What are the different types of ovarian cysts. How can you recognize the symptoms of a ruptured cyst. When should you seek emergency medical care for an ovarian cyst.

Understanding Ovarian Cysts: Types and Formation

Ovarian cysts are fluid-filled or tissue-filled sacs that develop in or on the ovaries. They are extremely common, particularly in women of reproductive age. While most ovarian cysts are benign and resolve on their own without causing symptoms, some types can lead to complications if they rupture or grow large.

There are two main categories of ovarian cysts:

1. Functional (physiologic) cysts: These form as part of the normal menstrual cycle
2. Pathologic cysts: These are abnormal growths that are not related to the menstrual cycle

Functional Ovarian Cysts

Functional cysts are the most common type and typically disappear on their own within a few weeks or months. The two main types of functional cysts are:

• Follicular cysts: Form when an egg-containing follicle fails to release an egg during ovulation
• Corpus luteum cysts: Develop after a follicle releases an egg and continues to grow instead of dissolving

Pathologic Ovarian Cysts

Pathologic cysts are less common but may require medical intervention. Examples include:

• Dermoid cysts: Contain tissue like hair, skin, or teeth
• Cystadenomas: Filled with watery or mucous material
• Endometriomas: Formed when endometrial tissue grows outside the uterus and attaches to the ovaries

Symptoms of Ovarian Cysts: When to Be Concerned

Many women with ovarian cysts experience no symptoms at all. However, when symptoms do occur, they may include:

• Pelvic pain or pressure
• Bloating or swelling in the abdomen
• Changes in menstrual patterns
• Pain during intercourse
• Frequent urination

Are these symptoms always indicative of a serious problem? Not necessarily. Many of these symptoms can be related to other conditions or even normal menstrual changes. However, if you experience persistent or severe symptoms, it’s important to consult with a healthcare provider.

The Rupture of Ovarian Cysts: Causes and Consequences

While the exact cause of cyst rupture is often unknown, several factors may contribute:

• Size of the cyst
• Vigorous physical activity
• Sexual intercourse
• Hormonal changes

A ruptured cyst can lead to sudden, intense pain in the lower abdomen. The pain may be accompanied by other symptoms such as nausea, vomiting, and dizziness. In some cases, a ruptured cyst can cause internal bleeding, which requires immediate medical attention.

Recognizing Emergency Situations: When to Seek Immediate Medical Care

While most ruptured cysts do not require emergency treatment, certain symptoms warrant immediate medical attention. These include:

• Severe, sudden abdominal pain
• Pain accompanied by fever or vomiting
• Signs of shock, such as cold, clammy skin, rapid breathing, and weakness
• Heavy vaginal bleeding
• Dizziness or fainting

Why are these symptoms concerning? They may indicate complications such as severe internal bleeding or infection, which can be life-threatening if left untreated.

Diagnosis and Treatment Options for Ovarian Cysts

Diagnosing ovarian cysts typically involves a combination of physical examination, imaging tests, and sometimes blood tests. Common diagnostic tools include:

• Pelvic ultrasound
• CT scan
• MRI
• CA-125 blood test (to check for potential ovarian cancer)

Treatment options vary depending on the type, size, and symptoms of the cyst. They may include:

1. Watchful waiting: For small, asymptomatic cysts
2. Hormonal birth control: To prevent new cysts from forming
3. Pain medication: To manage discomfort
4. Surgery: For large, persistent, or symptomatic cysts

How do healthcare providers decide on the best treatment approach? They consider factors such as the patient’s age, overall health, desire for future fertility, and the characteristics of the cyst itself.

Prevention and Management of Ovarian Cysts

While it’s not always possible to prevent ovarian cysts, certain strategies may help reduce their occurrence or manage existing cysts:

• Regular pelvic exams
• Use of hormonal contraceptives
• Maintaining a healthy weight
• Managing stress levels
• Avoiding excessive caffeine intake

Can lifestyle changes really make a difference in managing ovarian cysts? While research is ongoing, some studies suggest that diet and exercise may play a role in hormonal balance and overall reproductive health.

Long-term Outlook and Potential Complications

For most women, ovarian cysts are a temporary concern that resolves without long-term consequences. However, in rare cases, complications can arise, including:

• Ovarian torsion: When a large cyst causes the ovary to twist, cutting off its blood supply
• Rupture leading to severe bleeding
• Infertility: If cysts damage the ovaries
• Rarely, development of ovarian cancer

What factors increase the risk of complications? Age, cyst size, and certain medical conditions can all play a role. Women with a history of ovarian cysts or those with polycystic ovary syndrome (PCOS) may be at higher risk for recurrent cysts.

Ovarian Cysts and Fertility: Understanding the Connection

Many women worry about the impact of ovarian cysts on their fertility. In most cases, ovarian cysts do not affect a woman’s ability to conceive. However, certain types of cysts or related conditions may impact fertility:

• Endometriomas: Can cause scarring and adhesions that may affect fertility
• PCOS: A condition characterized by multiple small cysts on the ovaries, often associated with fertility issues
• Large cysts: May interfere with ovulation or increase the risk of ovarian torsion

How do healthcare providers address fertility concerns in women with ovarian cysts? They may recommend fertility-preserving treatments, such as laparoscopic cystectomy (removal of the cyst while preserving the ovary) or fertility treatments if needed.

Ovarian Cysts During Pregnancy

Ovarian cysts can also occur during pregnancy, usually discovered during routine prenatal ultrasounds. Most of these cysts are functional and resolve on their own. However, larger cysts may require monitoring or, in rare cases, surgical intervention.

What are the risks associated with ovarian cysts during pregnancy? While most cysts are harmless, there is a small risk of complications such as:

• Rupture
• Torsion
• Obstruction during delivery

Healthcare providers closely monitor pregnant women with ovarian cysts to ensure the health of both mother and baby.

Advances in Ovarian Cyst Research and Treatment

Ongoing research in the field of gynecology continues to improve our understanding and management of ovarian cysts. Some promising areas of research include:

• Improved imaging techniques for earlier and more accurate diagnosis
• Development of targeted therapies for specific types of cysts
• Investigation into the genetic factors contributing to cyst formation
• Exploration of minimally invasive surgical techniques

How might these advances change the way ovarian cysts are managed in the future? They could lead to more personalized treatment approaches, potentially reducing the need for invasive procedures and improving outcomes for women with complex or recurrent cysts.

The Role of Artificial Intelligence in Ovarian Cyst Diagnosis

Artificial intelligence (AI) is increasingly being explored as a tool to assist in the diagnosis and management of ovarian cysts. AI algorithms can analyze ultrasound images and other diagnostic data to help identify potentially concerning cysts more quickly and accurately.

What are the potential benefits of AI in ovarian cyst management? AI could help:

• Reduce diagnostic errors
• Improve early detection of malignant cysts
• Enhance treatment planning
• Streamline patient monitoring

While AI shows promise, it’s important to note that it’s intended to assist, not replace, the expertise of healthcare professionals in diagnosing and treating ovarian cysts.

Living with Ovarian Cysts: Coping Strategies and Support

For women living with recurrent or chronic ovarian cysts, coping with symptoms and managing anxiety about potential complications can be challenging. Here are some strategies that may help:

• Education: Learning about your condition can help you feel more in control
• Pain management techniques: Including heat therapy, relaxation exercises, and over-the-counter pain relievers
• Stress reduction: Through practices like yoga, meditation, or counseling
• Support groups: Connecting with others who share similar experiences
• Regular follow-ups: Maintaining open communication with your healthcare provider

How can partners and family members support women with ovarian cysts? They can offer emotional support, assist with practical tasks during flare-ups, and educate themselves about the condition to better understand their loved one’s experiences.

Navigating Work and Social Life with Ovarian Cysts

Managing ovarian cysts while balancing work and social commitments can be challenging, especially during symptomatic periods. Some helpful strategies include:

• Communicating with employers about potential needs for flexibility
• Planning social activities around your symptom patterns when possible
• Keeping a symptom diary to identify triggers and patterns
• Preparing a “cyst kit” with pain relief items for unexpected flare-ups

Remember, everyone’s experience with ovarian cysts is unique, and it’s important to find coping strategies that work best for your individual situation.

Holistic Approaches to Ovarian Cyst Management

While conventional medical treatments are the primary approach to managing ovarian cysts, some women find complementary therapies helpful in managing symptoms and promoting overall reproductive health. These may include:

• Acupuncture
• Herbal remedies
• Dietary changes
• Essential oils
• Massage therapy

Is there scientific evidence supporting these approaches? While some studies suggest potential benefits, more research is needed to fully understand the effectiveness of these methods. It’s crucial to discuss any complementary therapies with your healthcare provider before trying them, especially if you’re undergoing medical treatment for ovarian cysts.

The Role of Diet in Ovarian Cyst Management

Some research suggests that dietary factors may influence hormonal balance and potentially impact ovarian cyst formation and symptoms. While more studies are needed, some dietary recommendations that may be beneficial include:

• Increasing intake of anti-inflammatory foods (e.g., fruits, vegetables, whole grains)
• Reducing consumption of processed foods and added sugars
• Incorporating sources of omega-3 fatty acids (e.g., fatty fish, flaxseeds)
• Maintaining adequate hydration
• Limiting caffeine and alcohol intake

Remember, dietary changes should complement, not replace, medical treatment for ovarian cysts. Always consult with a healthcare provider or registered dietitian before making significant changes to your diet.

In conclusion, while ovarian cysts are common and often harmless, understanding their types, symptoms, and potential complications is crucial for maintaining reproductive health. By recognizing warning signs, seeking appropriate medical care, and adopting healthy lifestyle practices, women can effectively manage ovarian cysts and minimize their impact on daily life. As research continues to advance our understanding of these conditions, we can look forward to improved diagnostic tools and treatment options in the future.

Is It an Emergency? – Cleveland Clinic

Chances are, if you’re a woman with a period, you’ve had an ovarian cyst at some point. Ovarian cysts — fluid- or tissue-filled pouches in or on your ovaries — are extremely common and usually don’t mean anything is wrong, even when they burst.

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“Normal, physiologic cysts can grow, rupture and bleed every month, as part of your normal menstrual cycle,” says Cara King, DO, Director of Benign Gynecologic Surgery.

But then there are other ovarian cysts that aren’t so normal. These types — which Dr. King calls pathologic cysts — include dermoid cysts, cystadenomas and endometriomas.

“These are rare,” she says. “And cancerous
cysts are even more rare. However, when these pathologic cysts rupture, it can be
an urgent situation. ”

Why do ovarian cysts burst?

Usually we don’t know what makes a cyst burst, Dr. King admits.

Size can be a factor. The bigger the cyst,
the more likely it’ll pop, like an overfilled water balloon. Yet there can be
huge cysts that are so slow-growing that they don’t rupture — as well as small,
fast-growing cysts that do.

Sex and intense exercise also can cause a
cyst to rupture.

“Some ovarian cysts cause pain in your lower abdomen and other symptoms,” says Dr. King. “But there’s no specific warning sign that a cyst is about to rupture.”

Besides intense pain, watch for infection and bleeding

For many women, a ruptured cyst can be excruciating. Some say it feels like an attack of appendicitis, especially since ovarian cysts are more common on your lower right side, near your appendix.

However, the pain can be on either or both
sides of your abdomen. And it may come with:

• Nausea and/or vomiting. Depending on the cyst, contents that leak into your abdomen can make you really sick.
• Fever. This is a sign that you may have an infection of an ovarian cyst.
• Dizziness. This can indicate there’s a lot of bleeding in your belly. Other symptoms of hemorrhage include vision changes and a racing heartbeat. Not all ruptured cysts cause excessive bleeding, but you’re at a higher risk if you take blood thinners or have a bleeding disorder.

“If you have any of these symptoms, get to a
doctor right away,” says Dr. King. “Excessive bleeding or an infection is an
emergency that may require surgery or antibiotics.”

Typically, the surgery is minimally invasive.
The gynecologic surgeon will use a laparoscope to find the area that’s
bleeding, take out the cyst, and remove all the blood and infection-causing
material.

Where do the contents go?

Most of the time, a ruptured cyst doesn’t
require surgery. If you can manage the pain with over-the-counter pain
relievers and don’t have any signs of heavy bleeding or infection, you’ll likely
recover on your own.

Your body will absorb whatever bursts out of the cyst. That varies by the type of cyst it is, but can be blood, mucus or other fluid. Dermoid cysts can have all kinds of surprising stuff in them, including hair, skin and teeth.

Absorbing the fluid from normal, physiologic cysts happens pretty quickly — within 24 hours. Other content can take longer. For example, thickened blood from an endometrioma may take weeks to absorb. And the pain can linger while unabsorbed blood continues to irritate your abdominal lining.

“Most ovarian cysts are no cause for
concern,” says Dr. King. “Even if they rupture, your body usually takes care of
the healing and cleanup. It’s really only when you have sudden severe symptoms
that you should seek medical care.”

Ovarian cysts: Overview – InformedHealth.

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Introduction

Ovarian cysts are fluid-filled sacs in the ovaries. Some have tissue inside them. The cysts are surrounded by a capsule and usually about the size of a cherry. Most ovarian cysts go away on their own.

These cysts often develop due to normal hormonal changes in puberty or during menopause. Sometimes ovarian cysts are already there at birth or are caused by something else, but that’s much less common.

It is estimated that about 10 out of 100 women have ovarian cysts. They are usually non-cancerous (benign) and rarely cause problems, so they generally don’t need to be treated. Surgery is only very rarely needed.

Symptoms

Most women who have ovarian cysts don’t know that they have them. But some cysts cause dull pain in the lower abdomen (pelvic pain).

Ovarian cysts can also lead to problems with the menstrual cycle, such as heavy or irregular periods, or spotting (abnormal vaginal bleeding between periods). Menstrual cycle problems occur if the cyst produces sex hormones that cause the lining of the womb to grow more.

Very large cysts may push against the bowel or bladder. This can lead to a swollen tummy, a feeling of fullness and pressure, pain when urinating, or constipation.

If a cyst ruptures (bursts), it can be felt as a sudden pain – but usually doesn’t cause any other problems. The weight of the cyst can sometimes pull on the ovary and cause it to become twisted. This leads to sudden, severe, cramping pain on the affected side of the lower abdomen, as well as nausea, vomiting and a high pulse rate.

Causes

Most ovarian cysts develop during one part of the menstrual cycle (the growth and release of egg cells). Known as “functional cysts,” these mainly occur in puberty or during menopause. They may develop in one ovary or in both ovaries at the same time.

These are the most common types of functional ovarian cysts:

• Follicular cysts: Each egg cell is surrounded by a capsule known as a follicle. If the follicle doesn’t open and release the egg cell (if ovulation doesn’t occur), the follicle might gradually become filled with a fluid and turn into a cyst.

• Corpus luteum cysts: These occur when a corpus luteum fills with blood. The corpus luteum develops from the follicle that released the egg cell during ovulation. It secretes the sex hormones known as progesterone and estrogen.

• Theca lutein cysts: These mainly occur in women who have infertility treatment with hormones. The hormones stimulate the growth of egg cells in the ovaries. Cysts may develop as a side effect.

There is also a special type of cyst known as chocolate cysts (endometriomas). These are filled with dark, thick blood. They can develop as a result of endometriosis, for example.

Dermoid cysts (which are not functional cysts) are less common. They may develop if a non-cancerous tumor grows and it contains things like skin cells and sebaceous glands. Sebaceous glands produce an oily substance (sebum) that usually keeps skin moisturized. Because the sebum in this kind of tumor can’t “escape,” it builds up inside the cyst. Dermoid cysts might be there at birth. In rare cases they can turn into cancer (become malignant).

In another illness known as polycystic ovary syndrome (PCO), there are a lot of small cysts in the ovaries. Women who have PCO produce too many male sex hormones (androgens), which prevent the egg cells from maturing properly.

Effects

Most ovarian cysts are only 1 to 3 centimeters in size and go away on their own within a few months. They only rarely grow large enough to cause severe symptoms. In very rare cases they grow as big as 15 to 30 centimeters.

Complications are also rare. They may occur if the wall of the cyst ruptures (bursts) and the fluid leaks out into the space around it. Although ruptures can be painful, they are usually harmless. Only rarely do they lead to bleeding that needs to be stopped through surgery.

A more serious complication may occur if the ovary becomes twisted around the tissue that supports it. Known as ovarian torsion, this mainly happens in women who have larger cysts – often after jerky movements, for instance when playing tennis. Ovarian torsion is very painful. It may also cut off the blood supply to the ovary. If that happens, surgery is needed as soon as possible to prevent the ovary from dying.

Diagnosis

Ovarian cysts can be seen on an ultrasound. They are often discovered by chance, for instance when doing an ultrasound scan of the ovaries. Some cysts can be felt too.

If it is thought that you might have an ovarian cyst, the doctor will ask you about symptoms such as menstrual (period) problems and pain, and you may have a blood test.

Other examinations, such as a CT scan or laparoscopy (keyhole procedure to look inside your tummy), are only rarely needed. Diagnostic examinations are usually done to find out whether the changes in ovary tissue could be cancer. Although cysts are usually non-cancerous (benign), it’s not always easy to tell whether it’s a cyst or a tumor.

Treatment

If a cyst causes no symptoms, or only mild symptoms, it’s usually okay to wait and see what happens. Most cysts go away on their own. Depending on the results of diagnostic examinations, it’s sometimes a good idea to go for regular check-ups (every month or every few months) so the doctor can keep an eye on the cyst. If the cyst is painful, painkillers such as ibuprofen or other non-steroidal anti-inflammatory drugs (NSAIDs) can help.

If the cysts change over time or don’t get smaller and if the symptoms don’t go away, laparoscopy is an option. This procedure involves inserting thin instruments into the abdomen (tummy) through small cuts in the tummy wall. Doctors can then take a closer look at the cysts and remove them if necessary. But new cysts may develop after others have been removed.

In rare cases doctors suggest removing an ovary, or even both ovaries – for instance, if they think it could be cancer or that it will be difficult to cut the cysts out of the ovary tissue. Removing both ovaries can have a great impact on women’s lives, particularly women of childbearing age, because the operation immediately leads to menopause. The sudden drop in hormones can cause symptoms such as hot flashes, dizziness, headaches and nausea. And women can no longer become pregnant after menopause. Because of this, at least one ovary is kept, if possible – especially in women who wish to have (more) children.

Some doctors recommend treating ovarian cysts with the birth control pill. But the pill doesn’t help in the treatment of functional cysts. Although it reduces the amount of hormones produced in the ovaries and prevents ovulation, studies have shown that this doesn’t make the cysts go away any faster.

Further information

When people are ill or need medical advice, they usually go to see their family doctor first. Read about how to find the right doctor, how to prepare for the appointment and what to remember.

Ovarian Cysts: How Do They Rupture?

Ovarian cysts are small sacs full of fluid that form on your ovaries. You have two ovaries, each the size of an almond. An egg develops each month in your ovaries, and this then passes through the fallopian tubes and into your uterus. It is usually during ovulation, when the ovary releases an egg, that small cysts form.

Understanding Ovarian Cysts

During ovulation, cyst-like structures called follicles produce estrogen and progesterone. These structures usually pose no health risk, cause no discomfort or pain, and go away on their own during your cycle.

An ovulation cyst that doesn’t disappear on its own is known as a functional cyst. If the cyst fails to release an egg and continues to grow, it becomes a follicular cyst. If the cyst does release the egg but continues growing, it is called a corpus luteum. None of these are harmful to your health, and they usually go away on their own in two to three menstrual cycles.

Other types of cysts that develop may pose health risks. These include the following:

• Dermoid cysts. These cysts form from embryonic cells, so they may contain fetal tissue like hair, skin, or teeth. They are rarely cancerous but can be. 
• Cystadenomas. These cysts develop on the outside of your ovary and contain water or a type of mucous.
• Endometriomas. If you have endometriosis, uterine cells may grow outside of the uterus, causing a cyst to form on your ovaries.  

Ovarian Cyst Risk Factors

‌There are a few different ovarian cyst risk factors. Ovarian cyst risks are greater if you

• ‌have hormonal problems,
• use the fertility drug clomiphene,
• are pregnant,
• have endometriosis,
• develop a severe pelvic infection‌, or
• have previously had ovarian cysts.

Symptoms of a Ruptured Ovarian Cyst

Most cysts don’t cause harm. However, it is important to know the symptoms of a ruptured ovarian cyst in case you need immediate medical attention:

• abdominal pain that is sudden and severe,
• pain accompanied by fever or vomiting,
• feeling cold with clammy skin,
• fast breathing‌, and
• lightheadedness or weakness.

Diagnosing a Ruptured Ovarian Cyst

If you experience symptoms of a ruptured cyst, talk to your doctor right away. If you see a different doctor from the one you normally visit, make sure you tell them if you already know that you have a cyst. They will ask about your medical history and symptoms. They will also probably give you a physical exam, including a pelvic exam.

If your doctor suspects a ruptured cyst, you may need additional tests. Your doctor wants to rule out other health conditions like ectopic pregnancy, appendicitis, or a kidney stone. Additional tests may include the following:

• Ultrasound. This gives your doctor a picture of the size and location of your cyst. 
• Pregnancy test. Your doctor wants to see if pregnancy may be causing the cyst. If you’re pregnant, they will choose less invasive treatment options that don’t put your baby at risk. 
• Blood tests. These provide information on your iron levels and also check for signs of cancer.  
• Urine test. Your doctor looks for protein in your urine and other possible causes of your pain.
• Vaginal culture. This helps to rule out or diagnose a pelvic infection. It is used to check for a pelvic infection.‌
• CT scan. This uses a series of X-rays to provide a more detailed picture of your pelvis.

Treating a Ruptured Ovarian Cyst

If an ovarian cyst ruptures, you may need hospital care. You will be given IV fluids and pain medication. You may also need blood replaced if you’ve had a lot of internal bleeding. In the worst cases, internal bleeding can reduce blood flow to your vital organs, and you may be at risk of permanent damage.

If your condition is serious enough, you may need surgery for treating a ruptured ovarian cyst. After you have been anesthetized, a surgeon will make a small cut to control bleeding and remove clots or fluid. The surgeon will then remove the cyst or, in some cases, your entire ovary. You’ll need plenty of time to rest and recover after surgery.

It’s important to have dangerous cysts removed, but it is not without risks. You should be aware of the risks involved in getting surgery. Some of these risks are:

• bleeding,
• infection,
• an incision site that doesn’t heal well,
• blood clots,
• damage to your blood vessels, nerves, muscles, or other nearby tissue,
• need for a larger incision than anticipated, ‌and
• scar tissue from the incision.

Should I Be Worried About Ovarian Cysts?: Serrano OBGyn: OBGYNs

Your ovaries are two almond-shaped organs that sit on either side of your uterus. The ovaries are responsible for your eggs’ development each month and then their release during ovulation. Small fluid-filled sacs can form on your ovaries; these are ovarian cysts.

In most cases, ovarian cysts are nothing to be concerned about. But if you experience symptoms of a cyst or it becomes exceptionally large, you may need medical intervention. Here’s what we at Serrano Ob/Gyn Associates think you should know about ovarian cysts.

About cysts

Ovarian cysts form with your monthly cycle. Each month, your ovaries release an egg that’s encased in a fluid-filled space called a follicle. When the egg is released, your body typically absorbs that follicle. But in the case of ovarian cysts, the follicle may not have released the egg, so it grows larger and develops into a cyst. You may also develop a cyst after the follicle releases the egg — known as a follicular cyst.

You may also develop a dermoid cyst, which forms when the cells in your ovary start dividing even though the egg hasn’t been fertilized. These dermoid cysts are rare, but contains the genetic material for a fetus. They can grow large — up to 4 inches — and usually need to be surgically removed.

Symptoms of a cyst

In the vast majority of cases, you won’t even know you have an ovarian cyst, and it disappears on its own. These harmless cysts are just 1-2 millimeters in diameter.

Larger cysts may be identified during a regular pelvic exam. They may show up during an ultrasound scheduled for another diagnostic reason too, such as to rule out fibroids or endometriosis.

You may also come to our office with symptoms that suggest a cyst. These symptoms include pelvic pain or unusual uterine bleeding.

Serious cyst concerns

If you have pelvic pain with fever, nausea, and vomiting, it could be a sign you have an infection associated with the cyst. An infection deserves immediate medical attention. Cysts can also rupture or twist — a condition called torsion. This may cause an infection, plus cut off blood supply to your ovaries, which may result in serious complications.

You need immediate medical attention if you experience sudden pain in your lower abdomen along with nausea.

Solutions for cysts

If you have small cysts that cause no pain, you probably don’t need treatment. But if you have large cysts or those that appear to be at risk of causing torsion, you may need surgery. This surgery is usually done laparoscopically, which involves small incisions and a relatively short recovery time.

Polycystic ovary syndrome

In some cases, ovarian cysts are a symptom of a hormonal condition known as PCOS, or polycystic ovary syndrome. Usually, the cysts come with other symptoms, such as infertility, irregular periods, increased body hair, and weight gain. The cysts don’t need to be removed via surgery, but they can help the doctors here at Serrano Ob/Gyn Associates diagnose PCOS.

If you have unusual pelvic pain or irregular bleeding, make an appointment for an evaluation at our convenient location in San Antonio, Texas. We compassionately consider all potential causes, including ovarian cysts, and provide appropriate treatment.

Ovarian cysts | HonorHealth

Solid or fluid-filled sacs, most ovarian cysts occur as a result of your menstrual cycle. Each month, your ovaries release one egg inside a tiny sac called a follicle. When the egg is ready, the follicle opens to release it. If the sac fails to open, a follicle cyst results, producing no symptoms. It often disappears in one to three months.

What are the symptoms of ovarian cysts?

Typically you’ll have ovarian cysts and not notice them at all. Sometimes, however, an ovarian cyst produces symptoms — pain, pressure or abnormal bleeding. These issues often resolve on their own and don’t require intervention.

These issues often resolve on their own and don’t require intervention.

However, if the cyst grows and becomes abnormal or develops into an ovarian tumor, you may notice:

• Pelvic pain: An ache in one side of the lower abdomen
• Pressure: A feeling of fullness or heaviness in your abdomen
• Abnormal bleeding not associated with menstruation

How are ovarian cysts diagnosed?

If the cyst is causing symptoms, your HonorHealth gynecologist may order an ultrasound, MRI or CT scan to get a closer look at:

• The size of the cyst
• The cyst’s location
• Whether the cyst appears to be filled with fluid or is primarily solid

How are ovarian cysts treated?

In most cases, an ovarian cyst will resolve on its own, so observation is typically the recommended course of action. In rare cases, the cyst could rupture.

If a cyst doesn’t go away or gets bigger, typically five centimeters or greater, you might have:

• Sudden, severe pain in your lower abdomen
• Fever
• Vomiting
• Dizziness, weakness, feeling faint
• Fast breathing

This means the cyst is causing the ovary to twist.

If the cyst ruptures or causes the ovary to twist, it could become an emergency, and minimally invasive surgery may be necessary.

The goal of surgery is to remove the cyst without rupturing it. In some cases, the surgeon needs to remove the ovary, but every effort is typically made to maintain the hormonal functions regulated by the ovary.

If you continue to develop abnormal ovarian cysts, your gynecologist may prescribe birth control to shut down ovulation, at least for a while during the time you’re not hoping to conceive.

Could a cyst be cancerous?

If you have a family history of ovarian, fallopian tube or breast cancer, your physician may want to keep a more watchful eye on any cysts that are causing symptoms. It’s also important to let your gynecologist know about your family history. Genetic counseling may be an option to evaluate your risk for developing cancer.

Ovarian cysts in women after menopause are more likely to be cancerous than those in younger women.

A Practical Approach in Emergency Room

Corpus luteum cyst rupture with consequent hemoperitoneum is a common disorder in women in their reproductive age. This condition should be promptly recognized and treated because a delayed diagnosis may significantly reduce women’s fertility and intra-abdominal bleeding may be life-threatening. Many imaging modalities play a key role in the diagnosis of acute pelvic pain from gynecological causes. Ultrasound study (USS) is usually the first imaging technique for initial evaluation. USS is used to confirm or to exclude the presence of intraperitoneal fluid but it has some limitations in the identification of the bleeding source. Contrast-enhanced computed tomography (CT) is the imaging modality which could be used in the acute setting in order to recognize gynecological emergencies and to establish a correct management. Magnetic resonance imaging (MRI) nowadays is the most useful technique for studying the pelvis but its low availability and the long acquisition time of the images limit its usefulness in characterization of acute gynecological complications. We report a case of a young patient with hemoperitoneum from hemorrhagic corpus luteum correctly identified by transabdominal USS and contrast-enhanced CT.

1. Introduction

Acute pelvic pain in women of childbearing age is a common and frequent cause for admission to emergency room (ER), necessitating emergent medical evaluation especially when it is due to hemoperitoneum [1].

In this scenario, the wide range of differential diagnoses that must be considered when assessing abdominal pain represents an issue for the clinical approach.

Sometimes it can be difficult to distinguish gynecological from gastrointestinal and urinary tract emergencies because of overlapping symptoms and signs. Various imaging modalities in association with clinical findings play an important role in the characterization of the cause of pain [2, 3].

Early diagnosis is necessary to preserve the reproductive systems and the life of the patient in severe cases. Hemoperitoneum may occur in the context of various gynecological emergencies; in some cases it could be a complication of a ruptured hemorrhagic corpus luteum [3–5].

Suspecting gynecological disease in young women the use of X-ray radiation and computed tomography (CT) is not recommended due to the risks associated with irradiating the pelvis. Ultrasound study (USS) and magnetic resonance imaging (MRI) are the preferred imaging investigations in pelvic diseases; however, in gynaecological emergencies, when a simple and rapid assessment of the patient’s condition is required and once pregnancy is excluded, the CT is the investigation of choice [4].

We describe a case of hemoperitoneum from a ruptured hemorrhagic corpus luteum in an adolescent woman in which the use of emergent CT in the ER was necessary in order to obtain the correct diagnosis.

2. Case Presentation

A 16-year-old adolescent female presented to the ER with sudden onset abdominal pain, lasting for six hours. Her last menstrual period was 18 days back. The patient did not have previous diseases or surgery.

On physical examination she presented tachycardia (pulse rate 115 beats per minute), tachypnea (respiratory rate 22 breaths per minute), and hyperpyrexia (37.8°C) with abdominal distention and severe rigidity on the lower quadrants on palpation. Blood pressure (BP) was 85/60 mmHg and she was anxious but alert and oriented.

Laboratory investigations showed mild leukocytosis, slight elevation of C-reactive protein (CRP) (192 mg/L), and discrete anemia (hemoglobin 10 g/dL). Urine output was 26 cc/h and serum; β-human chorionic gonadotropin (βhCG) level was below 4 UI/L. Gynecological examination excluded abnormalities of the external genital structures in a virgin patient.

Transabdominal USS revealed a moderate amount of fluid in the abdomen and in the pouch of Douglas and a complex right adnexal mass with signs of peripheral vascularization (Figure 1).

An abdominal CT study was indicated and performed using a 64-row scanner (LightSpeed VCT, General Electric Medical System, Milwaukee, WI, USA), before and after the injection of iodinate contrast medium (Iomeron 350 mg/mL, Bracco Imaging, Milan, Italy).

The unenhanced CT scan (Figure 2) showed a low-attenuation fluid within the peritoneum surrounding spleen and part of liver with extension to the pouch of Douglas and to the periuterine area, where a round hypodense image was detected. The fluid showed progressively increasing attenuation values from the upper abdomen to the pelvis and it appeared clearly hyperdense in the pouch of Douglas (60–65 Hounsfield units, HU). These findings were suggestive for the presence of hemoperitoneum. A dynamic CT scan revealed thickened cysts with enhancing walls, such as a corpus luteum cyst. The arterial phase showed a cloud-like extravasation from the cyst, indicating the presence of active bleeding (Figure 3). The CT study excluded other diseases of the intra-abdominal organs, such as the uterus and left adnexae.

After fluid resuscitation, the patient became haemodynamically stable and the subsequent emergent laparoscopy confirmed a bleeding corpus luteum as the cause of the hemoperitoneum.

3. Discussion

Spontaneous hemoperitoneum may occur in various gynecological emergencies. The most common gynecological causes of spontaneous hemoperitoneum in women of childbearing age are ectopic pregnancy and ruptured corpus luteal cyst. More uncommon causes are uterine rupture, endometriosis, and ruptured hydropyosalpinx [5].

Corpus luteum is a functional cyst developing in the luteal phase of the ovarian cycle which regresses spontaneously in corpus albicans when pregnancy does not occur [6]. Being a thin-walled vascular structure corpus luteum is prone to hemorrhage even if bleeding is usually contained inside the cyst [2]. Corpus luteum cyst-wall rupture is a rare complication that occurs most frequently in women in their reproductive age but it is relatively uncommon in early adolescence [6, 7]. When bleeding occurs, hemorrhage may spread into the peritoneal cavity causing hemoperitoneum [2].

The diagnosis of ruptured corpus luteal cyst is based on a high historical suspicion (the patient generally is in the luteal phase of the ovarian cycle), clinical features, and laboratory tests. The latter often show anemia, raised CRP, and mild leukocytosis. These signs and symptoms are similar to gastrointestinal tract diseases. Patients may present a wide range of clinical signs, from no signs to severe peritoneal irritation which can be confused with, for example, acute appendicitis. The evaluation of serum βhCG-levels is necessary to differentiate ruptured corpus luteal cyst from ruptured ectopic pregnancy, which may have a similar presentation [4, 8]. A persistent corpus luteum may be associated with delayed menstrual cycle. Occurrence of a corpus luteum rupture may be indicative of the presence of an intrauterine pregnancy. Therefore, a ruptured corpus luteum cyst rupture should be considered even in the presence of a positive pregnancy test [7]. Various imaging modalities play an important role in diagnosing the ruptured corpus luteum cyst. Usually, USS is the first imaging modality due to its high sensitivity and fast and easy access. On the other hand, it can be difficult to localize the site of the disease and bleeding [3, 4, 9]. Bennett in ruptured corpus luteal cyst USS may reveal a complex cyst, with a rim of increased echogenicity surrounding the cystic component in the adnexal area, associated with free hypoechoic fluid in the peritoneal cavity (hemoperitoneum). Free hypoechoic fluid may contain focal collections of higher echogenicity (e.g., clotted blood) in the pelvis [2, 4]. Doppler USS may demonstrate the vascularized wall [4, 10].

Although MRI is the most adequate technique for the pelvic evaluation, thanks to its high-soft-tissue contrast capability, it is not usually used in the acute setting due to its considerably long acquisition time, limited availability, and high costs [3, 4].

For these reasons, MRI has limited availability in emergency department and it is not currently included in the American College of Radiology Appropriateness Criteria [11].

Therefore, in the ER gynecological diseases are frequently detected with CT examination [2, 4, 5]. The spectrum of attenuation values of abdominal fluid will direct the diagnosis of hemoperitoneum. Body fluids, with a density similar to water, have attenuation values in the range of 0–15 HU. Blood, which has a higher density than other body fluids, has attenuation values of 30–45 HU. Examination of attenuation values will permit estimating the time from bleeding, the diffusion, and location of the hemorrhage [3]. Peritoneal fluid typically shows higher attenuation values near the source of bleeding; these parameters progressively increase from the upper abdomen to the parietocolic gutters, where the pelvis becomes hyperdense (60–65 HU) [3]. The area with the highest attenuation values is defined as “sentinel clot” and it indicates the source of bleeding [4].

On CT examination, corpus luteum usually appears like a well-circumscribed unilocular adnexal lesion, rarely bilocular. The cyst walls appear slightly thickened (<3 mm) and show a characteristic inhomogeneous contrast enhancement after administration of contrast medium due to increased vascularity. The cystic content is mixed with a high attenuation component (45–100 HU) and in some cases it presents a “fluid-fluid hematocrit” level [4].

Contrast-enhanced CT may be helpful in excluding other intra-abdominal diseases (e.g., ruptured hepatic adenoma) that can cause hemoperitoneum in the young female patient [4, 9].

For the management of hemoperitoneum a standard algorithm is not reported in literature. Historically the treatment of corpus luteum hemorrhage was exclusively surgical, while nowadays it can be managed with a conservative approach. In either case the treatment targets at preserving ovarian function as well as at eliminating the source of bleeding [12].

In particular, the conservative approach is the first-choice treatment when the patient is hemodynamically stable (systolic BP > 90 mmHg) with hemoglobin values that keep being constant over 4–6 hours of monitoring [13]. In case of unstable vital signs the patient undergoes surgical treatment. Laparoscopy represents the first minimally invasive approach [14] that can eventually be converted to laparotomy in case of failure or of unstable vital signs such as important hemoglobin decrease over 4–6 hours (~2 g/dL) with increasing hemoperitoneum on follow-up imaging studies [13, 15].

4. Conclusion

In summary, USS is a helpful imaging modality in diagnosing some gynecological emergencies in the ER but may not detect the entire range of the disease, whereas contrast-enhanced CT of the abdomen is recommended in the acute ER setting to diagnose gynecological emergencies and to initiate correct management in a timely fashion.

Disclosure

The authors do not have a direct financial relation with the commercial identities mentioned in the paper that might lead to a conflict of interests.

Conflict of Interests

The authors declare that there is no conflict of interests regarding the publication of this paper.

Authors’ Contribution

All the authors of the paper gave their contribution to this work.

Warning Signs of Ovarian Cysts

While ovarian cysts are common and often asymptomatic for many women, they can also cause more severe health problems in others. Ovarian cysts are fluid-filled or solid sacs that often form during ovulation. There are different types of cysts that have the potential to cause mild to severe health problems. Most women get them at some point in their life, so it is essential to know the potential health hazards associated with them.

Here is a list of warning signs of ovarian cysts:

Pelvic Pain

One of the most common signs of an ovarian cyst is pelvic pain. The pain may be dull, like menstrual cramps, or it can be sharp and stabbing. The hormones secreted during your period can cause ovarian cysts to form or become inflamed, meaning you may have sharper pelvic pain during your period. If a cyst ruptures, the most common sign is sudden, severe pelvic pain.

Unusual Bleeding

Anytime you notice unusual bleeding of any kind, contact your doctor right away. Ovarian cysts can cause unusual bleeding because they affect your menstrual cycle. In some cases, hormones secreted from cysts can make your period severely abnormal or heavy.

Nausea and Vomiting

Nausea and vomiting are common for anyone, so it is easy to overlook them as possible signs of ovarian cysts. More severe cysts can cause your one or both ovaries to become twisted, causing severe pain and nausea in some cases. Many women compare the nausea and vomiting associated with cysts to morning sickness. Nausea, vomiting, and dizziness are also common signs of a ruptured cyst, so it is crucial to see your doctor immediately if you have these symptoms persistently.

Lower Back Pain

Along with your pelvic region, pain associated with ovarian cysts can spread to your thighs and lower back. The pain in your lower back may be dull and achy. If a cyst ruptures, the back pain will be more severe. Other symptoms associated with lower back pain include constipation and lower abdominal pain.

Infertility

There are multiple different kinds of cysts, including functional and dermoid cysts. Functional cysts are common are rarely cause issues. While most ovarian cysts are harmless and cause few to no symptoms, severe situations may cause fertility issues. Dermoid cysts and cystadenomas are more likely to become severe and are often associated with Polycystic Ovary Syndrome (PCOS). Ovarian cysts are extremely common in women with PCOS and can make getting pregnant difficult.

Pain During Sex

Painful sex is not only embarrassing but can be a sign of something serious. Ovarian cysts can cause pain and discomfort during sex due to increased irritation and inflammation. Pain during sex is often associated with endometriomas, which are cysts caused by endometriosis. Endometriosis is a condition that causes uterine tissue to grow outside the uterus. That tissue can attach to the ovaries and cause growths to form.

Bloating and Weight Gain

While uncommon, some ovarian cysts can grow quite large. The larger the cyst, the more inflammation and bloating you will see in your abdomen. Severe bloating can cause sudden weight gain, so tell your doctor right away if you notice any extra, unexplained weight on the scale.

Fever

If an ovarian cyst becomes infected or ruptures, you may develop a fever. If you develop a fever, see your doctor right away, especially if your temperature does not return to normal. An untreated infected cyst can cause more severe health problems.

Changes in Bowel Movements

In some cases, ovarian cysts can cause changes in urination and bowel movements. If you become constipated or begin urinating more frequently, see your gynecologist right away to rule out possible cysts.

How to Prevent Ovarian Cysts

It is impossible to fully prevent ovarian cysts, but there are steps you can take to be diagnosed early so they can be treated properly. Keep diligent track of your menstrual cycle and note any changes or abnormalities, especially if they happen during multiple cycles. Getting regular pelvic exams is essential as well, as your gynecologist can see if there is anything unusual. See your doctor right away if you are experiencing fever, fertility issues, persistent nausea and vomiting, dizziness, and abnormal bleeding.

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If you find yourself with ovarian cysts and need an exam, advice, or minimally invasive surgery, contact us today to book an appointment with Dr. Shabnam Dadgar. We are here to help you.

Ovarian cyst: types, diagnostic methods, surgery to remove

Classification of ovarian cysts depending on their structure and mode of formation:

1. Follicular (functional) ovarian cyst

Formed from follicles, it has smooth walls, a flat surface, the cavity of which is filled with liquid. Its size is usually no more than 8 cm in diameter. The cause of the cyst is considered to be an imbalance of hormones, therefore, it is most often diagnosed with puberty or menopause.Small cysts (up to 4 cm) can develop asymptomatically and disappear without a trace within 3 menstrual cycles.

With larger formations (6-10 cm), the following symptoms appear:

• violation of cyclic regulation,
• Prolonged painful regulation with profuse discharge,
• spotting between periods and after intercourse.
• worried about pain in the lower abdomen, which intensifies in the 2nd phase of the menstrual cycle, after active and sudden movements (somersault, tilt, sharp turn), after sex,
• often patients complain of a feeling of heaviness, a feeling of fullness in the groin area.

2. Corpus luteum cyst

It is formed in the 2nd phase of the menstrual cycle from the corpus luteum, which does not disappear in time. When the follicle bursts and a new egg falls, a corpus luteum appears in this place. If fertilization does not occur in this cycle, then the corpus luteum disappears by itself, due to the cessation of blood access. However, if blood flow is disturbed, the same corpus luteum can form cysts that do not exceed 8 cm in size, their cavity is filled with a yellowish-red liquid.Most often, this formation appears due to a violation of the hormonal background and blood circulation in the appendages.

Factors contributing to the formation of a corpus luteum cyst:

• inflammation in the appendages,
• malnutrition or starvation,
• physical activity and prolonged stress,
• artificial termination of pregnancy,
• hormonal contraception,
• preparation for in vitro fertilization (IVF).

Symptoms for this cyst are poorly expressed: (slight soreness, a feeling of heaviness and discomfort in the abdomen from the side of education, delayed menstruation, or, conversely, prolonged menstruation). Often, these cysts develop within 2-3 months, after which they spontaneously disappear.

3. Paraovarian ovarian cyst

It is formed from a rudimentary formation – paraovarium (ovarian epididymis), between the leaves of the wide uterine ligament, the ovary and the tube.It is usually located on the side or above the uterus. Anatomically, it is a one-chamber formation of a tight-elastic consistency with a cavity containing a clear liquid containing a lot of protein and a small amount of mucin. This content gradually accumulates, forming a thin-walled “bag” with smooth walls. The shape of the cyst is oval or round, its size ranges from small to large, in rare cases reaching the size of the head of a newborn. The development of such a cyst usually occurs in 3-4 decades of a woman’s life (maturity).There is a paraovarian cyst in 8-16% of all identified cysts.

More often, its development is asymptomatic. However, some patients have periodic pulling pains in the lower back, lower abdomen, the regulation cycle is disturbed, infertility. Similar symptoms appear when the size of the cyst is more than 5 cm. With the further growth of the formation of pain, they are bursting, aching in nature with the localization of these sensations in the lateral regions of the abdomen, capture the lower back and sacrum. There is no connection with the menstrual cycle or with the maturation of the egg.As a rule, the patient’s pain is associated with physical activity.

4. Mucinous ovarian cyst

It is a benign tumor with a bumpy surface and a multi-chambered cavity containing mucus. The main features that distinguish it from other types of cysts are its rapid growth rate and gigantic size (up to 30cm). Most often, such cysts are found in women over 45 years old, since the main reason is hormonal disruptions that occur during menopause.
Typical symptoms of a mucinous cyst: aching pain in the bosom, an increase in the abdomen in volume due to the rapid growth of the cyst, constant urge to urinate, a constant feeling of full bowel, frequent constipation.

5. Dermoid ovarian cyst

Also applies to benign tumors. The frequency of their detection is 15-20% of cases of all ovarian cysts. At first, it has a round shape, which then changes to an oval shape with smooth walls.Its contents are represented by various cells and tissues of the body (bones, hair, teeth, cartilage, muscles, adipose or nervous tissue, etc.). The size of the cyst diameter can be more than 15 cm.
Risk factors include hormonal surges, so this cyst develops most often in women with menopause and at the time of puberty.
Clinical manifestations of the dermoid ovarian cyst are associated with its large size (15 cm or more). These include: a feeling of fullness and heaviness, soreness in the lower abdomen, sometimes an increase in the size of the abdomen, and further increased urination, intestinal dysfunction (constipation or diarrhea).
Dermoid ovarian cyst does not cause hormonal changes and menstrual dysfunction.

6. Endometrioid cyst

It is a form of genital endometriosis. It is referred to as pseudocysts, since its wall does not have a secreting epithelium, as in true cysts, but is formed from the endometrium. The endometrium is a tissue that normally lines only the uterine cavity, and with endometriosis, endometrial cells are introduced into other organs, including the ovaries.It is believed that this happens with various surgical procedures on the uterus. But some experts put forward another possible way of bringing endometrial cells into the ovaries and abdominal cavity: with the help of retrograde flow of menstrual blood through the fallopian tubes, which is facilitated by significant physical activity, intercourse during menstruation, a significant width of the fallopian tubes, poor outflow of menstrual blood with a narrow the cervical canal. Endometrial cells trapped in the abdominal cavity, tubes and ovaries are implanted into these tissues.They are not atypical, but they are hormone-dependent and therefore have the ability to grow under certain conditions and, moreover, cyclically during regulation show a menstrual reaction, i.e. bleed. As a result, an endometrioid islet is formed, inside which a dark liquid accumulates – blood that has not found a way out. A cyst is formed. Due to the color of their contents, these cysts are also called “chocolate”. The diameter of the formation can vary from 1 to 10 cm.

Contribute to endometriosis in general, and the development of “chocolate” cysts including the following factors:

• Immune System Disorders,
• hormonal disorders (excess of estrogen and prolactin, lack of progesterone and androgens, dysfunction of other endocrine organs – the thyroid gland and adrenal cortex),
• operations (including abortion) and abdominal trauma,
• transferred stresses,
• inflammatory diseases of the female genital tract,
• other somatic diseases and metabolic disorders.

In some cases, an endometrioid cyst is asymptomatic, but it can manifest itself as pain in the lower abdomen, in the lumbosacral region. The menstrual cycle is disrupted: the menstrual periods themselves lengthen and become more abundant, smearing intermenstrual discharge appears. A woman may suffer from infertility.

Large cysts, squeezing the surrounding pelvic organs, can contribute to poor urination, constipation, and bloating.With long-term existence, “chocolate” cysts can be complicated by rupture, suppuration and the formation of an adhesive process.

7. Polycystic ovary disease.

With this syndrome, not one, but many small cavities appear in the ovaries.
The main cause of this disease is the body’s insulin resistance (impaired insulin perception and glucose absorption). As a result, insulin rises, and its excess negatively affects the ovaries.Subsequently, this leads to an increased production of androgens (male hormones), which disrupt the maturation of the follicles, as a result, many unexploded cavities remain.

Risk factors for the formation of polycystic disease:

• Early or late puberty.
• Late or early onset of menopause.
• Various malfunctions of the menstrual cycle.
• Termination of pregnancy, miscarriages, infertility.
• Inflammatory processes of the pelvic organs.
• Disruption of hormonal levels under the influence of endocrine diseases or the use of hormonal medications.
• Irregular intercourse.
• Overweight or underweight.
• Diabetes mellitus disease.
• Genetic predisposition.
• Prolonged stress.
• Strong physical activity.

Polycystic disease is: primary (true) and secondary.

• Primary polycystic disease.

It usually occurs during puberty. Imbalanced hormones in adolescent girls lead to late or no menses. The moment of the formation of a normal menstrual cycle is malfunctioning, oligomenorrhea (scanty discharge during menstruation) or amenorrhea (absence of menstruation) is observed, which indicates anovulation (the egg does not leave the ovaries).

• Secondary polycystic disease.

The disease is characteristic of older women, with increased weight and high insulin levels.

Most often, polycystic disease is manifested by infertility, in addition, it leads to the following changes: hair growth on any part of the body; changes in the skeleton and muscles of the male type; the development of subcutaneous tissue on the abdomen; changes in the vocal apparatus. These symptoms of hyperandrogenism have varying degrees of severity in different patients.

This condition requires dynamic monitoring of the patient, since the hormonal spectrum of women with polycystic disease contributes to proliferative processes in the myometrium, which is a risk in terms of the development of uterine cancer.

Complications of an ovarian cyst

Malignancy of the ovarian cyst.
Ovarian cysts are initially benign. Most often, these formations are asymptomatic and eventually resolve on their own, however, sometimes the cyst persists longer than the prescribed period, causing pain and bleeding, and can develop into malignant neoplasms.
The predisposition of an ovarian cyst to degeneration into a malignant tumor is determined by the type of tumor:

1. 1. The most favorable in terms of prognosis are follicular and corpus luteum cysts (luteal), which most often resolve on their own, especially if conservative hormonal therapy is prescribed.

2. 2. In the presence of a dermoid cyst, the likelihood of malignancy (malignancy) is very low.Its danger lies in the large size of the formation, which in the future can put pressure on the surrounding organs.

3. 3. Serous and mucinous cysts are often gigantic and in most cases quickly degenerate into a malignant tumor.

Ovarian cancer is diagnosed primarily in menopausal women. In most cases, in the absence of timely therapy, women seek medical help when the tumor causes pain.
In oncological practice, tumor marker analysis is used to identify cysts and tumors. The most common tumor marker is CA-125, as well as HE4 and the ROMA index. The final diagnosis is usually established based on the results of tumor biopsy.

The presence of cancer may be suspected if the following symptoms are present

1. 1. Change in general condition: increased fatigue and weakness.
2. 2.The appearance of discomfort in the lower abdomen.
3. 3. Probing a dense tuberous formation in the projection of the appendages.
4. 4. Often at the beginning of the process, there may be symptoms of dyspepsia, such as bloating and soreness of the abdomen, nausea, belching and loss of appetite.
5. 5. In the evening, the body temperature can rise to 38 degrees.

Diagnostics of the ovarian cyst

1. 1. A clinical blood test indicates the presence of inflammation (an increase in ESR and leukocyte counts) and anemia (a decrease in hemoglobin).
2. 2. Ultrasound examination (ultrasound) of the pelvic organs. This method of examination allows you to visualize the ovarian cyst and determine its location.
3. 3. Diagnostic laparoscopy. A camera is inserted into the pelvic cavity, which allows you to see the cyst, and, if possible, take a biopsy (a piece of ovarian tissue for histological examination). Histological examination contributes to the establishment of a definitive diagnosis.
4. 4. Puncture of the ovarian cyst under ultrasound control. With the help of a thin needle, the anterior wall of the abdominal cavity is punctured, then the needle is inserted into the capsule of the ovarian cyst, a liquid is taken from it for examination, which will determine the type and type of this formation.

Methods for the treatment of ovarian cysts

Conservative treatment of cysts

It is most often performed during menopause in women, when the patient no longer plans to become pregnant. The same tactic is used for newly identified cysts of small diameter (up to 10 centimeters).
If an ovarian cyst is found, treatment consists in expectant tactics for 3 months, given that most formations in the ovaries are able to reverse development (self-absorption) over several menstrual cycles. In this case, dynamic observation by ultrasound should be performed to control the size of the formation. If there is no positive dynamics, anti-inflammatory and hormonal therapy is performed.

Treatment of ovarian cysts with hormonal drugs (progesterone or its analogs) is aimed at reducing the level of estrogen in the patient’s body and creating conditions for preventing ovulation.This allows you to start the processes that will promote the reverse development of the cyst and prevent the formation of a new cyst.
Also, hormonal therapy can be supplemented by taking vitamins (folic and ascorbic acid and vitamin E) and general strengthening drugs. Stimulating the immune system can provoke defensive reactions that will be aimed at preventing the development of the disease. If, against the background of hormonal therapy, a positive effect is not observed, or an increase in cysts in size occurs, then surgical treatment is indicated.

Operation to remove ovarian cyst

The approach to the choice of the scope of surgery and access to the site of surgery is highly individual. The decision is made based on the results of the examination and is discussed with the patient before the operation, however, adjustments are possible during the operation.

Indications for surgery:

• Any formation that has existed in the ovary for more than 3 months, has not disappeared without treatment or against the background of hormonal therapy.
• Ovarian lesions found during menopause.
• Complications of the cyst: suppuration, hemorrhage, rupture of it, as well as torsion of the leg.
• Malignant process.

Relative contraindications to surgical treatment:

• diseases associated with poor blood clotting;
• acute cardiovascular and neurological diseases;
• infections of the genitourinary system;
• internal bleeding;
• advanced stages of obesity;
• lung damage;
• problems with persistent bloating;
• fistulas.

Methods for the operation to remove ovarian cysts

Laparoscopic ovarian cyst removal

Laparoscopy involves removing the cyst with 3-4 small skin incisions on the abdomen (1-2cm). First, an audit of all organs of the abdominal cavity is performed, then the diagnosis of the formation itself; The cyst is examined for torsion or rupture, after which it is removed if necessary. The whole procedure takes place under general anesthesia and lasts from 20 minutes to an hour.
This operation is performed using a special device – a laparoscope. It is equipped with lenses, a video camera and a magnification system, which allows you to get a fairly clear image of internal organs on a special monitor.

Types of laparoscopic operations:

• Hulling of the cyst capsule while preserving the unchanged ovarian tissue. This intervention is called a cystectomy.
• Ovarian resection.With this intervention, part of the ovary is removed along with the cyst.
• Removal of a mass and an ovary is called an oophorectomy in its entirety. At the same time, the pipe is preserved.
• Adnexectomy involves the removal of the ovary with a pathological formation and the fallopian tube from the side of the lesion.

Postoperative period

It is recommended to start getting up after the operation from the first day. It is very important that there is enough movement in the postoperative period.This is the prevention of postoperative complications. Food should be consumed in liquid form. The length of hospital stay is usually 1-2 days and depends on the volume of surgery and the general condition of the patient.

Usually, the ability to work is restored on the 10-14th day after the operation. Full recovery of the body at home occurs within 1 month, then the woman can return to full-fledged work. Laparotomy is an abdominal surgery.

The ovaries are accessed through an incision in the anterior abdominal wall. With this type of surgery, the ovary can be removed partially or completely. During abdominal surgery, general anesthesia is required. The postoperative recovery period after laparotomy lasts at least 2 weeks.

Indications for this type of operation are: obesity, complicated ovarian cyst with a purulent inflammatory component and bleeding, suspicion of a malignant process.

Surgical treatment of ovarian diseases is a serious intervention for the female body. Therefore, dynamic observation of a gynecologist and a planned ultrasound examination after 1, 3, 6 months, and then 1 time per six months are necessary. If a woman is operated on during her childbearing period, hormone therapy is usually used to restore ovarian function.

After surgery, it is recommended to plan a pregnancy no earlier than 3-4 menstrual cycles.

Ovarian cyst: will heal by itself or should it be treated? | Healthy life | Health

Where did it come from?

The main function of the ovaries is the production of special hormones that regulate the maturation of the follicle and the exit from the corpus luteum. In the middle of the menstrual cycle, the follicle bursts, the egg comes out and ovulation occurs. If ovulation does not occur, the unopened follicle continues to develop and fluid accumulates in it.This cavity is called a cyst.

With normally functioning ovaries, the cycle is reversed: that is, the corpus luteum should disappear. If this does not happen, after ovulation, excess fluid accumulates in the corpus luteum, which also leads to the formation of a cyst.

The cyst can also form from the appendages, then this fluid bubble is braided by the smallest blood vessels.

Who is to blame?

Throughout a woman’s life, a cyst often forms in the ovaries and then disappears.The reasons for its formation are quite numerous, but the palm still belongs to hormonal disorders. Ultimately, it is they who break the natural course of things and prevent the onset of ovulation.

Cysts are often formed in women during the menopause, when fertility begins to fade away, or in very young girls whose menstrual cycle is just getting established, as well as in women who have not given birth or who have had abortions. But having many children is some guarantee that a cyst does not form in the ovaries.

Cysts occur with frequent inflammatory diseases of the internal genital organs and infections. Even when the inflammation stops, the tissue remains inelastic and easily forms cavities with fluid.

Often against the background of endocrine diseases (obesity, diabetes mellitus, thyrotoxicosis) there are multiple cystic formations – polycystic ovaries.

Will it pass by itself?

“As a rule, a cyst does not cause any trouble,” explains gynecologist Alla Dyakova .- She does not hurt, does not bleed.

A woman may not even know that she has a cyst. After all, this formation has no specific symptoms. For example, with a cyst, menstruation delays occur, but delays can also cause endocrine diseases. Or with a cyst, pain in the lower abdomen may periodically occur, but they often occur with inflammation. That is why a woman, even if she feels some discomfort, sometimes does not pay attention to it: it will pass by itself.

“By itself” it will pass only if the cyst is functional, that is, formed due to failed ovulation or as a result of excess fluid.However, it can also cause unpleasant sensations if it is kept on a leg. Often the leg is twisted or, due to physical exertion, the cyst ruptures – then the pain in the lower abdomen is especially strong.

A functional cyst does not require special medical intervention, but if it has not resolved within three months, a thorough examination is necessary. After all, a cyst is a kind of signal that something is wrong in the body.

What if there is a tumor?

Is it worth worrying about a cyst at all?

“The problem is that a cyst is very similar to a tumor,” says Alla Dyakova. – And the diagnosis is necessary just in order to exclude the tumor, which requires drug treatment, and sometimes surgery. But without examination it is impossible to understand whether a neoplasm has appeared, so every woman should visit a gynecologist every six months. “

It is also impossible to determine by clinical signs or by palpation that this is a cyst that will pass in two months, or a neoplasm. Having found such an education, the doctor assesses the patient’s age, her hormonal background, external status (often cysts occur in women suffering from obesity or hirsutism – increased hair growth) and sends them for ultrasound examination. Sometimes on ultrasound it immediately becomes clear that this is a functional cyst, and then you just need to wait until it disappears.

If this does not happen, or if the cyst has increased in size, treatment with anti-inflammatory drugs, immunocorrection or hormonal therapy is prescribed.

If the nature of the cyst is in doubt, it contains dense parietal structures, papillae are visible on it, then it is necessary to conduct a test for possible oncology. In some cases, diagnostic laparoscopy may be necessary.

See also:

Cervical cyst: symptoms, diagnosis and treatment

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Yana Sergeevna

Obstetrician-gynecologist, endosurgeon Member of the European Society of Gynecological Endoscopy Member of the European Society of Human Reproduction and Embryology

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A cyst is a cavity of a pathological nature that develops in organs or tissues and has a wall and contents.What it is? A cervical cyst is a benign cavity that contains fluid. Such formations are not uncommon in women of childbearing age. 10 percent of patients are faced with this unexpected diagnosis for themselves, since the symptoms of the development of the pathological process often do not appear in any way or are simply absent. The most common causes of formations are inflammation of the organs of the reproductive system of the female body, as well as hormonal imbalance in the body of a woman.

The uterus is the main reproductive organ of a woman. The cervix is ​​an important part of it. It is a dense, oval-shaped body with a channel in the middle. This canal acts as a connecting element between the uterine cavity and the vagina. In this case, the internal pharynx looks into the uterine cavity. And the opening that tends to the vagina is called the external pharynx. The vagina has a squamous stratified epithelium. The part of the cervix in the vagina is most likely to develop cysts. The endocervix consists of mucous cells in the form of a cylinder.The mucous membrane is represented by a large number of folds, which are necessary for stretching the cervix during labor. The cervical canal produces mucus, which is endowed with bactericidal properties and is an excellent defense of the uterus against infections. The external pharynx is surrounded by the openings of the tubular glands. They are called nabotovy glands by doctors. If these glands become clogged and mucus accumulates in the ducts, the so-called retention or nabot cysts of the cervix form.

A cervical cyst can occur on the surface along the entire canal.

If formations appear in the vaginal part of the cervix, surrounded by the cervical canal, they are called paracervical.

When a cervical cyst develops within the canal, it is endocervical cysts of the cervix.

More often during the diagnosis, multiple small cysts of the cervix are found. These cysts are not treated, they are considered acceptable. Their presence often goes on without signs or symptoms for a long time.

The most dangerous are single cysts of the cervix. They are characterized by large sizes, as a result of which they often block the channel, which threatens to exacerbate some conditions. The pathological process requires careful diagnosis. Signs of such a neoplasm: irregular periods, severe pain during menstruation, impaired reproductive function of the body. Single cysts in the uterus, the size of which is more than one centimeter in diameter, are usually removed.

Symptoms and signs

What are the symptoms of this ailment? The disease is often asymptomatic.The patient does not feel symptoms and changes in the menstrual cycle, the nature of the discharge, and so on. Most often, a multiple or single cyst in the cervix can be detected only during a gynecological examination. Signs of formation are noticeable during colposcopy and other examinations.

Nabotova cervical cyst requiring treatment is a round formation of white or white-yellow color, has a dense consistency, its size is no more than 3 mm.

There are a number of signs by which a woman should understand that it is impossible to postpone a visit to gynecology and it is worth using the most effective methods of eliminating education that modern medicine offers today.Symptoms and indications for seeking medical attention are as follows:

• Disruptions in the menstrual cycle, because large cysts of the cervix often narrow the cervical canal.
• Inability to get pregnant for the same reason – due to narrowing of the canal.
• Light bleeding after examination by a gynecologist or sexual intercourse. Similar symptoms are possible when the formation is on the posterior lip of the canal.
• Feeling of discomfort. The presence of such a symptom is possible only with large cysts of the uterus.
• Manifestation in a woman of bloody discharge between periods.
• The lower abdomen may hurt – this is another symptom of a cervical cyst.

For any existing symptom, you should visit a doctor and, after receiving the results of the analysis, proceed with the treatment prescribed by the doctor.

Do you have symptoms of a cervical cyst?

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Diagnostics

Before treatment, you need to undergo a number of diagnostic measures.What tests should be taken if there is a suspicion of cervical cysts, what should be checked? The diagnosis of a cervical cyst is made in the hospital during a gynecological examination, and is confirmed by the necessary examinations. The neoplasm is diagnosed by means of vaginal speculum.

A retention cyst is a whitish or yellowish convex mass. An endometrioid cyst is a dark red or purplish lesion that bleeds when touched.Small formations are diagnosed when performing colposcopy, and endocervical formations are diagnosed by means of transvaginal ultrasound or hysteroscopy.

In order to identify urogenital infections, the following is performed:

• analysis of gynecological smear for flora,
• PCR diagnostics.
• Additional tests may be required:
• general analysis of blood, urine,
• biochemical blood test,
• HIV test,
• performing analysis on RW, HBS, HCV,
• tests for other sexually transmitted infections.

To exclude oncology, the attending physician prescribes a cytological examination of the cervical scrapings. Sometimes differential diagnostics are carried out, to clarify the diagnosis, a targeted biopsy is performed with a histology of the obtained tissue. Based on the results of diagnostic measures, the doctor gives recommendations for the treatment of the disease, prices differ depending on the class and equipment of the medical center.

Reasons

It is difficult to determine the reasons that provoked a cervical cyst, but there are a number of factors that can affect the occurrence of the problem:

• Birth of a child.This reason is called because the cervix is ​​damaged during childbirth. Her recovery starts very quickly. It is the excessive speed of the healing process that disrupts the normal functioning of the glands, as a result of which their ducts are clogged, pathology arises.
• Abortion. The disease occurs due to an unprofessional approach to manipulation or the occurrence of complications during or after it.
• The period of menopause in women is associated with an increased risk. The reason for the exit from reproductive age is accompanied by a thinning of the uterine membrane, vulnerability of the glands and other symptoms.All of them react sharply to any irritation, producing mucus in large volumes.
• Infection is called the cause of the disease. Check for which will be offered first. The disease affects the genitals, promotes the formation of oncogenic tumors.
• Using an intrauterine device.
• Failures in metabolic processes.
• The reasons for the cyst of the uterine cervix are also seen in the violation of the hormonal background.

In any case, whatever the reason for the development of the neoplasm, the patient must contact a clinic or medical center, whose specialists own the latest methods of therapy for this ailment.

Treatment

How to treat this ailment is an urgent question for every female who has heard this diagnosis from a doctor. Nobody wants to get sick. The principles of treating the disease are different in each case. If a small formation is found, treatment is usually not carried out. In case of detection of multiple cysts in the cervix or their suppuration, therapy is mandatory.

In some cases, it is possible to cope with the disease and cure the patient only with the help of surgical intervention.For example, the treatment of retention cysts in the uterus by doctors is carried out only by a surgical method, with concomitant sanitation of the vagina.

Methods for removing cysts in the cervix:

• Laser cyst removal.
• Radio wave excision is one of the least traumatic methods for tissues. This procedure is carried out using special equipment. With the help of non-contact sensors, they affect the localization zone of the cyst, under the action of high-frequency radio waves, it coagulates and evaporates.The technique is characterized by the absence of scars on the tissue, such therapy of retention neoplasms is suitable for patients who have not given birth.
• Cryodestruction of the cervical cyst is performed according to indications by means of liquid nitrogen. Due to the action of low temperatures on the tissue, the formation in the neck is destroyed. The procedure is performed on an outpatient basis immediately after the end of menstruation.
• Diathermocoagulation – this method is practically not used today. This is one of the irrelevant treatment methods.The essence of the method lies in the fact that a high-frequency current acts on the neck, causing tissue necrosis. After a while, a crust forms at this place, which is eventually rejected and healed, which subsequently, in childbirth, negatively affects the elasticity and dilatation of the cervix.

The doctor may prescribe another, less traumatic method of therapy for the disease – chemical (solkovagin). It is used in women who have not given birth. For small and shallow formations.Under the action of the drug, which includes acids, the cyst is destroyed, there is no scar, and the mucous membrane is restored.

Cervical cysts are not dangerous if they are detected in a timely manner and, together with a gynecologist, observe them.

Doctors treating this disease

What doctor can cure this condition? It is known that a gynecologist deals with all female diseases, their diagnosis and treatment. Therefore, if you suspect a cyst, you must make an appointment with a gynecologist at an antenatal clinic or at a private medical center.The specialist will carry out diagnostic activities, tell you what treatment methods are available, and select the most optimal solution to the problem for you. The admission price is indicated on the website.

Indications for disease

With a cyst in the cervix, a woman does not need to observe special restrictions in nutrition, physical activity, and sexual intercourse. Also, with a cyst, swimming in open reservoirs, visiting a bathhouse and a swimming pool is allowed.

But in order to prevent the development of such diseases and the stability of the hormonal background in women, among the indications is a full healthy diet, the use of vitamins and microelements.

Another recommendation of specialists for such an ailment is a therapeutic diet No. 15. Vitamins are shown in increased quantities. All types of cooking are allowed. Spicy and difficult to digest food is excluded.

Contraindications for disease

A number of contraindications for such a disease allow the patient to alleviate her condition:

• SPA and physiotherapy procedures will have to be postponed until the end of the treatment.
• Saunas, baths, hot baths are prohibited.
• Excessive sun exposure is contraindicated.
• Any doctor does not recommend lifting weights or performing exercises that involve the abdominal muscles.
• Do not use traditional medicine. The fact is that a variety of herbal lotions, infusions and other recipes from the times of our grandmothers can not only turn out to be useless, but also cause harm.

There are many foods available to stimulate cyst growth.Therefore, it is necessary to exclude from consumption all products containing yeast or created by fermentation. Bread, sauerkraut, pickles, unpasteurized beer, fruit and berry wines, and red meat are banned. At the same time, it is recommended to regularly consume boiled egg yolks, pumpkin seeds and sunflower oil.

With the development of technological progress and the popularity of the Internet, patients often look for ways to get rid of their illness on the pages of numerous forums and sites, without consulting a doctor, self-medicate, take hormonal drugs.This is, in principle, unacceptable, since in this way you can only complicate the course of the disease.

Cost of admission

The cost of cervical cyst treatment at Medicina JSC (Moscow) is presented in the table below. Please note that prices are categorized to make it easier to find the service you need. From the table below, you will find out the price for doctor’s appointments, examinations, tests and other medical procedures for both adults and children. The cost of the primary admission differs from the secondary one.If you have any questions, you can call our help desk and clarify the prices for treatment.

Benefits of treatment in the clinic of JSC “Medicine”

JSC “Medicine” is a high-tech medical institution that provides a full range of medical services and services according to modern international standards.

The clinic has been operating and accepting patients since 1990, guaranteeing absolute reliability, high quality service and innovative technologies.In our activities, we embody the revolutionary achievements of world health care.

A multidisciplinary medical center is successfully operating on the basis of Medicina, which includes an advisory clinic, a comfortable hospital, a 24-hour ambulance and a modern Sofia oncological center. We employ over 300 doctors of 67 specialties. The clinic conducts work, receptions and consultations in 69 medical areas, including diagnostics, therapy, pediatrics, outpatient and surgical gynecology, assisted reproductive techniques, including IVF, cardiology and cardiac surgery, otorhinolaryngology, ophthalmology and ophthalmosurgery, urology, andrology and nephrology, endocrinology and dietetics, traumatology and orthopedics, oncology (diagnostics, radiation and chemotherapy, surgical treatment), dermatology, cosmetology, dentistry, rehabilitation and restorative medicine, clinical examination and prevention, neurology, neurosurgery, neurorehabilitation, ambulance, family medicine and others …

We have a principle of continuity of stages of medical care: the curator treats the patient as a family doctor, therapist or pediatrician, coordinates the treatment prescribed by narrow specialists, and also takes part in the treatment of his patients in a hospital setting.

We provide services to the highest Russian and international standards. JSC “Medicine” is the first Russian medical center, which was accredited according to the most reliable international quality standards of medical care Joint Commission International.JSC “Medicine” was the first Russian clinic to receive a certificate from the All-Russian Organization for Quality.

We guarantee an impeccable quality of medical care, providing patients with services according to high quality criteria. If the client has a valid complaint, we are ready to pay compensation.

Highly qualified doctors. Specialists in JSC “Medicine” undergo advanced training and exchange experience with the best clinics in the world. Many medical areas, including a sleep laboratory, a center for traumatology and orthopedics, departments of chemotherapy and radiation therapy, were created in collaboration with renowned foreign colleagues.We are proud of our doctors. The clinic’s consultants are leading foreign and domestic experts with worldwide recognition. Information about our doctors, their work experience, education and experience can be found on the resource of our medical center.

University clinic. JSC “Medicine” is a multidisciplinary university clinic, we develop clinical and scientific solutions in various medical areas. The consultations are carried out by academicians and corresponding members of the Russian Academy of Sciences, professors and leading specialists in various fields of medicine.The teaching and laboratory base of the department is located in the building of the clinic.

We use advanced IT infrastructure in our work. To ensure high-quality service and comfort for patients and employees, we have developed an electronic medical history with a system for checking medications prescriptions, implemented digital archives solutions that make it possible to store the results of medical research obtained from various equipment (computed tomography, magnetic resonance imaging, X-ray equipment, equipment for ultrasound examinations, endoscopic equipment).

JSC “Medicine” operates under a smart clinic project. The work of our medical institution is coordinated by a data processing center (DPC), in the development of which high requirements were taken into account in terms of reliability, security and fault tolerance. A modern data transmission network is capable of processing a colossal amount of information and meeting the security requirements dictated by current legislation. Patients can make an appointment and view information relevant to them through convenient services: a mobile application, a personal account on the website, a Telegram bot.The test results can be copied to disk and issued to obtain a “second opinion” from specialists from other medical institutions. With the consent of the patients of the hospital, their relatives can receive SMS notifications about the stages of surgical intervention and observe the hospital and the ward in real time, each time making sure of the unsurpassed quality of service and treatment programs in our clinic.

Treatment of benign formations of the skin and subcutaneous tissue

Treatment: atheroma, hygroma, adipose tissue, dermatopapiloma, benign nevi, fibroma, hemangioma, candidaloma, spines, spines, plantar warts.

Atheroma (wen) – benign formation of the sebaceous gland, located in the subcutaneous tissue – pseudo-tumor, cyst of the sebaceous gland. Atheromas are formed as a result of blockage of the duct of the sebaceous gland, as a result of which the secretion produced by the gland accumulates, forming an encapsulated seal in the thickness of the skin and subcutaneous tissue. They can appear on any part of the body where hair grows, but its predominant localization is on the scalp, face, back, neck, genital area.Atheromas tend to grow by pushing back the surrounding tissue and inflammation. A complication of inflammatory manifestations in atheroma can be suppuration, abscess, phlegmon. The most favorable period of surgical treatment – excision of atheroma within the capsule without violating its integrity – is a treatment outside of inflammation.

Hygroma is a benign cystic tumor of the synovial bag or tendon containing a jelly-like liquid. Hygromas are more common in women aged 20-30 years [3].Usually, patients do not feel pain with the small size of the hygroma, which makes it difficult to detect and treat it in the early stages. Hygromas are located in the area of ​​the tendons of complex joints (joints involving several bones), mainly on the dorsal and palmar surfaces of the wrist joint, the posterior surface of the knee joint (Becker’s cyst). A small cyst can be cured conservatively – by performing a puncture of the cyst with the introduction of drugs into its lumen that dissolve the cyst wall.The greatest – without a recurrent effect of treatment is presented by surgical treatment, which consists in excision of the cyst with stitching of its neck at the base.

Lipoma is a benign tumor-like formation of subcutaneous adipose tissue. Lipoma consists of fat cells and connective tissue. If the lipoma consists only of fat, then it is soft to the touch. The more connective tissue it contains, the denser it is. This tumor is painless, causes discomfort and a violation of the aesthetic appearance, being located mainly in the subcutaneous fatty tissue of the back, neck, shoulders, hips.Nodes can be single or multiple. There are lipomas of internal organs (lipoma of the retroperitoneal tissue, mediastinum). Lipomas are prone to growth, pushing and squeezing the surrounding tissues, therefore, the volume and “trauma” of the operation depends on the size of the formation – the larger the lipoma, the more difficult the operation, the larger the postoperative scar. In the clinic, operations are performed under local anesthesia, aesthetics are taken into account (minimal cosmetic defect).

Benign skin lesions:

Dermatopapillomas , papillomas ( warts )

Benign skin lesions caused by the human papillomavirus (HPV).This formation consists of epidermal cells (flat cells), appears on the skin in the form of papillae on a thin or wide leg, is not pigmented, often there are hair follicles on the papilloma (a sign of a benign tumor). These formations are surgically excised with a scalpel within the unaltered tissues. In our clinic, we perform a less traumatic method of removing papillomas using a laser and a surhydron. This manipulation for one papilloma takes several seconds, is completely painless, does not require stitches.

Pigmented nevi (moles)

Benign skin lesions consisting of pigment cells (cells containing melanin). The sizes of these formations are varied, the color saturation depends on the amount of pigment, and they can also protrude above the level of the skin. This type of tumor must be differentiated from a malignant tumor of the skin (cancer) – melanoma. A benign nevus under the influence of ultraviolet radiation can degenerate into a malignant form, so doctors recommend removing the formation data, or periodically examining it, avoiding exposure to sunlight.This formation can be removed both by excision of the tissue with a scalpel followed by suturing of the tissue, and by the action of a laser or surgidron. The last two methods are cosmetic, less traumatic and completely painless.

Fibromas, sclerosing hemangiomas, dermato-fibromas.

In the common people, these formations are confused with warts, they are often called that. A benign type of tumor, consisting of connective tissue, located in the thickness of the skin.These tumors are more dense, can be located at the level of the skin or slightly protrude, have a color from purple to pale pink (depending on the composition of tissue cells). These formations mainly appear in women, localizing on the legs, thighs, chest, abdomen, and less often on the arms. It is possible to remove this type of tumor in combination: excision with a scalpel using a laser or a diathermocoagulator. After removal, the wound is sutured with a cosmetic suture. This method is necessary for the complete removal of the tumor, as cat fibromas often grow into all layers of the skin.

Skin hemangioma

A type of benign tumor, which includes the cells lining the capillaries and blood vessels. This type of tumor is often confused with moles. A distinctive feature is the change in color, whether the patient disappears when pressed. Hemangiomas can be at the level of the skin or slightly raised. In case of damage (injury), they bleed intensively. It is possible to remove this formation without pain and scars with a laser photo-coagulator.

Plantar warts (spines)

A benign tumor with an increase in keratinized epithelium, located mainly on the feet and palmar surface of the hand (fingers and palms), often resembles a callus, but unlike calluses, soreness appears when pressed.The causes of this formation are the papilloma virus, which is why they can multiply covering the entire surface of the foot or palm. It is possible to cure this disease either by excision with a scalpel (traumatic method), cryodestruction (with this method, a high percentage of recurrence), laser excision or surhydron. Laser excision is the most modern and most effective, painless way to remove spines today.

Cyst of Bartholin’s gland

Bartholin’s glands are located in the thickness of the labia majora, at their base, one on each side of the entrance to the vagina.Their excretory ducts open on the inner surface of the labia minora. They secrete a viscous fluid that lubricates the inside of the vagina during intercourse. When the excretory duct is blocked, fluid begins to accumulate in the gland, which leads to the formation of a cyst. Outwardly, it looks like a rounded swelling, usually on one side of the vagina.

Cyst of the Bartholin gland occurs in 2% of women, more often between the ages of 20 and 29 years. Children do not have this disease, since the glands begin to function after puberty.In many cases, women are unaware of the presence of a Bartholin gland cyst; it is often detected during a routine preventive gynecological examination. However, with a large size, the cyst can cause discomfort, and the addition of an infection threatens with an abscess of the Bartholin gland.

Most often, the cyst of the Bartholin gland goes away on its own or after using outpatient methods of treatment. However, if the cyst is large or an abscess occurs, surgical and medical treatment may be required.

In general, the prognosis of the Bartholin’s gland cyst is favorable. This disease does not pose a threat to a woman’s life, although it can cause serious discomfort. In extremely rare cases, cancer of the Bartholin gland occurs.

Synonyms Russian

Cyst of the Bartholin gland.

Synonyms English

Bartholin’s cyst, Bartholin’s abscess, vaginal lump, vaginal cyst.

Symptoms

In most cases, the cyst of the Bartholin gland does not cause any discomfort.With large cysts, pain and discomfort when walking and during intercourse are likely. With the addition of an infection, a woman may be disturbed:

• discomfort when walking and sitting,
• pain during intercourse,
• fever.

General information about the disease

The excretory ducts of the Bartholin glands are thin canals. When these channels are blocked, fluid accumulates in the gland, which leads to its stretching and enlargement.The cause can be trauma, infection, friction during intercourse. Outwardly, the cyst looks like a rounded swelling with a smooth surface, which is located at the entrance to the vagina. Most often, the size of the cyst does not exceed 1 cm. In some cases, the cyst can reach a size of 8 cm. With its small size, it does not cause discomfort to the woman, it can be detected on its own or during a gynecological examination. With a large cyst, a woman may experience discomfort or even pain when walking and during intercourse.The gland secretes fluid necessary for intercourse, so the size of the cyst may increase after intercourse.

In some cases, infection of the fluid in the cavity of the gland occurs – an abscess of the Bartholin gland is formed. The cause of an abscess can be both opportunistic microorganisms (that is, living in the human body normally, but causing the disease only under unfavorable circumstances), and sexually transmitted infections. An abscess usually develops within 3 to 4 days.In this case, a woman may experience pain when walking and during intercourse, discomfort in a sitting position, and the temperature may rise. If the cause is a sexually transmitted infection, the woman may be bothered by genital discharge and other symptoms that are characteristic of a particular infection.

Who is at risk?

• Women aged 20-29.
• Women with sexually transmitted infections.

Diagnostics

Most often, the diagnosis “cyst” or “abscess” is made already during a medical examination and on the basis of the patient’s complaints.However, sometimes additional laboratory and instrumental research methods may be required.

Laboratory diagnostics

General clinical trials

• Complete blood count (without leukocyte count and ESR). The level of leukocytes may be increased, which indicates the addition of an infection and the formation of an abscess of the Bartholin gland.
• ESR. Erythrocyte sedimentation rate. When the protein composition of the blood changes, the ESR may change. It increases with infections, including some sexually transmitted diseases (such as syphilis).
• General urine analysis. With an abscess of the Bartholin gland, a large number of leukocytes can be found in the urine.

Diagnosis of sexually transmitted infections

• Microscopy of a smear and subsequent culture of vaginal discharge with determination of sensitivity to antibiotics. With an abscess of the Bartholin gland, a diagnosis of sexually transmitted infections is carried out as a possible cause of the disease. To do this, use a microscopic examination of the vaginal discharge, as well as sowing on a nutrient medium to determine the sensitivity of the identified microorganism to a certain group of antibiotics.This is necessary to prescribe the most effective treatment.
• Enzyme-linked immunosorbent assay (ELISA) – allows you to identify antibodies (immunoglobulins) to certain infections, that is, specific proteins that are produced in response to the penetration of a microorganism.
• Polymerase chain reaction (PCR) – allows you to identify the genetic material of the pathogen in biological material – blood, urine, urethral or vaginal discharge, tissue sample, cerebrospinal fluid.

Additional studies

• Bartholin gland biopsy.Taking a sample of the gland tissue with a needle after anesthesia. The sample is then examined under a microscope to detect changes in cellular composition. This is necessary to exclude cancer of the gland in women over 40 years of age with suspected malignant neoplasm.

Treatment

In many cases, the cyst of the Bartholin gland heals on its own. Sometimes outpatient treatment is sufficient, such as warm baths for 3-4 days. If the gland is large, surgical treatment may be required.In some cases, the so-called marsupilization of the cyst is performed – the doctor makes a small incision in the membrane (capsule) of the cyst, and then sews the edges of the membrane to the edges of the wound. An opening is formed, which gradually narrows over two months, forming a new excretory duct of the gland. In the first days after the operation, a flexible thin tube is inserted into the lumen of the wound for a better outflow of the contents of the cyst.

With an abscess of the Bartholin gland, drainage of the abscess may be required: after local anesthesia, the doctor makes a small incision into which a rubber tube (catheter) is inserted to drain fluid from the abscess cavity.At the same time, a course of antibiotics is sometimes prescribed to fight the infection.

If the listed methods of treatment do not give a positive effect, the gland is removed surgically.

Prevention

There is no specific prophylaxis of the Batrolin gland cyst. Prevention of gland abscess is to protect against sexually transmitted infections (for example, using barrier methods of contraception).

Recommended analyzes

• Complete blood count
• Leukocyte formula
• ESR
• General urine analysis with microscopy
• Study of vaginal microbiocenosis with determination of sensitivity to antibiotics
• Sowing for flora with determination of sensitivity to antibiotics and bacteriophages
• Syphilis RPR (anticardiolipin test / micro-precipitation reaction), titer
• Treponema pallidum, DNA [PCR] (urogenital smear, scraping, urine, prostate secretions, ejaculate)
• Treponema pallidum, antibodies, hypersensitive
• Syphilis RPHA (passive hemagglutination reaction), titer
• Neisseria gonorrhoeae, DNA [real-time PCR] (urogenital smear, urine)
• Chlamydia trachomatis, DNA [PCR] (urogenital smear, urine, ejaculate, prostate secretion)
• Culture for Chlamydia trachomatis with determination of antibiotic susceptibility
• Histological examination of biopsy diagnostic material (endoscopic material, tissues of the female reproductive system, skin, soft tissues)

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A repeated consultation is considered to be a consultation of one specialist within 30 days from the date of the previous appointment.On the 31st day from the previous visit to a specialist of this profile, the consultation will be primary.

90,000 Symptoms of urethral diverticulum in women | Treatment (removal) of cysts of the vestibule, posterior and anterior walls of the vagina

Below is a general background information about the disease, in practice the course of the disease may proceed differently.Do not try to engage in self-diagnosis and treatment, seek a free consultation from our experienced specialists.

Vaginal cyst treatment

In all cases, treatment involves the complete removal of the vaginal cyst, urethral diverticulum and / or paraurethral cyst. At the same time, in some clinics and today, methods such as marsupialization (excision) and puncture aspiration (puncture) are used. Unfortunately, a puncture or incision of the cyst is often insufficient: it quickly refills with fluid.In such cases, a radical method will be required – complete excision of the paraurethral cyst and / or diverticulum. Due to the high complexity and significant risk of complications, such operations are recommended to be trusted by experts of an expert level. The complexity of the operation is associated with a high risk of damage to the urethra with the possibility of developing a urethrovaginal fistula or urinary incontinence in the postoperative period. You can get a specialist consultation and choose an individual treatment by signing up for a free appointment.

Reasons

Vaginal cyst, urethral diverticulum, paraurethral cyst in women are diseases that are simultaneously within the competence of a urologist and a gynecologist. Due to the low prevalence of these diseases, the overwhelming majority of full-time doctors of local polyclinics today do not have the necessary experience in differentiating these pathologies. Conventional diagnostic methods do not allow identifying the characteristic features of these diseases.

Vaginal cyst is a hollow tumor-like formation filled with watery or mucous fluid.The cyst can reach 9-10 cm in diameter and is located both on the surface of the vaginal walls and in the depths of the tissues. This disease occurs in 1-2% of patients. Experts distinguish the following types of cystic vaginal formations:

• Congenital. Most often localized in the middle lateral or posterior walls of the vaginal cavity. Less common is a congenital cyst of the anterior vaginal wall. Formed due to anomalies of intrauterine development.

• Traumatic or implantation . Most often they are located much lower than congenital cysts in the posterior walls of the vaginal cavity. Formed as a result of surgery, birth trauma, abortion.

• Cysts of the vestibule of the vagina. Formed due to inflammation of the Bartholin gland. The cause of inflammation can be injuries, sexually transmitted infections, non-observance of the rules of intimate hygiene.

Paraurethral cyst is a rounded, hollow formation that forms from the glands of the urethra. The urethral cyst in women is filled with mucous fluid and can reach 2-4 cm in diameter. Most often it develops at the outer opening of this channel and much less often in the depths of the tissues. Formed as a result of inflammatory diseases of the genitourinary system, birth or surgical injuries, due to a decrease in immunity (including against the background of diabetes mellitus).Urethral cyst occurs in 2-6% of women.

Urethral diverticula in women is a hollow, rounded formation, most often formed in the region of the posterior wall of the urethra, usually communicating with the urethra. The cavity of the diverticulum can be up to 3 cm in diameter, and the wall of the diverticulum is similar to the wall of the urethra. When urinating, the diverticulum may enlarge, as some urine may be retained in the cavity. Urethral diverticula occur in 1.6-5% of women.Experts distinguish the following types of this disease:

• Congenital. Formed as a result of intrauterine developmental disorders: expansion of paraurethral cysts, improper fusion of the embryonic folds of the urethra.

• Purchased. Formed as a result of the transformation of paraurethral cysts, while there is a communication between the cyst and the urethra.

Symptoms

In small tumors, such as a paraurethral cyst, urethral diverticulum or vaginal cyst, most often there are no symptoms.Complaints arise with an increase in pathological formations or with their infection, which may occur due to the accumulation of stagnant urine in a tumor-like cavity. In diverticula, stagnant urine can also lead to the formation of stones, in rare cases, to the formation of a malignant tumor. In the process of development of these diseases, there may be a feeling of discomfort or pain during intercourse, periodic purulent discharge, a feeling of a foreign object in the perineum or vagina, fever, intermittent and / or difficult urination, as well as the release of drops of urine after emission.

Diagnostics

Correct diagnosis has a decisive influence on the success of the treatment of paraurethral cysts, urethral diverticula and vaginal cysts. Due to similar symptoms and a wide variety of factors leading to the onset of these diseases, their diagnosis is a rather difficult task. An incorrect interpretation of clinical symptoms can lead to the appointment of inadequate treatment and, as a result, to a lack of positive results.

Examination of patients with suspected pathology of the genitourinary system includes:

• Gynecological examination .Allows an experienced urogynecologist to identify the typical signs of these diseases in the vast majority of cases.

• Laboratory diagnostics . Includes clinical analyzes and bacteriological studies of urine and the secreted contents of cystic formations.

• Instrumental, radiation, urodynamic, endoscopic, etc. diagnostics . The purpose of these types of research is determined by the doctor individually for each patient, depending on the initial diagnosis.

In our clinic, complex examinations (including MRI of the pelvis and three-dimensional ultrasound) and operations of the paraurethral cysts, diverticula and vaginal cysts are carried out by specialists under the guidance of Professor D.Yu. Pushkar. We carry out successful treatment of patients previously unsuccessfully operated in other clinics. Leading experts – Associate Professor M.Yu. Gvozdev and associate professor G.R. Kasyan are recognized experts in urogynecology and vaginal surgery in our country.

To date, the clinic is recognized as a leading training center for specialists in urogynecology (including surgery of the female urethra) in the European Association of Urology. In our clinic, not only Russian, but also foreign specialists are trained to perform operations on vaginal cysts, urethral diverticula and paraurethral cysts.