Could Ovarian Cysts Be Causing Your Low Back Pain?: Signature Women’s Healthcare: Obstetricians & Gynecologists

Ovarian cysts form naturally, usually around the time you ovulate. These fluid-filled sacs typically don’t cause troublesome symptoms and go away on their own without treatment.

If you develop large cysts or multiple cysts, however, you might experience unpleasant symptoms, like pain. While it’s more common to experience abdominal pain, ovarian cysts could also be responsible for pain in your lower back.

At Signature Women’s Healthcare in Lawrenceville and Lithonia, Georgia, our OB/GYN physicians, Jacquline Hayles-Patterson, MD and Tyndal M. Jones, MD, diagnose and treat problematic gynecological issues, like ovarian cysts.

If you’re experiencing low back pain, keep reading to learn more about ovarian cysts, how they can trigger your pain, and what we can do to help. 

Ovarian cysts 101

Your ovaries play a big role in your menstrual cycle, breast development, and pregnancy. They’re responsible for producing the hormones estrogen and progesterone, and each month an ovary releases an egg as part of your normal cycle. 

Ovarian cysts develop for various reasons. Most of the time, they aren’t cause for concern, forming during normal menstrual cycle processes when you ovulate and an egg is released from the follicle. If the egg isn’t released, however, you might develop a follicular ovarian cyst.

Cysts vary in size, ranging from less than an inch to more than four inches. The development of problematic ovarian cysts may be triggered by: 

• Hormonal issues
• Pelvic infections
• Endometriosis

While adolescents and women of childbearing age commonly develop cysts, it’s less likely you’ll get them if you’re menopausal or pre-pubescent. 

Low back pain and ovarian cysts

Most of the time, if an ovarian cyst causes pain, you feel it in your lower abdomen. Although everyone is different, most women describe this abdominal pain as dull, mild, and intermittent.  

Recent studies, however, have shown that low back pain is more common than originally believed when it comes to ovarian cysts. In fact, nearly 45% of women with low back pain also had an ovarian cyst. 

Ovarian cysts are more likely to cause low back pain when they’re large. That’s because larger cysts can press on your tissues and organs, triggering pain or discomfort in your lower back.

This type of low back pain is most often described as dull and achy, but if the cyst ruptures, the pain may become sharp and severe. It is also usually accompanied by other symptoms, including: 

• Fullness or pressure in your pelvis
• Bloating or swelling 
• Painful or irregular periods
• Spotting between periods
• Pain during sex 
• Constipation

You may also feel the need to urinate more often than normal or have burning during urination if you have an ovarian cyst. Because these symptoms are shared with other conditions, it’s imperative to visit your gynecological provider for an accurate diagnosis.

Treating ovarian cysts

It’s important to keep in mind that most ovarian cysts go away on their own and don’t require medical intervention. If you have recurrent ovarian cysts, or if the ovarian cysts cause you pain, your Signature Women’s Healthcare OB/GYN might recommend hormonal contraceptives to stop cysts from developing. 

To address your pain or discomfort, your provider may also prescribe pain-relieving medications, like nonsteroidal anti-inflammatory drugs (NSAIDs), and other pain-reducing techniques, like warm compresses. 

If you’re diagnosed with a large ovarian cyst or one that doesn’t go away on its own, your provider at Signature Women’s Healthcare provider might determine that surgical intervention is the best treatment option. Most surgeries for ovarian cysts leave your ovary intact; although rare, ovary removal is sometimes required.  

Find out if your low back pain could be caused by ovarian cysts by contacting the Signature Women’s Healthcare office nearest you. You can reach us at 678-380-1200 to schedule, or book an appointment online today.

Pelvic pain and ovarian cysts: Do they mean cancer?

While pain is a common symptom of a woman’s period, it might seem uncommon if you’re having persistent pelvic pain. It might come every month for a few months, then stop. Or you might feel it randomly throughout the month, with no association with your period at all.

In this age of self-diagnosis, pelvic pain is just a Google search away from a cancer diagnosis. In fact, many young women who experience pain in their lower abdomen may simply have a benign ovarian cyst. Ovarian cancer is rare during a woman’s childbearing years (most women with ovarian cancer are between ages 55 to 64). But ovarian cysts are quite common, and the symptoms may be similar to those of ovarian cancer: pelvic pain, bloating, back pain and nausea or vomiting.  Learn about ovarian cancer survival statistics and results.

What’s the difference?

It’s important to know about various types of ovarian cysts and understand the symptoms of ovarian cancer. Most women with an ovarian cyst have what’s called a functional cyst, which is associated with their menstrual cycle. These types of cysts develop during or after ovulation, which is when an egg may be released for conception.

Follicular cysts form before the egg is released. They usually take one to three months to go away on their own.

Corpus luteum cysts form after the egg is released. These cysts usually go away on their own in a few weeks.

Other types of cysts include:

Endometriomas: Women with endometriosis may develop this type of cyst. With endometriosis, tissue that looks and acts like the lining of the uterus grows outside the uterus. Cysts may develop when the tissue attaches to the ovary.

Cystadenomas: These cysts may be filled with fluid and may become large, causing pain.

Dermoid cysts: These cysts may be filled with seemingly odd materials such as hair, teeth and other tissues. They also may become large and cause pain.

Polycystic ovaries: Many cysts form when follicles do not release their eggs on a cyclical basis.

A pelvic exam is the first step toward diagnosing ovarian cysts or ovarian cancer. During the exam, your doctor may be able to feel the cyst manually. Either way, your doctor may order an ultrasound to determine the cysts’ size, shape, location and composition before deciding next steps, which are typically either watchful waiting or surgery.

The symptoms of ovarian cancer, though vague, may be more extensive than those of ovarian cysts. Along with the symptoms shared with ovarian cysts, possible signs of ovarian cancer include:

• Difficulty eating or feeling full quickly
• A feeling of heaviness in the lower abdomen or pelvis
• Constipation and increased gas
• Lack of appetite
• Urinating more frequently

Any symptoms associated with ovarian cancer should not be ignored. But if you are younger, they should be kept in perspective. If you have experienced any of the above symptoms, pay particular attention to bloating or a swollen belly, difficulty eating or feeling full quickly, as well as pelvic pain or pelvic heaviness. See your gynecologist if these occur every day for more than a few weeks.

Learn more about how men and women experience chemotherapy differently.

Tarlov cysts: A cause of low back pain?

Do Tarlov cysts usually cause back pain?

Answer From John Atkinson, M.D.

It’s possible. However, Tarlov cysts are an uncommon cause of back pain.

Tarlov cysts are fluid-filled sacs that most often affect nerve roots at the lower end of the spine. Such cysts typically cause no symptoms and are found incidentally on magnetic resonance imaging (MRI) studies done for other reasons.

However, in some cases, the cysts expand, putting pressure on the affected nerve root. The results may include sharp, burning pain in the hip and down the back of the thigh, possibly with weakness and reduced sensation all along the affected leg and foot. Tarlov cysts sometimes enlarge enough to cause erosion of the surrounding bone, which is another way they may cause back pain.

In most cases, Tarlov cysts require no treatment. For those that do, some surgical treatments — such as draining the cyst — have had promising results. Because symptomatic Tarlov cysts are uncommon, studies have been too small and too dissimilar to identify the most effective treatment procedure.

Get the latest health advice from Mayo Clinic delivered
to your inbox.

Sign up for free, and stay up-to-date on research
advancements, health tips and current health topics,
like COVID-19, plus expert advice on managing your health.

Learn more about our use of data

To provide you with the most relevant and helpful information and to understand which
information
is beneficial, we may combine your e-mail and website usage information with other
information we have about you. If you are a Mayo Clinic Patient,
this could include Protected Health Information (PHI). If we combine this information
with your PHI, we will treat all of that information as PHI,
and will only use or disclose that information as set forth in our notice of privacy
practices. You may opt-out of e-mail communications
at any time by clicking on the Unsubscribe link in the e-mail.

Subscribe!

Thank you for Subscribing

Our Housecall e-newsletter will keep you up-to-date
on the latest health information.

We’re sorry! Our system isn’t working. Please try again.

Something went wrong on our side, please try again.

Please try again

• Prolotherapy: Back pain solution?
• Back pain relief: Ergonomic chair or fitness ball?

April 20, 2019

Show references

1. Burke JF, et al. Microsurgical treatment of sacral perineural (Tarlov) cysts: Case series and review of the literature. Journal of Neurosurgery: Spine. 2016;24:700.
2. Potts MB, et al. Microsurgical fenestration and paraspinal muscle pedicle flaps for the treatment of symptomatic sacral Tarlov cysts. World Neurosurgery. 2016;86:233.
3. Hulens M, et al. Electromyographic abnormalities associated with symptomatic sacral Tarlov cysts. Pain Practice. 2016;16:E81.

See more Expert Answers

Products and Services

1. Book: Back and Neck Health
2. Book: Mayo Clinic Guide to Pain Relief

.

Tarlov Cysts and Back Pain

A Tarlov cyst (TC) is a fluid-filled sac that can develop anywhere in the spine affecting the nerve roots. These cysts are sometimes called perineural, meaning the cyst can surround (peri) a nerve (neural). They are also known as sacral nerve root cysts because TCs are more common in the sacrum. These cysts can compress spinal nerve roots causing pain, weakness and numbness that radiates (radiculopathy) into the lower extremities (eg, legs).
Magnetic resonance imaging (MRI) of a Tarlov cyst. By Malisan.mrosa. Own work, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=8434925

Roger’s Experience With Tarlov Cysts

Five years ago, I went to the doctor because of low back pain. The imaging test revealed Tarlov cysts around my sacrum, but my doctors told me not worry—the cysts were not the cause of my back pain (“asymptomatic”). Last year, I suffered a terrible fall down a flight of steps. That changed everything, as the fall aggravated my cysts. Suddenly, I began to experience debilitating nerve pain and weakness radiating down the bottom half of my body. Sitting and standing for more than a few minutes at a time was unbearable. What should I know about Tarlov cysts, and can anything be done?—Roger, Great Falls, MT

What Are Tarlov Cysts?

Tarlov cysts are fluid-filled cysts that can develop along the nerve roots in your spine. They are most often found in your sacrum, but they can occur at any spinal level.

Tarlov cysts can be asymptomatic (causing no symptoms) or symptomatic (causing symptoms). While large symptomatic Tarlov cysts are rare, the smaller asymptomatic variety is much more common—in fact, as much as 9% of the population have asymptomatic Tarlov cysts.

As Tarlov cysts grow, they can press on your spinal nerve roots—this is when symptoms develop. The primary symptom is radiculopathy, or nerve pain.

Women develop Tarlov cysts more often than men, though researchers aren’t sure why.

What Causes Tarlov Cysts?

Tarlov cysts were first identified in 1938, but the medical community still doesn’t know the exact cause of this spinal disease.

However, doctors believe they know why asymptomatic Tarlov cysts become symptomatic. Spinal trauma from a severe fall or car accident that impacts the low back and tailbone area may cause increased cerebrospinal fluid pressure. Cerebrospinal fluid is what fills Tarlov cysts, and this increased pressure may cause the cysts to grow and become symptomatic.

What Are the Symptoms of Tarlov Cysts?

As Tarlov cysts grow and put pressure on your spinal nerves, simple postures like sitting, standing, bending, and walking may become incredibly painful. Symptoms may vary based on where the cyst is located on your spine, but you may experience:

• Radiculopathy (radiating nerve pain)
• Sciatica
• Pain near the site of the cysts
• Muscle weakness
• Difficulty maintaining certain postures (such as sitting or standing) for long periods
• Poor or absent reflexes
• A loss or change in skin sensation
• Bowel and bladder dysfunction
• Sexual dysfunction

Why Are Tarlov Cysts Difficult to Diagnose?

Doctors may struggle to accurately diagnose a Tarlov cyst because it’s a rare disease, and few doctors have a strong understanding of it. Secondly, the symptoms of Tarlov cyst mirror those of other much more common spinal problems (such as a herniated disc or degenerative disc disease).

A Tarlov cyst is usually confirmed by results of a magnetic resonance imaging (MRI), computed tomography (CT) scan, or myelogram. These imaging tests can illuminate the fluid-filled cyst around the spinal nerve roots.

Who Treats Tarlov Cysts?

As with most health concerns, your primary care physician (PCP) is often the starting point to securing a diagnosis and coordinating specialist referrals. If you are having pain in your lower back or in another part of your spine, don’t wait to see your PCP.

Your PCP may refer you to a neurologist and pain management specialist to help you understand your treatment options. If you have bladder dysfunction, your PCP may also refer you to a urologist, and in some cases a spine surgeon.

What Non-surgical Treatments Ease Tarlov Cysts Pain?

While there is no cure for Tarlov cysts, several non-surgical treatments may help you manage symptoms. No standard treatment plan exists for Tarlov cysts, so your health care team may recommend a combination of the following therapies:

Unfortunately, none of these therapies prevent a cyst from recurring.

Is Spine Surgery an Option for Tarlov Cysts?

If you have tried various non-surgical treatments with no success, your doctor may recommend spine surgery for your Tarlov cyst(s).

Surgery for Tarlov cysts involves opening the cyst and draining its fluid. The surgeon then injects the cyst with a fibrin glue to prevent the fluid from coming back.

Because Tarlov cysts develop alongside spinal nerves, your surgeon may use a spinal decompression technique, such as a laminectomy, to create space around the cramped nerves. Your surgeon may also remove the cyst and surrounding nerve roots.

Spine surgery may not fully alleviate your symptoms. Talk to your spine surgeon about the risks and benefits of surgery for you prior to undergoing a procedure.

Preserving Your Quality of Life with Tarlov Cysts

Symptomatic Tarlov cysts are a rare spinal disease, and you may feel like no one else understands your pain. But, you’re not alone. Joining a support group can be an extremely helpful coping strategy and staying in close contact with your pain management team is a strong defense against symptoms.

Spinal Cysts | Johns Hopkins Medicine

What are spinal cysts?

Ganglion and synovial cysts are benign lumps caused by a buildup of fluid in a tendon sheath or joint capsule. They most commonly show up on the top of the wrist, but may also affect the feet or the spine.

What are the symptoms of spinal cysts?

Depending on the size and location of the cyst, symptoms may be similar to those of spinal stenosis, including:

• backache
• radicular (“pinched nerve”) pain on one or both sides
• neurogenic claudication (pain or weakness due to compressed nerves)
• numbness
• difficulty moving
• diminished reflexes
• paralysis (very rare)
• change in bowel or bladder function

What are the risk factors for spinal cysts?

Spinal cysts are more common in people over the age of 50.  The cause of spinal cysts is unknown, but they may result from degeneration and instability of the spine in areas subjected to repetitive motion, particularly the joints in the lumbar region. Patients with spinal cysts may have other degenerative conditions of the spine, such as arthritis and disk disease.

Spinal Cyst Diagnosis

For a patient reporting symptoms, a doctor may recommend an X-ray to rule out other problems, but the cyst is usually found through magnetic resonance imaging (MRI). The cyst will clearly appear as a bubble-like growth near a facet joint, which is a connection between vertebrae of the spine.

Knowing the cyst’s size and position will help the doctor develop a treatment plan.

Spinal Cyst Treatment

Conservative treatment may include rest, anti-inflammatory medications, painkillers, steroid injections and drainage. Though these approaches may temporarily relieve the symptoms, cysts may reform or refill, resulting in further discomfort.

Surgery may be recommended for persistent cysts that cause pain and impaired movement. There are several surgical approaches to removing a cyst and preventing recurrence. Patients should discuss the options with their spine surgeon for guidance on what’s most likely to provide lasting relief.

Lumbar Spine Cysts

Question: My husband has a cyst on his lumbar spine. Can the cyst become infected or burst? And is surgery the only option?
—Kenosha, WI

Answer: There are actually 6 kinds of cysts that occur near the lumbar spine. The causes and treatments for each are very different.

The first kind is called a synovial cyst. This is an outpouching of the lining of the facet joint. The joint is normally lined with lubricating fluid called synovium. That lining can extrude out of the joint from trauma or degeneration and form a cyst.

This cyst can be painful and can also pinch nerves. They may rupture, but usually it is the cyst wall that is problematic. The wall is often very thick and adheres to the surrounding nerve tissue. Consequently, needle aspiration, or drainage, of these cysts is seldom effective and surgery is usually required.

Ganglion cysts function much like synovial cysts but arise from the posterior longitudinal ligament (which is located behind the spine and inside the spinal canal). They often require surgical removal if they become symptomatic.

The third kind of cyst is a Tarlov cyst, which is a cyst of the nerve roots commonly in the sacrum (or lower spine). These are more common in women and are frequently found incidentally on MRI imaging for low back pain.

Tarlov cysts rarely cause any problems, but when they do, they can affect the neighboring nerves. This may result in pain, weakness, numbness, or bowel/bladder problems. While drainage of the cyst is easy, the fluid typically recurs. So if treatment is truly indicated, most surgeons recommend removal of the cyst and closure with glue.

Arachnoid cysts are the fourth type of lumbar spine cyst and, like Tarlov cysts, they are usually asymptomatic (that is, they typically don’t have any symptoms). They are often present at birth and make a pocket of fluid in the cerebrospinal fluid space that may be found on MRI but have no clinical consequence (they won’t cause medical problems down the line). Since they cause no symptoms, they do not need to be treated.

Intradiscal cysts are the fifth kind of cyst, but they are very rare. They are similar to disc herniations in that they arise from the disc and can cause radiculopathies (pain that travels away from its source). These cysts typically respond to non-operative treatments.

Finally, sebaceous cysts are the sixth kind of cyst that may be found in the low back. These are cysts in the skin that can occur anywhere in the body. Typically they arise from swollen hair follicles, and these cysts may produce protein or oil.

Because sebaceous cysts can build up pressure and are close to the skin where normal bacteria are found, they can rupture and become infected. These are the only cysts with a propensity for infection. Like the other lumbar spine cysts, they may need surgery if other treatments fail.

Spinal Cysts: Symptoms, Causes and Treatment

Recent advances in imaging have made the diagnosis of spinal cysts more common than in previous years, but they’re still a relatively rare cause of back pain.

The exact cause of spinal cysts is unknown, but research is beginning to find that there might be a connection between natural degeneration and their formation. This would explain why they’re almost exclusively found in patients aged 50 and older and rarely found in patients younger than 45.

Synovial fluid is a gel-like substance that helps lubricate the facet joints in the sine and allows them to operate smoothly and effectively. If our bodies were a car, synovial fluid would be oil.

However, as we grow older, our joints begin to naturally wear down. In response to this, our body’s may begin to produce more synovial fluid in order to make sure that joint operation continues to be smooth and pain-free. If too much fluid begins to fill up in the synovial sac, one of the seven parts that make up a joint, it can cause a cyst.

Other systemic conditions, like rheumatoid arthritis, can also be associated with the formation of spinal cysts, though it is more rare.

What are the Symptoms of a Spinal Cysts?

A spinal cyst that is causing back pain often shares characteristics similar to spinal stenosis because it almost always involves the pinching of a nerve. Symptoms typically include:

• Backache

• Radicular pain (pain that results from a pinched nerve) on a particular side of your body

• Pain or weakness in your arms or legs

• Numbness or tingling

• Pain that is noticeably worsened by leaning in a certain direction or by sitting or standing.

Exact symptoms can vary depending on the size and the location of the spinal cysts. It’s also important to note that spinal cysts are benign which means that they aren’t inherently harmful to the body. This being the case, many cysts can go completely unnoticed for years or for an entire lifetime with no consequences.

If a spinal cyst is identified in an imaging scan and isn’t causing any noticeable symptoms, your doctor might recommend simply leaving it in order to avoid any unnecessary treatment on the spine.

Are Spinal Cysts Dangerous?

Spinal cysts are known as a benign, non cancerous lumps, which means that they are, inherently, not harmful to your body. However, the symptoms they cause can dangerous depending on their size and location. Research is beginning to suggest that they might cause instability in the spine and also permanent nerve damage if left unattended.¹

If you have a symptomatic cysts, you should talk to your spine surgeon to discuss treatment options.

How do You Treat a Spinal Cyst?

Many cysts heal on their own, which means that conservative treatments like rest and anti-inflammatory painkillers can often be enough to get rid of them. However, in some cases, routine drainage of the sac may be necessary to reduce symptoms.

Though relatively uncommon, some cysts can refill and continue to cause problems in the spine. If this occurs there are several minimally invasive surgical options that allow a neurosurgeon to enter the spine, remove the cyst and ensure that it doesn’t reoccur.

Any patient with asymptomatic spinal cyst should contact their spine surgeon to discuss their options for permanent relief.

References

_{1. Spinal Cysts. (n.d.). Retrieved March 7, 2019, from https://www.hopkinsmedicine.or…}

90,000 Synovial cysts of the spine – Neurosurgery in Latvia

What treatments are available for synovial cysts of the spine?

Conservative treatment may include rest, anti-inflammatory medication, pain relievers, and epidural steroid injections. Although these methods can temporarily relieve symptoms, most often they cannot be cured.

For symptomatic cysts causing pain and / or muscle weakness, surgery may be recommended.The purpose of the operation is to remove the cyst and decompress (relieve pressure from) the spinal cord and / or nerve roots. The surgical approach to the cyst is very similar to the microdiscectomy operation. Usually this is a minimally invasive intervention, which is performed through a small (18 to 25 mmR) skin incision.

In rare cases, after removal of the cyst or in cases of recurrence of the cyst, a more voluminous operation to fix the affected joint (transpedicular fixation of the spine) may be required. This type of surgery prevents the cyst from re-forming by preventing any movement in the affected joint.

But we must point out that no one treatment method is universal for everyone. It is necessary to consult a specialist to determine the best treatment for each patient and each situation.

We provide surgical treatment to both residents of Latvia and foreign patients – find out more here about the treatment options with us if you do not live in Latvia.

Our clinical base (the place of operations and manipulations) is a modernly equipped and comfortable hospital “Aiwa clinic”, find out more here!

If you are considering the possibility of treatment with us, here you can read the reviews of local and foreign patients about their treatment with us.

In general, the operation to remove the synovial cyst of the spine is very safe, but with any operation there is a small risk of a list of complications. Find out more about possible postoperative complications here.

There are many myths regarding spinal surgery, most of them untrue. Here you can find out about the most common myths about spinal surgery and their refutation.

When it is necessary to carry out an operation, preparation for it often raises many questions – find out here the answers to the most frequently asked questions about preparing for the operation.

90,000 treatment in Moscow, symptoms and causes

Description of the disease

A brain cyst is a fluid-filled cavity that is localized in the structures of the brain. The contents of the cyst can be represented by blood, pus, cerebrospinal fluid. Some cysts form during fetal development.

It is worth noting that, despite the benign nature of most cysts, they can put pressure on the structures of the brain, causing a vivid clinical picture, characteristic symptoms and serious complications.

Types of brain cysts:

• Arachnoid cyst – forms between the substance of the brain and the arachnoid membrane. The main function of the arachnoid is protection. An arachnoid cyst is filled with cerebrospinal fluid, more often formed in children, but it can also occur in adults, mainly in men. In most cases, it is asymptomatic.
• Colloid cyst – filled with a kind of gel. It is formed, as a rule, in the ventricle of the brain.A cyst can occasionally block the outflow of cerebrospinal fluid circulating in the ventricles and cause an increase in intracranial pressure.
• Dermoid cyst is a congenital cyst that is formed due to a violation of the migration of cellular elements in the prenatal period. The content can be represented by hair, teeth, cellular elements of the sweat glands.
• Epidermoid cyst is another type of congenital tumor. It is characterized by slow growth, manifests itself, as a rule, in adulthood.
• Pineal cyst. It is discovered by chance when conducting a survey for other reasons. It can form at any age. When reaching a certain size, it can cause visual impairment.

Symptoms of a brain cyst

Symptoms depend on the size of the cyst and the location of the cyst in the brain.

Most of the symptoms are due to impaired outflow of cerebrospinal fluid and increased intracranial pressure.

Symptoms include the following:

• Impaired coordination and balance
• Pain in the facial area
• Headache
• Hearing and vision impairment
• Nausea, vomiting
• Dizziness
• Convulsions
• Positional headaches

Diagnostics

Often, a brain cyst, without causing symptoms, is an accidental finding during examinations of another pathology.

In the case of a targeted appeal for medical help and the presence of characteristic symptoms, the doctor conducts a survey, a complete medical examination, including an assessment of the neurological status. To assess the condition of the brain, imaging tests such as MRI and CT scans of the brain are performed. Contrasting during these studies is an important step for differential diagnosis.

With the development of a seizure, electroencephalography is performed.

Treatment of a brain cyst

Observation in dynamics is recommended only in the case when the cyst does not reach large sizes and is asymptomatic.

Surgical treatment is indicated in case of rapid growth of the cyst and the risk of developing complications against the background of exposure to the structures of the brain.

The essence of surgical treatment is to drain the cyst using endoscopic equipment.

In the conditions of the neurosurgical hospital of the FNCC, patients receive highly specialized complex treatment, undergo full-fledged rehabilitation with the participation of psychologists, exercise therapy doctors, reflexology specialists.

Nonparasitic liver cysts – symptoms, modern methods of diagnosis and treatment

Nonparasitic liver cyst (NCP) refers to benign focal lesions in the liver and is a fluid-filled cavity in the liver.

Currently, nonparasitic liver cysts are detected in 5-10% of the population. Moreover, in women, they are found 3-5 times more often. The disease usually develops between 30 and 50 years of age.

Allocate true and false cysts. True cysts differ from false ones by the presence of a columnar or cubic epithelium on the inner surface of the epithelial cover. False cysts usually develop after injury.

Causes of the disease

The reasons for the occurrence of NCP have not yet been fully clarified. Currently, the prevailing opinion is that liver cysts arise from aberrant bile ducts, i.e.That is, during embryonic development, there is no connection to the biliary tract system of individual intralobular and interlobular bile ducts. Liver cysts may occur when taking certain medications (estrogens, oral contraceptives).

Sign up for a consultation The first consultation is free!

Symptoms of the disease

The clinical picture of NCP is usually poor and nonspecific.Most often, liver cysts are accidentally detected by ultrasound of the abdominal organs. The manifestations of the disease depend on the size of the cyst, its location, as well as on the effect of the cyst on adjacent organs. An enlargement of the cyst also leads to atrophic changes in the liver tissue.

The most common complaint with solitary liver cysts is pain in the upper right quadrant or epigastric region. The pain in many cases is permanent. Patients also report a fast-onset feeling of fullness and abdominal discomfort after eating.

Complications

The most common complications of LCP are suppuration, bleeding into the cyst cavity, wall rupture, portal hypertension, obstructive jaundice, and liver failure. When a cyst ruptures, a secondary infection is possible, the formation of external and internal fistulas, and torsion of the cyst leg. These complications occur in 5% of cases. Malignant transformations are rare.

Diagnostics

LCP should first of all be differentiated from parasitic cysts.For this, specific serological blood tests are performed (reaction of indirect hemagglutination and enzyme immunoassay for echinococcosis). In some cases, there is a need for differential diagnosis with hemangioma, cystoadenoma, retroperitoneal tumors, tumors of the intestine, mesentery, pancreas, dropsy of the gallbladder and metastatic tumor lesions of the liver.

Treatment

Due to the real possibility of complications: rupture of cysts, infection and hemorrhage into the lumen of the cyst, liver cysts are subject to surgical treatment.In addition, rapidly growing large cysts lead to liver dysfunction due to atrophy and replacement of the hepatic parenchyma with cystic formation. Among the operations, the most commonly used are liver resection, pericystectomy and cyst exfoliation.

Operations

In recent years, transparietal punctures of cysts under the control of ultrasound or CT have become widespread. After aspiration of the contents, a 96% solution of ethyl alcohol is injected into the lumen of the cyst to harden the inner membrane of the cyst.This operation is effective when the size of the cyst is up to 5 cm.If there is no effect from these methods of treatment or the cyst has a larger size, an operation is indicated – laparoscopic excision of the cyst area, followed by de-epithelialization of the inner membrane of the cyst with argon-enhanced plasma or a defocused laser beam. A similar tactic is used for polycystic liver disease. With complicated polycystic liver disease (suppuration, bleeding, malignancy, compression by large cysts of the biliary tract, portal or vena cava), surgical treatment is indicated.Usually, fenestration (opening of cysts protruding above the surface of the liver) is performed, followed by de-epithelialization of the inner membrane of the cyst.

Any questions?

Leave your phone number –
and we will call you back

Our leading specialists

Advantages of the Hospital Center

Individual treatment regimen for each patient

For each patient, without fail, even at the prehospital stage, an individual treatment regimen is developed, taking into account all the characteristics of the body: age, health status, medical history, etc.- this approach allows you to minimize risks both during the operation and in the postoperative period, and as a result, to ensure the fastest possible rehabilitation with a minimum period of hospitalization.

Multidisciplinary approach

The medical staff of the Hospital Center is a single team made up of doctors – experts of different specializations, which allows for a multidisciplinary approach.We treat a patient, seeing in front of us not a list of the diseases he has, but a person whose problems are interrelated and interdependent. The therapeutic measures taken are always aimed at improving the overall health, well-being and quality of life of the patient, and are not limited to eliminating the symptoms of a specific disease.

Surgical treatment of any level of complexity

The operating doctors of the Hospital Center possess advanced and high-tech methods of performing operations.The combination of highly qualified doctors and innovative equipment allows for surgical treatment of the highest level of complexity.

High-tech, minimally invasive treatment methods

The basis of the methodology of treatment carried out in the Hospital Center is the principles of minimizing risks for the patient and the fastest possible rehabilitation.

Implementation of such an approach is possible only with the use of the most high-tech techniques, modern equipment and the application of the latest achievements of medical science.

The qualification of doctors in combination with modern equipment allows us to successfully implement this approach to treatment.

Fast-track surgery

Fast-track is a comprehensive technique that allows you to minimize the patient’s stay in the hospital without compromising the quality of treatment.

The approach is based on minimizing surgical trauma, reducing the risk of postoperative complications and accelerating recovery after surgery, which ensures our patients have a minimum hospital stay.

Even such complex operations as, for example, cholecystectomy, thanks to this approach, require a hospital stay of no more than 3 days.

Personal medical supervision in the postoperative period

To completely exclude the development of possible complications, the early postoperative period, all patients, regardless of the complexity of the operation, are carried out in the intensive care unit under the individual supervision of an intensive care physician.

Transfer of the patient to the ward is carried out only in the complete absence of even the smallest possible risks.

Informing relatives 24/7

We are as open as possible and take care not only of the patient, but also of his loved ones. Patient health information is provided to relatives seven days a week, 24 hours a day.

Visiting patients is also possible at any convenient time.

Highly comfortable single and double rooms

At the service of patients are spacious comfortable single and double rooms equipped with everything necessary for rest and recovery.

In the pediatric department, our little patients are accommodated together with their parents.

Tax deduction

According to the tax legislation of the Russian Federation, each patient has the right to compensation up to 13% of the amount spent by him on his treatment, as well as the treatment of close relatives.

Our specialists will prepare for you a package of documents for the tax office for a refund of 13% of the amount of treatment costs, as well as give recommendations on various ways of interacting with the tax office.

Contacts

+7 (499) 583-86-76

Moscow, Bakuninskaya street, building 1-3
Nearest metro station: Baumanskaya

90,000 The effectiveness of the use of epidural injections of hormonal drugs in the treatment of pain in the lumbosacral spine

Epidural steroid injections are a common treatment option for many forms of low back pain and radiating leg pain.

Epidural steroid injections are a common treatment option for many forms of low back pain and radiating leg pain. This type of treatment was first used in 1952 and is still an integral part of the non-surgical treatment for sciatica and low back pain. Sometimes one epidural injection is enough to get rid of pain, but quite often drug therapy is used in combination with a comprehensive rehabilitation program to achieve an optimal result.

Most physicians would agree that the effectiveness of the injection is usually temporary, providing pain relief from one week to one year. At the same time, an epidural injection can be very helpful in relieving acute low back pain and / or leg pain. It is important to note that the injection can provide sufficient pain relief to allow the patient to begin their rehabilitation program more quickly, such as exercise.If the injection is used for the first time, then its effectiveness can be longer from three months to one year.

It should be noted that epidural steroid injections are not only given in the lumbosacral spine, but are also frequently used to relieve neck and thoracic pain.

Efficacy of epidural injections

Many studies show the short-term benefits of epidural steroid injections.With regard to data on the long-term efficacy of epidural steroid injections for low back pain, the issue continues to be a matter of debate. This is compounded by the lack of properly conducted research.

For example, many studies do not include the mandatory use of an X-ray control (fluoroscope) of the injection itself, which allows you to check the correct administration of the drug. In addition, in many studies, patients are not classified according to the diagnosis, which does not allow to clearly trace the effectiveness of the treatment method for various pathologies of the spine, which are symptomatic of lower back pain.These methodological weaknesses tend to make it difficult or nearly impossible to assess treatment outcomes.

Despite this, most studies indicate that in more than 50% of patients, epidural steroid injections have analgesic effects and resolve the problem. The researchers also emphasize that the effectiveness of the procedure largely depends on the professionalism of the physician performing the manipulation, as well as the need to always use fluoroscopy to ensure accurate needle placement.

X-ray-guided epidural steroid injections allow the drug to be injected directly (or very close) to the source of the pain. In contrast, low concentrations of oral steroids and pain relievers reach the site of the lesion, and have a less focused effect, which can subsequently lead to side effects.

Since the vast majority of pain is caused by inflammation, an epidural injection can help control local inflammation by flushing out inflammation-causing chemicals (proteins and chemicals) in the affected area that aggravate pain.

How Epidural Block Works

Epidural injection delivers the hormone directly to the epidural space of the spine. The most commonly used additional components are local anesthetics.

The epidural space contains epidural fat and small blood vessels and surrounds the dural sac. The dural sac contains the spinal cord, nerve roots, and cerebrospinal fluid (the fluid in which the nerve roots are located).

Typically, the injection uses a solution containing a hormone (cortisone) with a local anesthetic (lidocaine or bupivacaine) and / or saline.

1. The hormone is usually administered as an anti-inflammatory agent. Inflammation is a common component of lumbar pain. The hormone reduces inflammation and thus helps relieve pain. Triamcinolone acetonide, dexamethasone, methylprednisolone acetate, betamethasone are used as the main steroid drugs.
2. Lidocaine is a fast-acting local anesthetic that is used to temporarily relieve pain. Bupivacaine can also be used.
3. Saline is used to dilute a local anesthetic or as a “flush” agent to dilute chemical or immunological agents that promote inflammation.

Epidural injections are often used to treat radicular pain, also called sciatica (pain that radiates from a pinched nerve in the lumbar spine, radiating down the back of the leg or into the foot).

Inflammatory mediators (eg PLA2 substance, arachidonic acid, TNF-α, IL-1, and prostaglandin E2) and immunological mediators can generate pain and associated back problems such as herniated disc or arthritis with facet joints. These diseases, as well as many others, cause inflammation, which in turn can cause significant irritation of the nerve roots, their swelling and soreness.

Hormones suppress inflammatory reactions caused by chemical and mechanical sources of pain.They also decrease the ability of the immune system to respond to inflammation associated with nerve or tissue damage. The body’s typical immune response is the production of white blood cells and chemicals to protect it from infections and foreign substances such as bacteria and viruses. Inhibition of the immune response with an epidural steroid injection can reduce pain associated with inflammation.

Indications for lumbar spine epidural injection

The main indications include:

• Protrusion of intervertebral discs.
• Herniated disc;
• Spondyloarthrosis;
• Degenerative stenosis of the spinal canal;
• Compression fractures of the vertebrae;

For these and many other conditions that can cause lower back and / or leg pain (sciatica), an epidural steroid can be an effective conservative treatment option.

Who Should Avoid Epidural Steroid Injection Procedure

Several conditions can prevent the patient from performing the procedure:

• Local or systemic infections
• Pregnancy (if fluoroscopy is used)
• Bleeding tendency – for patients with hemophilia;
• Epidural injections of hormonal drugs are also not available for patients with cancer-related pain.If a tumor is suspected, an MRI (CT) scan should be performed.

Injections can be performed, but with caution, for patients with other potentially problematic conditions, such as:

• Allergy to the injected solution;
• Uncontrolled medical problems such as kidney disease, heart failure and decompensated diabetes, as they can be complicated by fluid retention;
• Use of high doses of aspirin or other antiplatelet drugs (eg Cardiomagnyl) as they may cause bleeding during the procedure.These drugs should be discontinued while the injection is in progress.

Perform an epidural injection procedure

The epidural injection procedure usually takes 15 to 30 minutes and follows the standard protocol:

• The patient is lying on a table with a small pillow under his abdomen. If this position is painful, the patient may be allowed to sit or lie on their side in a slightly bent position.
• An area of ​​skin in the lumbar region is treated with an antiseptic and then anesthetized with a local anesthetic.
• Under X-ray control, a needle is inserted under the skin and guided into the epidural space. Radiography ensures that the needle is accurately inserted into the desired location in the epidural space. Studies have shown that in many (> 30%) cases, when an epidural injection is carried out without X-ray control, the results of treatment were negative.
• After the needle is in the correct position, contrast is injected to confirm the position of the needle site. A hormone and local anesthetic solution is then injected into the epidural space. Although the steroid solution is administered slowly, most patients feel some pressure and discomfort due to the amount of solution used (which can range from 3 to 10 ml when injected).

• After the injection, before the patient is discharged home, he is under the supervision of a doctor for 10-20 minutes.

During the procedure, sedatives may be used to ensure patient comfort.However, sedation is rarely needed because epidural injections usually do not cause significant discomfort. If sedation is used, some precautions must be taken, including the patient should not eat or drink for several hours before the procedure. Before undergoing the procedure, the patient should be instructed by the doctor to receive specific instructions.

Soreness at the injection site may persist for several hours after the procedure.If pain persists in the injection area, the manipulation site can be treated with ice for 10 to 15 minutes, once or twice an hour. In addition, patients are encouraged to generally rest and rest for the remainder of the day after the procedure. Habitual activity can usually be resumed the next day. Temporary soreness may persist for several days after injection due to fluid pressure trapped in the area of ​​the procedure or due to local chemical irritation.

The patient should also talk to the doctor about whether pain relievers (or some other medications) can be taken on the day of the injection.

Number and frequency of epidural injections of hormonal drugs

There are actually no studies that indicate the optimal number of procedures and how often the procedures should be performed. In general, most doctors believe that up to three epidural injections per year should be performed, which on average equates to the number of cortisone injections given to patients with arthritis (shoulder or knee).Various strategies are used:

• Some doctors perform injection manipulations evenly throughout the year;
• Others take a different approach, giving 2 or 3 epidural injections of hormone during flare-ups at 2-4 week intervals.

If, after the injection, the patient does not experience pain relief in the back or leg, further injections are useless, a different method of treatment should be selected accordingly.

Efficacy of epidural hormone injections in the treatment of pain

Although the analgesic effect of an epidural injection is usually temporary (lasting from one week to a year), epidural steroid injections are a popular and effective treatment for many patients with low back pain.

• The administration of the drug is carried out under X-ray control and confirmation through the use of contrast, more than 90% of patients are thus relieved of pain.
• The analgesic effect has been observed with this method in the treatment of primary radicular pain syndrome in the leg, and equally good results in the treatment of low back pain.
• Pain relief and control induced by injections can improve the patient’s mental health and quality of life, minimize the need for pain relievers, and potentially delay or avoid surgery.

The success of this method may vary depending on the patient’s condition, which is directly related to the degree of manifestation of radicular pain syndrome in the leg:

• Recent studies have shown that epidural injections of hormones in the lumbar spine are effective in treating sciatica in patients with lumbar hernias. Moreover, more than 85% of patients experienced pain relief (as opposed to 18% of patients in the group who received placebo injections of saline).
• Similarly, a study was carried out in a group of patients diagnosed with lumbar spinal stenosis, who showed symptoms of sciatica. As a result of treatment, 75% of patients receiving injections experienced more than 50% pain relief, while the effect of treatment persisted for 1 year after injections.

However, to date, there is still some mistrust about the effectiveness of injections and the appropriateness of injections for most patients.As noted earlier, most of the controversy was generated by studies analyzing the results of injections, where there was no fluoroscopic control, respectively, ensuring the accurate administration of the hormonal drug solution at the pathological level remained doubtful. Accordingly, the injection into the affected area was not controlled, which could lead to poor treatment results.

Download pdf file – The effectiveness of the use of epidural injections of hormonal drugs in the treatment of pain in the lumbosacral spine

Symptoms of a paraurethral cyst, clinical manifestations of benign paraurethral formations

Symptoms of paraurethral cysts are nonspecific and resemble other urological diseases.The clinical manifestations of paraurethral cystic lesions vary considerably from patient to patient and can also change depending on when the diagnosis was made during the development of the disease. In the early stages, when the paraurethral gland is initially infected, the predominant symptoms may be urination.

At this stage, the patient may be disturbed by dysuria, frequent urination, and the presence of discharge from the urethra. Later, since chronic and ongoing inflammation develops around the cyst, one or another kind of pelvic pain, dyspareunia, may join. There may also be clinical symptoms such as pyuria, foreign body sensation in the urethral region, thickening of the paraurethral zone, and its increased sensitivity.

The most frequent complaints of patients are signs of urinary infection (frequent urination, urgency, painful urination) and are observed in more than 90% of patients. Patients also often present with many non-specific complaints, including back pain, vaginal discharge, and vaginal pressure.

Many authors distinguish the following main symptoms of paraurethral cysts: the presence of swelling at the external opening of the urethra, purulent discharge from the urethra, pain during intercourse, urinary disorders, pain in the urethra and above the pubis. Cystic diseases of the urethra are often accompanied by the clinic of urethral syndrome: burning and pain in the urethra, discomfort in the perineum and above the pubis, slightly difficult urination, feeling of incomplete emptying of the bladder, urge to urinate, and others.

With inflammation of the cysts, abscesses occur, which often open into the urethra with the subsequent formation of diverticula. Hematuria should merit immediate attention due to the increased incidence of urethral cancer.

Cysts look like tumor-like formations of a spherical shape, soft-elastic consistency with clear boundaries, their surface is tense, located mainly at the external opening of the urethra.

Sizes range from 2 to 4 cm.They are easily felt from the side of the vagina, and when pressed, a mucous fluid is released from the urethra. However, there are also much larger formations.

In the cysts, calculi can form, which are clearly palpable and clearly visible on the urethrogram.

Often paraurethral cysts are completely asymptomatic and can be detected during a routine examination. The incidence of asymptomatic cases varies from 1.6% to 20% of patients.

One of the factors that can explain these wide differences in the symptoms of paraurethral cystic formations is the frequent use of antibiotics by patients and doctors themselves, who do not pay enough attention to patients of this kind, which smooths the clinical picture and, as a positive point, prevents the formation of abscesses.

The whole truth about painkillers, “translucency” and COVID-19

Medicines designed to relieve pain sometimes cause pain. Excessive research – unnecessary worries: you do not need to do an ultrasound if the doctor has not prescribed it. We must learn to coexist with the coronavirus. Doctor Myasnikov from the clinic on Belorusskaya spoke about this on the air of on the Russia 1 TV channel . He began his traditional Sabbath reception with rubric “Simple Truths” : “Today, all three simple truths will be very important to your health.”

Painkillers. We all cannot live without them. We got hooked on them. But most people only know one variety. Analgin, paracetamol, acetylsalicylic acid, ibuprofen and so on. All this, one way or another, is included in the class of non-steroidal anti-inflammatory drugs, that is, they work in any process where pain is a reflection of the inflammatory process. But there are many conditions in which they do not help. Let’s say your lower back hurts.There is no inflammation – there is a muscle spasm, and in order to relieve it, you need to take a relaxant. Or, let’s say you have a constant headache. And you take analgin tablets every day. And if you take more than 15 of them a month, then this in itself can provoke a headache, but another one. You rearrange your pain receptors so that they begin to feel a completely different pain threshold. And now you need other medicines. These include antidepressants , especially the first generation of the type amitriptyline (excellent relieves neuralgic pain) and many anticonvulsants.Therefore Truth number one – learn the difference between painkillers, it can ease your condition.

Truth number two is called “X-rays do not heal”. If only this truth could be brought to the doctors … Our entire population firmly believes that X-ray cures, MRI cures, CT cures, and ultrasound as cures! In fact, it does not heal, but cripples. When you go to research just like that, it brings innumerable harm. Well, we saw you have a hernia in the spine image, and now what? It will resolve itself in three to four months, and you will all treat it.Because 30% of healthy people who do not have lower back pain will see a hernia during examination. Every tenth person has a cyst in the kidney, every tenth person has a cyst in the liver, every twentieth has a hemangioma in the liver, every second has a thyroid nodule. Research should only be done when indicated. Our medicine is choked with finds of unclear clinical significance, when we find something, and then do not know what to do. Therefore, if the doctor tells you that you do not need to do the research, then it is not necessary.

The third and most basic truth: COVID . He came and will not leave us anywhere, but will cause an ever weaker disease, he will degenerate into a common ARI. He’s so angry right now, simply because he’s new to humans. Yes, we were scared: we lived so well and happily, and suddenly this virus destroyed our life. But in fact, we have a million suicides, we only have half a million drowning. We die by the millions from diseases that are vaccinated against, we die under the wheels of cars, we die from smoking on a huge scale.We are dying of vodka and overeating. “I mean that when a small part of 70 million deaths a year was added, for some reason we panicked and became so afraid of it ,” explains Myasnikov. that to the hundreds and hundreds of viruses that live around us, another one has been added. ” Yes, presentation was formidable, and there will be more – in those parts of the world that have not yet got acquainted with the coronavirus. You don’t have to be reckless, but you don’t have to go too far.You just need to weigh the risks correctly. Get vaccinated against influenza, pneumococcus , because if everything is together, it can be dangerous.