Benign tumors of ovaries
Benign tumors of ovaries – group of the pathological additional educations of ovarialny fabric resulting from violation of processes of cellular proliferation and a differentiation. Development of a benign tumor of an ovary can be followed by belly-aches, violation of menstrual and reproductive functions, a dizuriya, disorder of defecation, increase in the sizes of a stomach. Diagnosis of benign tumors of ovaries is based on data of a vaginal research, ultrasonography, definition of tumoral markers, MRT, laparoscopy, etc. researches. Treatment of tumors of ovaries quick for restoration of specific women's functions and an exception of a malignization.
Benign tumors of ovaries
Benign tumors of ovaries are a burning issue of gynecology as quite often develop at women of childbearing age, causing decrease in reproductive potential. Among all formations of ovaries benign tumors make about 80%, however many of them are inclined to a malignization. Timely detection and removal of ovarialny tumors is extremely urgent in respect of prevention of ovarian cancer.
Reasons of development of benign tumors of ovaries
The question of causality of benign tumors of ovaries remains debatable. Various theories consider the hormonal, virus, genetic nature of ovarialny tumors as the etiologichesky moments. It is considered that precedes development of benign tumors of ovaries the condition of a giperestrogeniya causing diffusion and then both a focal giperplaziya and proliferation of cages. In development of germinogenny educations and tumors of a sexual tyazh embryonic violations play a role.
Women with a high infectious index and a premorbidny background treat risk groups on development of benign tumors of ovaries; late menarche and violation of formation of menstrual function; early climax; frequent inflammations of ovaries and appendages of a uterus (ooforitama, adneksitama), primary infertility, myoma of a uterus, primary amenorey, abortions. Benign tumors of ovaries are quite often associated with hereditary endokrinopatiya – diabetes, diseases of a thyroid gland, a carriage of VPCh and a virus of herpes of the II type.
Classification of benign tumors of ovaries
According to kliniko-morphological classification of benign tumors of ovaries allocate:
- epitelialny tumors (superficial epitelialnostromalny). Benign tumors of ovaries of epitelialny type are presented serous, mutsinozny, endometrioidny, by the light-cellular (mezonefroidny), mixed epitelialny tumors and Brenner's tumors. Most often among them the operational gynecology faces with tsistadenomy and adenoma.
- tumors of a sexual tyazh and stromalny. A main type of stromalny tumors is ovary fibroma.
- germinogenny tumors. Teratoma, dermoidny cysts, etc. are among germinogenny tumors.
On the basis of hormonal activity differentiate gormonalno inactive and gormonprodutsiruyushchy benign tumors of ovaries. The last of them can be feminizing and veriliziruyushchy.
Symptoms of benign tumors of ovaries
To early and rather constant symptoms of benign tumors of ovaries treat pulling, mainly unilateral pain with localization in the bottom of a stomach, not connected with periods. The pollakiuriya and a meteorizm as a result of the tumor pressure upon a bladder and intestines can be observed. On this background of the patient quite often note increase in the sizes of a stomach.
In process of the growth benign tumors of ovaries usually form a leg which part artery ligaments, lymphatic vessels, nerves are. In this regard quite often the clinic demonstrates from symptoms of the sharp stomach caused reabrupt tumor legs, a sdavleniye of vessels, ischemia and a necrosis. At a quarter of patients with benign tumors of ovaries violation of a menstrual cycle, infertility is observed. At fibromas of ovaries anemia, ascites and which regress after removal of tumors can develop.
The feminizing tumors promote premature puberty of girls, an endometrium giperplaziya, dysfunctional uterine bleedings at reproductive age, to bloody allocations in a postmenopause. Viriliziruyushchy benign tumors of ovaries are followed by masculinization signs: amenorey, hypotrophy of mammary glands, infertility, voice coarsening, girsutizm, clitoris hypertrophy, baldness.
Diagnosis of benign tumors of ovaries
Benign tumors of ovaries are distinguished taking into account the given the anamnesis and tool inspections. At a gynecologic research existence of a tumor, its localization, size, a consistence, mobility, sensitivity, character of a surface, relationship with bodies of a small pelvis is defined. Carrying out a rektovaginalny research allows to exclude germination of a tumor in adjacent bodies.
Transabdominal ultrasonography and transvaginal ekhografiya in 96% of cases allow to differentiate benign tumors of ovaries from myoma of a uterus, inflammatory processes in appendages. In atypical cases carrying out a computer and/or magnetic and resonant tomography is shown.
At detection of any tumoral processes in ovaries definition of tumoral markers is made (SA-19-9, SA-125, etc.). At violations of a menstrual cycle or post-menopausal bleedings resort to carrying out a separate diagnostic scraping and hysteroscopy. For an exception of metastatic tumors in ovaries according to indications gastroscopy, a tsistoskopiya, excretory urography, an irrigoskopiya, a kolonoskopiya, a rektoromanoskopiya are carried out.
The diagnostic laparoscopy at benign tumors of ovaries has 100% diagnostic accuracy and quite often develops into medical. True benign tumors of ovaries differentiate with retentsionny cysts of ovaries (the last usually disappear during 1-3 menstrual cycles independently or after appointment the COOK).
Treatment of benign tumors of ovaries
Detection of a benign tumor of an ovary is the unambiguous indication to its removal. Surgical tactics concerning benign tumors of ovaries is defined by age, the reproductive status of the woman and gistotipy educations. Usually intervention consists the affected ovary (ooforektomiya) or an adneksektomiya at a distance. At patients of reproductive age performance of a wedge-shaped resection of an ovary with the emergency histologic diagnostics and audit of other ovary is admissible.
In a perimenopauza, and also at bilateral localization of benign tumors of ovaries or suspicion on their malignization removal of appendages is made together with removal of a uterus (pan-hysterectomy). Access of the choice at benign tumors of ovaries is now the laparoscopic, allowing to reduce operational trauma, risk of development of adhesive process and a thrombembolia, to accelerate rehabilitation and to improve the reproductive forecast.
Prevention of benign tumors of ovaries
It is proved that long reception monophase the COOK possesses preventive action concerning benign tumors of ovaries. For an exception of undesirable hormonal changes, it is important that selection of contraception was carried out only by the specialist gynecologist. Besides, it is noted that at patients with the realized generative function, benign tumors of ovaries develop less often. Therefore termination of pregnancy, in particular the first is not strongly recommended women.
It is also known that the women who transferred a hysterectomy or bandaging of uterine tubes have smaller risks of development of tumors of ovaries though this protective mechanism remains obscure. A certain value in prevention of benign tumors of ovaries is allocated for the sufficient use of vegetable cellulose, selenium and vitamin A. As measures of screening of benign tumors of ovaries allocate regular gynecologic surveys and ultrasonography of a small pelvis.