses its typical color, it acquires a yellowish tint, just like with a hematoma - a bruise, from red to yellow, bypassing blue and green. The formation of the corpus luteum is a temporary gland, which is designed to adapt the body to a possible conception. If it does not occur, the corpus luteum regresses after 2 weeks, but may continue to be filled with fluid due to disturbances in the functioning of the hormonal system or pregnancy.

The cyst of the corpus luteum of the right ovary, like the left, is always one-sided, located in the direction of the abdominal wall and, as a rule, small in size. The contents of the cyst are liquor serosus (serous fluid), often mixed with blood (hemorrhagic fluid). Such cysts are practically safe and in 90% of cases they tend to self-resorption during two menstrual cycles. The danger of luteal cyst lies in the potential for hemorrhage into the peritoneum, 20-27th days of the monthly cycle are especially critical in this sense.

Usually, the cyst of the corpus luteum of the right ovary is asymptomatic, if it is detected on an ultrasound, the doctor chooses a waiting tactic, that is, observation. Rupture of a cyst requires emergency measures - surgery. It should be noted that a luteal cyst is diagnosed as such; if its dimensions exceed 2.5-3 centimeters, all new growths of a similar structure of a smaller size are defined as the corpus luteum itself.

[3], [4], [5]

Follicular cyst of the right ovary

The follicular cyst of the right ovary is the most common type of mildew (benign ovarian tumors), according to statistics follicular formation occurs in 83-85% of cases among all cystic tumors in women.

This type of cyst is considered benign in 99%, besides follicular cysts almost always resolve themselves without medication.

A follicular cyst of the right ovary is formed as a result of abnormal ovulation of the most active follicle. It does not burst, does not release the oocyte (ovum) and begins to overflow with fluid, growing in this process from 2 to 15 centimeters in diameter. Follicular cysts can persist in the ovaries for many periods of the menstrual cycle, almost asymptomatic, provided that the size of the tumor does not exceed 3 centimeters.

The true causes of the appearance of follicular cysts are not clear, but gynecologists claim that in this way the ovary responds to the failure of the hormonal system, as well as to a possible inflammatory process in the pelvic organs. Also in gynecological practice there is an opinion that the right ovary is anatomically somewhat more left and participates much more actively in ovulation, therefore, it is more susceptible to cystic formations. Therefore, according to unconfirmed research data, it is the most common follicular cystic formation, in the left it is diagnosed 15-20% less.

Diagnosis of follicular cystic formations occurs, as a rule, during medical examination, gynecological examination, aimed at identifying a completely different pathology and whether the condition.

Statistics of the development of follicular cyst: 

• Cysts up to 5-6 centimeters in diameter are resolved independently over a period of 2–3 months, during which they are subject to regular control with the help of examinations and ultrasound.
• Self-resorption during the first menstrual cycle occurs in 25% of women.
• Follicular cyst resolves after 2 cycles in 35% of women.
• Resorption of a cyst after 3 menstrual cycles occurs in 40-45% of cases.

If after 4 months the follicular neoplasm continues to persist, but does not grow, the doctor decides on treatment with hormonal oral contraceptives. If the cyst grows more than 6-7 centimeters, it is recommended to remove it in order to avoid torsion of the leg, which in cysts of this type is long and prone to mobility. During the operation, the cyst is husked, the walls are sutured, partial resection of the ovary is possible. Treatment of follicular cyst operatively is most often carried out using laparoscopy, that is, the surgeon does not resort to a large abdominal incision.

Endometrioid cyst of the right ovary

Endometrioid cyst of the right ovary is most often formed in a pathological combination with endometriosis - the main disease provoking the cyst.

Cystic formation of this type is the germination in the ovarian tissue of transported endometrial cells. The endometrium implanted into the ovary goes through all the stages of the monthly cycle, including the release of blood. During an abnormal development, adhesions of the ovary itself with the adjacent abdominal wall tissue and surrounding organs may form. As a rule, in the initial stage, endometrioid cysts develop asymptomatically, slowly, if temporary, transient pains occur in the lower abdomen, this indicates a possible adhesive process due to constant leakage of the cyst contents into the peritoneum.

The pain most often radiates to the rectum, less frequently to the perineum, and is acute but quickly transient. Also, an endometrioid cyst of the right ovary can be large in size, when a permanent hemorrhage from the primary endometriotic focus forms a cavity with dark, thick blood. Such cysts are called "chocolate" because their contents really resemble dark chocolate in color. In addition, symptoms of endometriotic growth in the form of a cyst can be such signs: 

• Subfebrile body temperature against the background of periodic radiating lower abdominal pain.
• Increased pain at the beginning of the monthly cycle.
• Clinical symptoms of "acute abdomen" at rupture of a cyst capsule and hemorrhage into the peritoneum.

Endometrioid cyst is treated surgically, and hormonal preparations are also included in the complex of therapeutic measures. In the process of surgery, the cyst is removed, coagulation of endometrial foci in the abdominal cavity, ligaments and fallopian tubes is performed. Hormone therapy is aimed at restoring the normal interaction of the pituitary and ovaries. The prognosis for timely and adequate complex treatment is favorable.

[6], [7], [8]

Paraovarian cyst of the right ovary

Paraovarian cysts are one of the varieties of retention formations, that is, those that are formed against the background of the inflammatory process in the pelvic organs.

The paraovarian cyst of the right ovary is a cyst that develops next to the fallopian tube or ovary, its difference is the fact that it is not attached to the tissues. Such a neoplasm always has a small size (rarely up to 2 centimeters), it is formed from embryological or remaining, "unused" eggs. Paraovarian cyst is completely unsafe and persists without any clinical manifestations. Most often, it is detected during medical examination, on a gynecological examination or on an ultrasound scan at random.

Symptomatology can manifest when a paraovarial cyst of the right ovary begins to thrive and reaches a large diameter, squeezing the fallopian tube, intestines or pushing the ovary, bladder. Such cases in gynecological practice are extremely rare and are a sign of multiple chronic pathology of the pelvic organs. As a rule, paraovarial formations are treated using surgical laparoscopy to minimize the risk of adhesions and further infertility. Unlike a follicular cyst, paraovarial is not capable of self-dissolving or diminishing, therefore enucleation and dissection of the leaf connecting the cyst and nearby organs is inevitable.

[9]

Cyst of the right ovary functional

If a woman is diagnosed with a cyst of the right ovary, it is functional or inflammatory, non-functional, determined by the doctor with an ultrasound scan and additional examinations — a blood test for LH and FSH, a biochemical study and histology.

The functional category includes uncomplicated follicular and luteal cysts (corpus luteum cyst), which are formed as a result of impaired ovulation or changes in hormonal balance.

Unlike other types of MILF (benign ovarian tumors), a simple cyst of the right ovary, functional - follicular or luteal, is generally considered safe, since it is almost never malignant. However, just like other cysts, functional ones can be complicated by suppuration, rupture of a capsule, or twisted legs.

A large or complicated functional cyst provokes the following symptoms: 

• Lower right abdominal pain, often similar to the clinic inflammation of the appendix.
• Violation of the monthly cycle - mode, schedule.
• Periodic vaginal discharge, often with blood.
• Increased body temperature.
• Pain during sexual contact.
• Clinic "acute abdomen" at rupture of the capsule, twist the legs or hemorrhage into the abdominal cavity.

Treatment of functional cysts, as a rule, consists in dynamic observation, since such neoplasms tend to resolve themselves. Complicated situations require surgical intervention, including emergency. The prognosis for timely detection and seeking medical assistance is favorable in 95% of cases.

[10]

Retention cyst of the right ovary

Retention cyst (from Latin - retentio, preserve, delay) - this is a neoplasm that is formed when fluid accumulates in the secretory cavity, organ. A retentional cyst of the right ovary can be either congenital or acquired as a result of splicing, adhesions of the surrounding walls, glands.

The pathogenetic mechanism of the formation of a true, retention cyst is as follows: 

• As a result of the pathological process, the gland (duct) is blocked, most often by the condensed secret itself.
• The blockage of the duct can also be caused by pressure on it from the side of the tumor.
• Accumulated, unseparated fluid stretches the cavity and forms a cyst.

A retentional cyst of the right ovary is a follicular or luteal cyst, which are diagnosed, as a rule, in a random way, since they tend to persist for a long time asymptomatically. Most often, a retention cyst is one-sided and its symptoms manifest in the case when the tumor grows in size. Treatment in 50% of diagnosed retention cysts is not required, complications such as torsion of the legs, suppuration of a large cyst, the potential risk of its rupture dictates the need for surgical intervention.

The prognosis for treatment of retention tumors is favorable, such cysts never transform into malignant ovarian tumors.

[11]

Hemorrhagic cyst of the right ovary

When a hemorrhagic cyst of the right ovary is diagnosed, confusion may occur in the definition of education, in terminology. Hemorrhagic can be considered any cyst in principle, since all types of cysts are prone to bleeding, hemorrhage due to its structure. However, most often potential hemorrhagic cysts are functional entities, that is, cysts of the corpus luteum or follicular cyst.

Сorpus hemorrhagicum - hemorrhagic cyst of the right ovary is much more common than the left-sided, most likely this is due to its more intensive blood supply. The right ovary is directly connected to the important, central aorta, and the left is supplied through the renal artery, that is, more slowly.

Ovarian haemorrhage develops in two stages: 

• Ovarian hyperemia.
• Hemorrhage.

In the clinical sense, bleeding is more dangerous, which can be limited - only in the follicle, in the corpus luteum or widespread, diffuse - in the ovarian tissue with leakage into the peritoneum.

Hemorrhagic cyst of the right ovary most often develops in the middle of the period between menstruation and depends on the timing of the follicle rupture. Local hemorrhage into the cavity of the cyst is considered more favorable than diffuse, which can occur against the background of persistent hyperemia, thinning the cyst capsule. Also a factor causing diffuse hemorrhage into the peritoneum can be excessive exercise, weight lifting, active sexual contact, fibromyoma.

According to statistics, hemorrhage is more often diagnosed in the right ovary, due to its vascular architectonics.

If a hemorrhagic cyst ruptures, an anemic form of apoplexy may develop when surgery becomes unavoidable. If the cyst is small, and the symptoms of hemorrhage inside are just beginning to manifest, conservative treatment is possible.

[12]

Dermoid cyst of the right ovary

The dermoid cyst of the right ovary is a congenital neoplasm, which is formed in utero as a result of pathological embryogenesis. Dermoid, unlike other types of cysts, contains cells of all three germinal layers in various combinations. Such cysts are considered benign, but they are not able to dissolve as follicular, since the elements of bone, cartilage, adipose tissue, hair, particles of teeth, skin flakes do not dissolve in principle. The dermoid cyst of the right ovary is diagnosed as often as the dermoid of the left ovary; laterality in this type of neoplasm is not statistically noted. The etiology of dermoid formations has not yet been clarified, there is a version concerning the genetic factor, and the hypothesis about the pathological influence of bad habits, inflammations, venereal diseases on normal embryogenesis is also accepted.

Dermoid can persist in the ovary for many years without any clinical symptoms. About 3 percent of dermoid cysts are prone to malignancy, so they are removed at the first opportunity.

[13], [14]

Cyst on the right ovary: is there any cause for concern?

Benign cysts are the most common among all ovarian tumor formations. A cyst on the right ovary, just as all types of cysts are classified in a certain way, depending on the structure of the capsule and the composition of the contents of the cavity:

1. Functional, that is, such that is formed in the tissue of the ovary as a result of its functional cyclic activity. Functional cysts are follicular and luteal cysts (cysts of the corpus luteum). Most often, the follicular cyst of the right ovary, the corpus luteum cyst is formed in the body of women of childbearing age and develops asymptomatically; in the process of ovulation and the monthly cycle, such cysts are able to self-destruct without a trace. Follicular or cyst of the corpus luteum is located laterally or in front of the uterus.
2. A non-functional cyst is a dermoid, paraovarial, mucinous, endometrioid, serous cyst. These neoplasms develop as a result of genetic changes, as well as due to pathological processes occurring in the pelvic organs.

In addition, the cyst of the right ovary, like the tumor of the left, is classified according to the following features: 

Amount: 

• Single, solitary cyst.
• Multiple ovarian cysts.

On the development and course of the process: 

• Uncomplicated, simple.
• Complicated (purulent, with twisted legs).

By etiology, origin: 

• Follicular - as a result of ovulation.
• Luteal - reverse development (regression) of the corpus luteum.
• A dermoid cyst is a neoplasm from embryonic germ cells (leaflets).
• Paraovarial - a cyst that forms from an appendage above the ovary.
• Endometrioid - proliferation of endometrial tissue into ovarian tissue.

In fact, the classification of ovarian neoplasms, to which the cyst of the right ovary belongs, is more extensive and expanded, it includes an enumeration of both benign and malignant tumors. In gynecological practice, WHO uses the definitions proposed at the end of the last century, but which have not lost their relevance and importance until now.

Consequences of a cyst of the right ovary

Complications and consequences of untimely diagnosed or untreated cysts can be quite serious. The main reason for the occurrence of complications is self-treatment with the help of the so-called alternative methods, as well as the unwillingness to undergo regular dispensary gynecological examinations.

Gynecologists call the following effects of a cyst of the right ovary: 

• The risk of malignancy of certain types of cysts - dermoid, endometrioid, mucinous cysts.
• Twisting the legs of a cyst, follicular cysts are especially prone to such consequences. Necrotizing the tissues of the ovary, its apoplexy, further infertility due to adhesions - this is far from an exhaustive list of the risk of torsion of the cyst legs.
• Suppuration of the cyst, inflammation of the pelvic organs.
• Rupture of a large cyst capsule, secretion of cyst contents into the peritoneum, inflammation, suppuration. Most often, a cyst of the right ovary is exposed to this complication, the consequences can be extremely unfavorable.
• Bleeding into the abdominal cavity, peritonitis.
• Cyst enlargement leads to disruption of the functioning of nearby organs.
• Persistent infertility.

[15]

Rupture cyst of the right ovary

According to statistics, the rupture of a cyst of the right ovary exceeds the neoplastic apoplexy in the left ovary, this is due to the specific features of the blood supply. The right ovary, in addition to being more active, is much more intensive, is supplied with blood from the main aorta more quickly, it connects directly with the vessels of the ovary.

The risk of cyst rupture exists with such provoking factors: 

• A sharp increase in cysts in size.
• Abdominal trauma - fall, blow.
• Active, overly intense sexual contact.
• Active sports training.
• Physical exhaustion.
• Weight lifting
• The combination of the above factors with a concomitant inflammatory disease.

Hemorrhage during apoplexy can be either internal, into the cyst cavity, or directly into the abdominal cavity, or external through the vagina.

Most often, apoplexy, rupture of a cyst of the right ovary is accompanied by internal bleeding - into the peritoneum, which causes a typical picture of the "acute abdomen" and requires immediate surgical intervention.

• Symptoms of bleeding: 
• Sharp pain spreading all over the abdomen.
• Pain radiates to the perineum, into the rectum.
• The pain is often similar to the symptoms of appendicitis.
• Drop in blood pressure.
• Pale skin.
• Symptoms of anemia - cyanosis, dizziness, nausea, fainting, cold sweat.

Treatment of apoplexy is only surgical, during which blood is removed (aspirated), fluid from the abdominal cavity, washed and drained. In parallel, the cyst is also removed. As a rule, the operation is performed using laparoscopy, but the technique can also depend on the patient's condition, the size and structure of the cyst. With timely assistance provided, the prognosis is favorable, moreover, all functions - fertility, reproduction, are restored. If the operation is performed as complete, cavitary and the ovary is completely removed, the risk of infertility or difficulty in conceiving is possible.

[16]

Cyst of the right ovary with hemorrhage

The cyst of the right ovary, hemorrhagic, with hemorrhage in symptomatology and pathogenesis differs little from the apoplexy of the entire ovary. Moreover, in the diagnostic criteria there are no specific differences between hemorrhage of the cyst and "AJ" - ovarian apoplexy. Thus, ovarian hematoma, cyst apoplexy, ovarian infarction, cyst rupture are practically synonyms that combine the following process steps: 

• Dystrophic changes in the tissues of the ovary and cysts.
• Inflammatory processes in the pelvic organs.
• Fragility of blood vessels, changes in the structure of the tissue of the capsule cyst.
• Filling the cyst with liquid, magnification.
• Squeezing by nearby organs.
• Injury or physical strain.
• Capsule rupture.

The cyst of the right ovary with hemorrhage develops in three directions: 

Pain form without clinic hemorrhage into the abdominal cavity: 

• Abdominal pain dull, transient.
• Dizziness, nausea for a week or more.
• Drop in blood pressure.

Anemia as a symptom of bleeding in the peritoneum: 

• Tachycardia.
• Drop in blood pressure.
• Cyanose.
• Weakness.
• Chill, cold sweat.
• Vomiting - once.
• Dryness of the oral mucosa.
• Dull pains all over the abdomen.
• Chance of fainting.

[17]

Mixed form

Diagnosing a cyst with hemorrhage can be difficult because the clinical symptoms are very similar to the signs of inflammation of the abdominal organs. As a rule, patients are transported to the hospital with a preliminary conclusion - “acute abdomen”, the diagnosis is already specified on the spot, often during surgery. Conservative treatment even in the case of suspicion of a mild form of hemorrhage is ineffective, since in 90% of cases there are relapses.

[18]

Diagnosis of cyst of the right ovary

Diagnostic measures for suspected cyst of the right ovary: 

• Collection of anamnestic information, including hereditary, family information.
• Refinement of subjective complaints in the sense of localization, nature, frequency of pain.
• Bimanual inspection.
• Ultrasound - transabdominal, transvaginal - echoscopic picture of the state of the pelvic organs and the abdominal cavity, including tumors.
• Vaginal fornix may be punctured to determine if there is blood in the peritoneum.
• Diagnostic laparoscopy, during which direct removal of a cyst is possible.
• OAK - complete blood count, blood biochemistry.
• Blood on CA-125 (tumor markers).
• Determination of LH and FSH - hormones.
• Computed tomography to determine the structure of the capsule, the contents of the cyst, the presence of adhesions and relationships with nearby organs.
• Exclusion or confirmation of a possible pregnancy.

Diagnosis of a cyst of the right ovary depends on the type of neoplasm, the period, the period of its development and the timeliness of seeking help. As a rule, complex diagnostic measures are carried out on an outpatient basis, urgent cito-diagnostics is indicated in emergency cases, when there are complications - rupture of a cyst, torsion of the legs, ovarian apoplexy.

Echo signs of cyst of the right ovary

Ultrasound is the most informative method for detecting cystic tumors, as a rule, accurate conclusions can be made with transvaginal examination. The accuracy of this method reaches 90%.

Most often in women, at the clinical examination, follicular cysts are detected. The norm of the follicle in the ovary, which are visualized on ultrasound, is from one millimeter to 30 millimeters. Any follicle over 30 mm can be diagnosed as a functional cyst.

Ultrasonography identifies such cysts depending on the structure of the capsule, the color of the contents: 

• Functional cysts - follicular and luteal.
• Endometrial cyst.
• Teratoma, dermoid cyst.
• Cystadenoma.

The echo signs of a cyst of the right ovary or signs of a neoplasm of the left ovary do not differ from each other and are a dark, anechoic mass with a rather thin capsule wall. The structure and composition of the contents can be different - both homogeneous and multi-layered - in dermoids.

• In addition, the following parameters can be differential echo signs of a cyst: 
• Clear contour (unlike the contour of the tumor).
• Anechogenicity within solid tumors due to possible hemorrhage into the cavity.
• Smooth round shape.
• The effect of pseudo amplification.
• Clear connection of the cyst with ovarian tissue.
• Increased echogenicity in the back wall may indicate a multicameral cyst.
• Cysts located behind the uterus or behind the bladder are poorly visualized by ultrasound.
• Dermoids have good echogenicity and are defined as solid cysts. It is also important to investigate the dermoid tubercle, which is a specific feature that allows you to separate the dermoid from the endometrioid cyst. The tubercle is more round and has a high echogenicity. This type of cyst requires additional radiography to clarify the nature of the contents.
• Endometrioid cysts, which are located laterally or behind the uterus, have medium or increased echogenicity. In such cysts, the double contour of the capsule is visible, the contents are visualized as a fine suspension.

A detailed diagnosis is carried out with the help of histology, since echo-signs of a cyst of the right ovary are not always specific.

[19], [20]

Cyst of the right ovary 5 cm

The method of treating it most often depends on the size of the cyst, it can be a wait-and-see tactic using dynamic observation control, or conservative treatment with medications, and surgical intervention to remove the cyst is possible.

A cyst of the right ovary 5 cm can pass on its own if it is a follicular cyst. If a woman is diagnosed with a dermoid (mature teratoma) of this size, the removal of a cyst is unavoidable, since a dermoid cyst is not capable of self-resorption due to its specific structure - embryonic tissues.

If a woman is diagnosed with a cyst of the right ovary 5 cm, treatment depending on the species can be as follows: 

• Follicular cyst of more than 5 centimeters is dangerous torsion of the leg, which in such cysts is longer than in other types of neoplasms. In addition, a cyst of 5-6 centimeters is prone to ruptures, so it should be treated. Unlike the smaller follicular cysts that are to be observed, large cystic formations are treated with oral contraceptives for 2–3 months.
• Cyst of the yellow body to 4-5 centimeters most often develops asymptomatically. The luteal cyst of the right ovary 5 cm is already a rather large cyst that causes discomfort in the form of abdominal pain, pain during sexual contact. Such a cyst is easy to visualize on ultrasound and it is treated by conservative methods.
• Dermoid cyst, as already indicated above, no matter how large it is, requires removal in the nearest favorable period, since all dermoids are prone to malignancy.

In general, a cyst of 5 centimeters is a medium-sized neoplasm, but such cysts can grow, therefore, as a rule, they need not only observation, but also complex treatment. In addition, even with surgical intervention, a five-centimeter cyst of the right ovary is removed using the gentle method - laparoscopy and has a favorable prognosis.

[21], [22], [23]

Dual chamber cyst of the right ovary

The etiology of the formation of two-chamber cysts has not yet been clarified, however, as well as the true reason for the formation of cysts in principle. The generally accepted hypothesis is considered to be a version of the hormonal disorder, and rupture of the interaction between the pituitary and the hormonal system.

The two-chamber cyst of the right ovary is a neoplasm of benign nature, which, unlike typical cysts, consists of two cavities - chambers. Most often, a two-compartment is a paraovarial cyst, which develops as a congenital abnormality, when the cyst is located between the ovary and the fallopian tube and is formed from the appendage tissue. Also, a follicular cyst is sometimes recognized as a two-compartment, although it is more like a diagnostic error when a true functional cyst and an enlarged follicle next to it are recognized as a two-compartment formation. Alternatively, a combination of a true cystic tumor and a functional cyst may also look like a two-chamber structure. In addition, two-chamber formations on ultrasound may look like echogenic structures that are not associated with neoplasms, that is, any ultrasound diagnosis requires further clarification. It should be noted that the two-chamber - this is not polycystic, which is a separate pathology, often leading to persistent infertility.

Treatment of a cyst of the right ovary

Treatment of a cyst of the right ovary is directly related to such factors: 

• The nature and type of cysts.
• The severity of symptoms.
• The age of a woman, her potential desire to conceive and give birth to a child.
• The risk of complications - rupture, suppuration, inflammation and so on.
• Risk of malignancy.
• Concomitant pathology.

Expectant tactics in the form of dynamic observation and control using ultrasound is shown in many functional cysts - follicular, luteal, especially if they are small in size. Larger functional cysts are treated conservatively with the help of hormonal drugs, oral contraceptives. It also shows vitamin intake, homeopathy, diet, physiotherapy, and even a visit to a therapist, as one of the reasons for the formation of cysts is stress, a psycho-emotional disorder.

If there is no result within 2–3 months after conservative therapy, as well as an increase in the cyst and the risk of complications, prompt removal of the cyst within healthy tissues is indicated. The operation is most often performed using a laparoscopic gentle method, after which the woman’s reproductive function is restored within 6-12 months.

Dermoid cyst, paraovarial cyst to be removed, these types of cysts are not able to resolve themselves as well as an endometriotic cyst.

Options for surgery to remove a cyst: 

• Cystectomy or enucleation of a cyst within healthy ovarian tissue. The capsule is to be husked, the walls of the cyst are sclerosed, all functions of the ovary are gradually restored.
• Resection of a part of the ovary when a cyst is removed with a wedge resection is excised together with a part of the ovary.
• Ovariectomy - removal of cysts and ovaries.
• Adnexectomy - removal of cysts, ovaries and appendages. Such operations are shown to women in menopausal age in order to avoid the risk of oncoprocess.
• The sooner an accurate diagnosis is made, the more effective the treatment of a cyst of the right ovary will be.

How to treat a cyst of the right ovary?

How to treat a cyst of the right ovary can only decide the doctor after receiving the results of a comprehensive examination.

Treatment options for cyst of the right ovary: 

• Conservative therapy is indicated if a patient has a follicular cyst of more than 5-6 centimeters. Small functional cysts are subject to observation, as a rule, they resolve themselves without any treatment.
• Cyst of the corpus luteum is also not treated if it is small. Moreover, during pregnancy, such a cyst is considered admissible. However, therapy may be prescribed in the event of an increase in luteal cyst or the risk of its rupture.
• Surgical treatment is suggested if a woman has a dermoid cyst, a mature teratoma. These types of cysts do not dissolve, not amenable to medical treatment. Removing them is not difficult, sparing laparoscopy is performed, complications, as a rule, are not the same as relapses.
• Also, surgical removal of festering cysts, cysts, which increase rapidly and can cause ovarian apoplexy, hemorrhage into the abdominal cavity.
• Gentle operations in which a cyst is removed without resection of the ovary are shown to all women of childbearing age. Patients over the age of 40-45 are likely to be operated on in another embodiment - with a wedge-shaped resection of the ovarian tissue or with its complete removal in order to avoid the risk of possible age-related complications.
• After surgery, a woman is prescribed hormone therapy for 3-6 months to speed up the process of recovery of ovarian function.

In general, the question - how to treat a cyst of the right ovary can be answered only after a series of studies and analyzes. Sometimes such a diagnosis is prescribed 2-3 times to track the dynamics of changes in the state of the cyst and the organism as a whole against the background of several menstrual cycles.