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Ovary cyst

Ovary cyst – opukholevidny formation of an ovary of good-quality character. Represents the cavity on a leg filled with liquid contents and tending to increase in the size due to accumulation of a secret. Distinguish ovary cysts (follicular, cysts of a yellow body, endometrioidny, etc.) and a nadjyaichnikovy appendage (paraovarialny). Often proceeds asymptomatically, it can be shown by discomfort and pain in the bottom of a stomach, violation of menstrual function, dizurichesky frustration (at a bladder sdavleniye). Becomes complicated reabrupt cyst legs, a rupture of the capsule, conducting to a picture of a sharp stomach and peritonitis.

    Ovary cyst

    Ovary cyst – opukholevidny formation of an ovary of good-quality character. Represents the cavity on a leg filled with liquid contents and tending to increase in the size due to accumulation of a secret. Distinguish ovary cysts (follicular, cysts of a yellow body, endometrioidny, etc.) and a nadjyaichnikovy appendage (paraovarialny). Often proceeds asymptomatically, it can be shown by discomfort and pain in the bottom of a stomach, violation of menstrual function, dizurichesky frustration (at a bladder sdavleniye). Becomes complicated reabrupt cyst legs, a rupture of the capsule, conducting to a picture of a sharp stomach and peritonitis.

    The term "cyst" (Greek "kystis" - a bag, a bubble) is used in medicine for designation of pathological cavities in the bodies consisting of the capsule and liquid contents and increasing the size in process of accumulation of a secret. Cysts are the most extended by a type of good-quality educations and can arise practically in all fabrics and bodies: teeth, kidneys, liver, mammary glands, pancreas, thyroid gland, male and female genitals etc.

    Cysts of ovaries are a widespread disease and meet more often at women in the genital period: in 30% of cases they are diagnosed for women with a regular menstrual cycle and in 50% - with broken. In the period of a menopause of a cyst of ovaries occur at 6% of women. Under the concept "ovary cyst" the big group of the opukholevidny new growths differing from each other in a structure, the causes, a current and approaches to treatment disappears.

    General information

    Cysts of ovaries belong to good-quality new growths of fabrics of gland, usually develop is long, their size can vary from several millimeters in the diameter up to 20 and more centimeters.

    Depending on character of an origin of education and its contents distinguish the following types of a cyst of an ovary:

    Follicular cysts and cysts of a yellow body belong to the formations of functional character which are formed in the tissue of an ovary and directly connected with the cyclic changes happening in it. Formation of a follicular cyst happens on the place of an unexploded follicle, and a cyst of a yellow body – on the place of not regressing yellow body of a follicle. Pathological cavities at these types of cysts of an ovary are formed respectively of covers of a follicle and a yellow body. Their emergence is the cornerstone hormonal violations. Usually follicular cyst of an ovary and a cyst of a yellow body do not reach the considerable sizes and can independently disappear in process of a rassasyvaniye in them of a secret and falling off of a cystous cavity.

    Paraovarialny cysts proceed from nadjyaichnikovy appendages without involvement in ovary tissue process. Such cysts of ovaries can reach the huge sizes. Endometrioidny cysts are formed of parts of a mucous uterus (endometrium) at its pathological focal growth on ovaries and other bodies (endometriosis). To contents of endometrioidny cysts of an ovary serve old blood.

    Mutsinozny cysts of ovaries often happen multichamber, they are filled with dense slime (mutsiny) which is produced by an internal mucous membrane of a cyst. Endometrioidny and mutsinozny cysts of ovaries in higher degree are inclined to regeneration in malignant new growths. The dermoidny cysts which are formed of embryonic rudiments belong to congenital cysts of ovaries. They contain fat, hair, bones, cartilages, teeth and other fragments of body tissues.

    Ovary cyst symptoms

    The most part of cysts of ovaries a long time have no the expressed clinical manifestations and often come to light at routine gynecologic inspections. In some cases (increase in the size, the complicated current, hormonal secretion etc.) cysts of ovaries can prove the following symptoms:

    • pains in the lower departments of a stomach

    Pains can arise in connection with possible complications: reabrupt legs, rupture of a cover, bleeding or suppuration of a cyst of an ovary. The constant aching pains are caused by pressure upon the next bodies because of significant increase in a cyst of an ovary in sizes.

    • increase and asymmetry of a stomach

    Increase in a circle of a stomach or its asymmetry can be connected both with the big size of a cyst of an ovary, and with ascites (a liquid congestion in an abdominal cavity).

    • symptoms of a sdavleniye of bodies and vessels

    The growing cyst of an ovary can squeeze a bladder or the lower departments of intestines that is shown by dizurichesky frustration and locks. Sdavleniye of venous vascular bunches can cause varicose change of veins of the lower extremities.

    • violations of a menstrual cycle

    Gormonalno active cysts of ovaries cause violations of a menstrual cycle – irregular, plentiful or long periods, acyclic uterine bleedings. At secretion the organism giperandrogenization which is followed by voice coarsening, growth of hair on a body and a face on men's type (girsutizm), increase in a clitoris can arise tumors of male sex hormones.

    Ovary cyst reasons

    Cysts of ovaries can develop under the influence of a number of the reasons, the most widespread of of which are:

    Complications

    Some types of cysts of ovaries can independently disappear, some demand carrying out a course of anti-inflammatory or hormonal treatment, and in some cases surgical intervention is required to prevent development of terrible complications. The cyst of an ovary constitutes potential danger of an ozlokachestvleniye, the risk of development of cancer of ovary from mutsinozny and endometrioidny cysts is especially high. Therefore for the purpose of the prevention of development of an onkoprotsess the priority in treatment of cysts of an ovary is given them to surgical removal.

    The ovary cyst most often represents mobile education on a leg. Pereknut legs of a cyst is followed by violation of its blood supply, a necrosis and the phenomena of peritonitis (a peritoneum inflammation) that is clinically shown by a picture of "a sharp stomach": sharp belly-aches, temperature increase of a body to 39 °C, vomiting, tension of muscles of a belly wall. It is possible pereknut cysts together with a uterine tube and an ovary. In these cases the emergency surgery during which the issue of the volume of necessary surgery is resolved is required.

    At some types of cysts of ovaries (especially at endometrioidny) the probability of a rupture of the capsule and an izlitiya of contents in an abdominal cavity is high. As other complication of a cyst of an ovary serves infection and suppuration of education. In these cases the emergency surgical actions are also required. Cysts of an ovary can serve as the reason of female infertility or the complicated pregnancy. Endometrioidny cysts of an ovary often cause development of adhesive process in a small basin.

    Advantages of planned surgical treatment of a cyst of an ovary before emergence of emergency situation are obvious. In the solution of a question of volume and access of surgical intervention now the operational gynecology adheres to organ-preserving and low-traumatic techniques. Usually planned operations on removal of a cyst of an ovary are performed by laparoscopic access and whenever possible as much as possible keep fabrics of body.

    Diagnostics

    Diagnosis of a cyst of an ovary is carried out on the basis of the following methods:

    • collecting anamnesis and complaints of the patient
    • the bimanualny (two-handled) gynecologic survey allowing to reveal pathological educations in ovaries, their mobility and morbidity
    • the transabdominal or transvaginal ultrasonic diagnostics giving an ekhoskopichesky picture of a condition of bodies of a small pelvis. Today ultrasonography is the most reliable and safe method of diagnosis of a cyst of an ovary and dynamic observation of its development
    • the puncture of the back arch of a vagina allowing to reveal existence of an exudate or blood in an abdominal cavity (is more often at the complicated ovary cysts)
    • the diagnostic laparoscopy allowing to make also removal of a cyst of an ovary with the subsequent histologic research and final definition of a type of a tumor
    • definitions of an onkomarker of SA-125 in blood which increased maintenance in a menopause always indicates ozlokachestvleny cysts of an ovary. In a reproductive phase its increase is observed also at an inflammation of appendages, endometriosis, simple cysts of an ovary
    • computer or magnetic and resonant tomography (KT or MPT), supplying information on an arrangement, the sizes, structure, contents of a cyst of an ovary and its relation to the prelying bodies
    • the test for pregnancy excluding extra-uterine pregnancy.

    Treatment of a cyst of an ovary

    The choice of tactics of treatment depends on the nature of education, expressiveness of clinical symptoms, age of the patient, need of preservation of reproductive function, risk of development of malignant process. Waiting tactics and conservative treatment are possible at functional character and the uncomplicated course of a cyst of an ovary. In these cases reception of monophase or two-phase oral contraceptives during 2-3 menstrual cycles, a rate of vitamins A, B1, B6, E, C, K, homeopathic treatment is usually appointed.

    Of cases the dietotherapy, remedial gymnastics, acupuncture, treatment are shown to Vryada by mineral waters (balneoterapiya). In the absence of positive effect from conservative therapy or at increase in the sizes of a cyst of an ovary surgical intervention – removal of education within healthy tissues of an ovary and its histologic research is shown.

    In recent years in surgical treatment of cysts of ovaries the laparoscopic method is widely applied. The laparoscopy usually is not applied if it is authentically known of a process zlokachestvennost in ovaries. In this case the expanded laparotomy (band operation) with the emergency histologic research of a tumor is carried out.

    At cysts of ovaries the following types of operations are carried out:

    • Kistektomiya removal of a cyst and preservation of healthy perspective tissue of ovary. At the same time the capsule of a cyst of an ovary vylushchivatsya from the bed with carrying out a careful hemostasis. Tissues of an ovary remain, and after restoration the body continues to function normally.
    • Wedge-shaped resection of an ovary – excision of a cyst of an ovary together with surrounding fabric.
    • Removal of all ovary (ooforektomiya), is frequent together with a tubektomiya (i.e. full removal of appendages - an adneksektomiya).
    • Ovary tissue biopsy. It is carried out for ovary tissue material capture on a histologic research at suspicion of a cancer tumor.

    Dermoidny, mutsinozny, endometrioidny cysts of ovaries are subject only to surgical removal. It is also necessary to remove an ovary cyst before the planned pregnancy because of high risk of a perekrut of her leg or increase in a tumor in sizes. Early diagnosis of a cyst of an ovary and planned surgery allow to reduce significantly the surgery volume, terms of recovery and to avoid terrible consequences of a disease.

    At ovary cysts at young age when it is necessary to keep reproductive function, the kistektomiya or a resection of body with preservation of the healthy not changed fabrics is carried out. In the climacteric period for the purpose of prevention of oncological processes removal of a uterus with appendages - an expanded hysterectomy (pan-hysterectomy) is made. After surgical removal of a cyst of an ovary the course of recovery treatment is appointed.

    In order to avoid risk of emergence of complications, for preservation of reproductive function of a cyst of ovaries it is necessary to diagnose and treat in due time. It is possible only at the competent, conscious attitude towards the health and regular (2 times a year) to routine inspections of the gynecologist.

    Forecast

    Cysts of ovaries of functional character can repeatedly be formed during life until menstrual function remains. Correctly picked up hormonal therapy allows to avoid a recurrence.

    Perhaps also renewal of endometrioidny cysts of ovaries, however it depends on correctly performed operation and further treatment. Remote dermoidny cysts of ovaries anew are not formed. After removal or conservative treatment of a cyst of an ovary pregnancy approach is possible.

    Ovary cyst - treatment

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