What are the symptoms and causes of ovarian cysts? How are they diagnosed and treated? Get all the answers in this comprehensive article.

Understanding Ovarian Cysts: An Overview

Ovarian cysts are fluid-filled sacs that develop within the ovaries. They are a common occurrence, and in the vast majority of cases, they are benign (noncancerous). Ovarian cysts can vary in size and may form at different locations within the ovary. The most common type of cyst develops when a follicle, the structure that houses the egg, fails to rupture and release the egg, instead swelling with fluid to form a follicular cyst.

Symptoms of Ovarian Cysts

In many cases, ovarian cysts do not produce any symptoms. However, some women may experience the following:
– Mild abdominal ache
– Abdominal swelling or a feeling of fullness or pressure
– Pain during sexual intercourse
– Menstrual irregularities, such as absence of menstrual bleeding (amenorrhea), heavy bleeding (menorrhagia), and painful periods (dysmenorrhea)
– Unusual hair growth on the face and body caused by an increased production of masculinizing hormones (hirsutism)
– Sudden, sharp abdominal pain, fever, and nausea if a cyst becomes twisted or ruptures
– Rarely, painful, frequent urination or urinary retention if a cyst presses against the bladder

Diagnosing Ovarian Cysts

To diagnose an ovarian cyst, a gynecological examination is necessary. If a lump or mass in the ovary is detected, further tests are required to rule out the possibility of ovarian cancer. Your doctor may perform one or more of the following tests:

Pelvic Exam

Oftentimes, ovarian cysts are detected during a routine pelvic exam. However, the pelvic exam alone cannot provide a definitive diagnosis, so the next step is typically a vaginal sonogram.

Vaginal Sonogram

This imaging test allows a physician to get the most accurate picture of the ovary and cyst. The test is performed by inserting a small instrument into the vagina, which then bounces sound waves off the uterus, fallopian tubes, and ovaries, forming a picture on a monitor. This image enables the doctor to determine the size of the cyst and whether it is solid or fluid-filled. While the vaginal sonogram can detect the presence of a cyst, it cannot verify whether it is benign or malignant.

Laparoscopy

If a cyst is detected, the next step may be a laparoscopy, a minimally invasive surgical procedure that allows the doctor to see and remove the cyst through a small incision in the abdomen.

Treatment of Ovarian Cysts

In many cases, ovarian cysts disappear without any treatment. However, surgery may be necessary if cancer is suspected, if the cyst does not go away, or if it causes symptoms. In many cases, the cyst can be removed without damaging the ovary, but sometimes the ovary may need to be removed. In rare cases, an ovarian cyst may be drained during laparoscopy.

Your doctor may also recommend hormonal therapy to prevent future ovarian cysts.

Types of Ovarian Cysts

Ovarian cysts can be categorized as either functional cysts or pathological cysts:

Functional Cysts

Functional ovarian cysts are linked to the menstrual cycle and are very common in women who have not yet reached menopause. They occur when a follicle (the structure that contains the egg) does not release the egg or discharge its fluid and instead swells to form a cyst. Functional cysts are benign and usually harmless, although they can sometimes cause symptoms such as pelvic pain. Most functional cysts will disappear within a few months without needing any treatment.

Pathological Cysts

Pathological cysts are caused by abnormal cell growth and are not related to the menstrual cycle. They can develop for various reasons and may require more extensive treatment, including surgery.

Seeking Medical Attention

If you experience any symptoms of ovarian cysts, it is important to call a gynecologist. If you have been diagnosed with an ovarian cyst and you experience sudden, sharp abdominal pain, fever, or vomiting, you should see a doctor immediately, as these could be signs of a more serious complication.

At Johns Hopkins, our physicians are experts at diagnosing and treating ovarian cysts. While most ovarian cysts are benign and harmless, there are cases where they can be cancerous or dangerous to a woman’s future fertility. That is why it is so critical to be evaluated by an ovarian cyst expert at Johns Hopkins.

Key Takeaways

• Ovarian cysts are fluid-filled sacs that develop within the ovaries, and in most cases, they are benign.
• Symptoms of ovarian cysts can include mild abdominal ache, abdominal swelling, pain during intercourse, menstrual irregularities, and unusual hair growth.
• Ovarian cysts are diagnosed through a pelvic exam, vaginal sonogram, and sometimes a laparoscopy.
• Treatment options include watchful waiting, hormonal therapy, and in some cases, surgical removal of the cyst or the ovary.
• Ovarian cysts can be categorized as either functional (related to the menstrual cycle) or pathological (caused by abnormal cell growth).
• If you experience any symptoms of ovarian cysts, it is important to seek medical attention, and if you have an existing cyst, you should seek immediate care for sudden, sharp abdominal pain, fever, or vomiting.

Benign Ovarian Cysts

An ovarian cyst is a fluid-filled sac that forms in the ovary. Ovarian cysts are common and, in the vast majority of cases, they are benign (noncancerous). They vary in size and may occur at different sites in the ovary; the most common type develops when an egg-producing follicle does not rupture and release the egg but instead swells with fluid and forms a follicular cyst.

Cysts often disappear on their own without treatment, but in some cases they may require surgical removal. In rare cases a cyst that twists or ruptures may cause serious complications warranting emergency surgery.

At Johns Hopkins, our physicians are experts at diagnosing and treating ovarian cysts. While ovarian cysts are mostly benign and harmless, there are cases where they can be cancerous or dangerous to a woman’s future fertility. That is why it is so critical to be evaluated by an ovarian cyst expert at Johns Hopkins.

Symptoms can include:

• In many cases, ovarian cysts produce no symptoms.
• Mild abdominal ache.
• Abdominal swelling or a feeling of fullness or pressure.
• Pain during sexual intercourse.
• Menstrual irregularities including absence of menstrual bleeding (amenorrhea), heavy bleeding (menorrhagia), and painful periods (dysmenorrhea).
• Unusual hair growth on the face and body caused by an increased production of masculinizing hormones (hirsutism).
• Sudden, sharp abdominal pain, fever, and nausea if a cyst becomes twisted or ruptures.
• Rarely, painful, frequent urination-or urinary retention-if a cyst presses against the bladder.

If you experience any of the symptoms of ovarian cysts, call a gynecologist. If you have been diagnosed with an ovarian cyst and you experience sudden, sharp abdominal pain, fever, or vomiting, see a doctor immediately.

Diagnosis of ovarian cysts

A gynecological examination is necessary to diagnose an ovarian cyst. If a lump or mass in the ovary is detected, further tests are necessary to rule out the possibility of ovarian cancer.

Your doctor may perform one or more tests to diagnose a benign ovarian cyst:

• Pelvic Exam
  Oftentimes, ovarian cysts are detected during a routine pelvic exam. But because the pelvic exam cannot produce a definitive diagnosis, the next step is to perform a vaginal sonogram.
• Vaginal sonogram
  This imaging test allows a physician to get the most accurate picture of the ovary and cyst. The test is performed by inserting a small instrument into the vagina, which then bounces sound waves off your uterus, fallopian tubes and ovaries, forming a picture on a monitor. This image enables the doctor to determine with accuracy the size of the cyst and, just as importantly, to see inside it and detect whether it is solid or fluid-filled. While the vaginal sonogram detects the presence of a cyst, it cannot verify whether it is benign or malignant. Therefore, if the sonogram detects a cyst, the next step may be the surgical removal of the cyst to find out if it is malignant or benign.
• Laparoscopy
  This minimally invasive surgical procedure allows your doctor to see and remove the cyst by making a small incision in the abdomen rather than a long cut. The laparoscope, a thin lighted telescope, is inserted through a small incision into your abdomen. Small instruments placed near the pubic bone allow the doctor to then remove the cyst.

Treatment of ovarian cysts

Ovarian cysts often disappear without treatment. Surgery to remove the cyst may be needed if cancer is suspected, if the cyst does not go away, or if it causes symptoms. In many cases it can be taken out without damaging the ovary, but sometimes the ovary has to be removed. In rare cases an ovarian cyst may be drained during laparoscopy.

Your doctor may recommend hormonal therapy for preventing future ovarian cysts.

Ovarian cyst – Causes – NHS

Types of ovarian cyst

There are many different types of ovarian cyst, which can be categorised as either:

• functional cysts
• pathological cysts

Functional cysts

Functional ovarian cysts are linked to the menstrual cycle. They happen if you have not been through the menopause, and they are very common.

Each month, ovaries release an egg, which travels down the fallopian tubes where it can be fertilised by sperm.

Each egg forms inside the ovary in a structure known as a follicle. The follicle contains fluid that protects the egg as it grows, and it bursts when the egg is released.

But sometimes a follicle does not release an egg, or does not discharge its fluid and shrink after the egg is released. If this happens, the follicle can swell and become a cyst.

Functional cysts are non-cancerous (benign) and are usually harmless, although they can sometimes cause symptoms such as pelvic pain.

Most will disappear in a few months without needing any treatment.

Pathological cysts

Pathological cysts are caused by abnormal cell growth and are not related to the menstrual cycle. They can develop before and after the menopause.

Pathological cysts develop from either the cells used to create eggs or the cells that cover the outer part of the ovary.

They can sometimes burst or grow very large and block the blood supply to the ovaries.

Pathological cysts are usually non-cancerous, but a small number are cancerous (malignant) and often surgically removed.

Conditions that cause ovarian cysts

In some cases, ovarian cysts are caused by an underlying condition, such as endometriosis.

Endometriosis occurs when pieces of the tissue that line the womb (endometrium) are found outside the womb in the fallopian tubes, ovaries, bladder, bowel, vagina or rectum. Blood-filled cysts can sometimes form in this tissue.

Polycystic ovary syndrome (PCOS) is a condition that causes lots of small, harmless cysts to develop on your ovaries.

The cysts are small egg follicles that do not grow to ovulation and are caused by altered hormone levels.

Management & Treatment, Symptoms, Diagnosis

Overview

What is an ovarian cyst?

An ovarian cyst is a sac filled with fluid or a semisolid material that forms on or within one of the ovaries. The ovaries are small organs in the pelvis that make female hormones and hold egg cells.

There are different types of cysts, many of which are normal and harmless (benign). Functional cysts, which are not disease-related, occur as a result of ovulation (the release of an egg from the ovary). Functional cysts generally shrink over time, usually within 60 days, without specific treatment.

Functional ovarian cysts, which are relatively common, should not be confused with other types of cysts that are disease-related. Conditions such as polycystic ovary syndrome and ovarian cancer also involve growths on the ovaries. Tell your healthcare provider if you have any of the symptoms listed in the symptoms section. He or she can determine the type of cyst you have.

Symptoms and Causes

What causes an ovarian cyst?

The exact cause of ovarian cysts is not known.

What are the symptoms of an ovarian cyst?

Some smaller cysts cause no symptoms. In these cases, you may not even know you have a cyst. Larger cysts may cause the following symptoms:

Some prolonged symptoms may be associated with a condition called polycystic ovary syndrome. This is a condition that causes irregular periods and other hormone-related problems, including obesity and infertility. Other symptoms of polycystic ovary syndrome include hirsutism (increased growth of body hair) and difficulty losing weight.

What are the complications of an ovarian cyst?

If a cyst breaks open, it can cause severe pain and swelling in the abdomen. Often, the cyst reabsorbs on its own.

Diagnosis and Tests

How is an ovarian cyst diagnosed?

Your healthcare provider will first rule out pregnancy as the cause of your symptoms. He or she then may use the following tests to diagnose an ovarian cyst:

• A pelvic exam: During this exam, the doctor uses an instrument to widen the vagina, which allows the doctor to examine the vagina, cervix and uterus. The doctor also feels the reproductive organs for any lumps or changes.
• Blood tests: These tests are used to measure the levels of certain hormones in the blood.
• Ultrasound: This test uses sound waves to create images of the body’s internal organs. It can be used to detect cysts on the ovaries.
• Laparoscopy: This is a procedure, performed in an operating room, in which the doctor inserts a small device through an incision (cut) in the abdomen. He or she views the reproductive organs and pelvic cavity using the device. If a cyst is diagnosed at this time, it can be removed.

Management and Treatment

How is an ovarian cyst treated?

Functional ovarian cysts generally go away without treatment. Your healthcare provider may give you medications containing hormones (such as birth control pills) to stop ovulation and prevent future cysts from forming. If you do not ovulate, you will not form functional cysts. In some cases, surgery may be necessary to remove a cyst.

What types of surgery are used to treat ovarian cysts?

The type of surgery used depends on the size of the cyst and how it appears on the ultrasound. The different procedures used include:

• Laparoscopy: This is a procedure in which the doctor inserts a small device through a small incision in the abdomen. He or she views the reproductive organs and pelvic cavity using the device. The doctor can remove the cyst through tiny incisions.
• Laparotomy: This procedure uses a bigger incision to remove the cyst. The cyst will be tested for cancer. If it is cancer, the doctor may need to remove one or both ovaries, the uterus, a fold of fatty tissue called the omentum and some lymph nodes. Lymph nodes are small, bean-shaped structures found throughout the body that produce and store infection-fighting cells, but may contain cancer cells.

Prevention

Can ovarian cysts be prevented?

Taking medications that contain hormones (such as birth control pills) will stop ovulation. However, many women taking low-dose oral contraceptives may still ovulate. Although there has been no study that shows that oral contraceptive pills reduce the formation of the ovarian cysts, many physicians still do prescribe this regimen.

Living With

When should I call my healthcare provider?

Call your healthcare provider if any of the following occur:

• Your menstrual periods are late, irregular, or painful.
• Your abdominal pain doesn’t go away.
• Your abdomen becomes enlarged or swollen.
• You have trouble urinating or emptying your bladder completely.
• You have pain during intercourse.
• You have feelings of fullness (bloating), pressure, or discomfort in your abdomen.
• You lose weight for no apparent reason.
• You feel generally ill.

Ovarian Cyst – StatPearls – NCBI Bookshelf

Continuing Education Activity

Ovarian cysts are fluid-filled sacs that may be simple or complex. They are common findings that are usually discovered incidentally on physical examination or imaging. Ovarian cysts can be complicated by rupture, hemorrhage, and torsion, which are considered gynecological emergencies. Therefore, it is essential to promptly diagnose and treat them to avoid high morbidity and mortality. This article reviews the evaluation, treatment, and complications of ovarian cysts and highlights the role of the interprofessional team in evaluating and treating patients with this condition.

Objectives:

• Describe the pathophysiology of the different types of ovarian cysts.

• Outline the typical presentation and most common physical exam findings for patients presenting with ovarian cysts.

• Review the criteria for conservative versus surgical management of ovarian cysts.

• Explain the importance of collaboration and highlights the role of the interprofessional team in evaluating and treating patients affected by life-threatening complications of ovarian cysts.

Access free multiple choice questions on this topic.

Introduction

The adnexa is a set of structures adjacent to the uterus that consist of the ovaries and fallopian tubes. Even though the fallopian tubes are one of the major adnexal structures, the focus of this article will be on the ovaries and the different types of cysts that can form within the ovary. The ovaries are suspended laterally to the uterus via the utero-ovarian ligament, covered by the mesovarium, which is one of the three components of the broad ligament, and connected to the pelvic sidewall via the infundibulopelvic ligament, which is also known as the suspensory ligament of the ovary. The blood supply to the ovaries comes directly from the ovarian artery, a direct branch of the aorta. The venous drainage is unique as the right ovarian vein drains directly into the inferior vena cava, whereas the left renal vein drains the left ovarian vein. In premenopausal women, the ovaries function to produce numerous follicles a month, with one dominant follicle maturing and undergoing ovulation.

As a result of ovulation, a fluid-filled sac known as an ovarian cyst can form on one or both ovaries. Adnexal masses or ovarian cysts are not uncommon, with 20% of women developing at least one pelvic mass in their lifetime. More than thirty types of ovarian masses have been characterized by various subcategories, and management is determined by the characteristics of the lesion, the age of the patient, and the risk factors for malignancy. In women of reproductive age, most ovarian cysts are functional, benign, and do not require surgical intervention. However, ovarian cysts can lead to complications such as pelvic pain, cyst rupture, blood loss, and ovarian torsion that require prompt management.[1]

Etiology

The etiology of ovarian cysts or adnexal masses ranges from physiologically normal (follicular or luteal cysts) to ovarian malignancy. Ovarian cysts can occur at any age but are more common in reproductive years and have an increased occurrence in menarchal females due to endogenous hormone production. Simple cysts are the most likely to occur in all age groups, and mixed cystic and solid and completely solid ovarian lesions have a higher rate of malignancy than simple cysts. Although most ovarian cysts are benign, age is the most important independent risk factor, and post-menopausal women with any type of cyst should have proper follow-up and treatment due to a higher risk for malignancy.[2][3]

Risk factors for ovarian cyst formation include

Epidemiology

The actual prevalence of ovarian cysts is unknown, as many patients are believed to be asymptomatic and undiagnosed, and the prevalence depends on the population studied. Approximately 4% of women will be admitted to the hospital for ovarian cysts by age 65.  In a random sample of 335 asymptomatic 24-40-year-old women, the prevalence of an adnexal lesion was 7.8%. Another study that examined ovarian cysts in postmenopausal women showed a prevalence of 2.5% for a simple unilocular adnexal cyst.  In a survey of 33,739 premenopausal and postmenopausal women, 46.7% had an adnexal cyst on transvaginal ultrasound, with 63.2% showing resolution of the abnormality on subsequent ultrasounds.[7][8][9][10]

In postmenopausal women, 18% can develop one or more Graffian follicles, which appear as cysts on imaging.[7][11][12] Most of these cysts are benign. Mature cystic teratomas or dermoids represent more than 10% of all ovarian neoplasms. Ovarian cysts are the most common tumor in infants and fetuses, with more than 30% prevalence.[13] In the United States, ovarian carcinomas are diagnosed in more than 21000 women per year, causing 14,600 deaths.

Pathophysiology

During the normal menstrual cycle, the follicular phase is characterized by increasing follicle-stimulating hormone (FSH) production. That leads to the selection of dominant follicles for priming to release from the ovary. In a normal functioning ovary, estrogen production from the dominant follicle leads to a surge of luteinizing hormone (LH), resulting in ovulation. After ovulation, follicular remnants form a corpus luteum, which produces progesterone. This inhibits FSH and LH production. If pregnancy does not occur, the progesterone declines and FSH, LH rises, and the next cycle begins.

Functional Cysts

Follicular and Corpus Luteal Cysts

Follicular and corpus luteal cysts are considered functional or physiologic cysts, and both occur during the normal menstrual cycle. Follicular cysts arise when follicles fail to rupture during ovulation and can appear smooth, thin-walled, and unilocular. In the follicular phase, follicular cysts may form because of a lack of physiological release of ovum due to excessive FSH stimulation or absence of the usual LH surge at mid-cycle just before ovulation. These cysts continue to grow because of hormonal stimulation. Follicular cysts are usually larger than 2.5 cm in diameter. Granulosa cells lead to excess estradiol production, which in turn leads to decreased frequency of menstruation.

Without pregnancy, the life span of the corpus luteum is 14 days. If the egg is fertilized, the corpus luteum continues to secrete progesterone until its dissolution at 14 weeks, when the cysts undergo central hemorrhage. If the dissolution of the corpus luteum does not occur, it may result in a corpus luteal cyst, which usually grows to 3cm. Corpus luteal cysts can appear complex or simple, thick-walled, or contain internal debris. Corpus luteum cysts are always present during pregnancy and usually resolve by the end of the first trimester. Both follicular and corpus luteal cysts can turn into hemorrhagic cysts. They are generally asymptomatic and spontaneously resolve without treatment.[14]

Theca Lutein Cysts

Theca lutein cysts are luteinized follicle cysts that form as a result of overstimulation in elevated human chorionic gonadotropin (hCG) levels. They can occur in pregnant women, women with gestational trophoblastic disease, multiple gestation, and ovarian hyperstimulation.

Neoplastic Cysts

These cysts arise from the inappropriate overgrowth of cells within the ovary and may be malignant or benign. The benign cysts are serous, mucinous, and cystadenomas. Malignant cysts arise from all ovarian subtypes. These most frequently arise from the surface epithelium and are partially cystic. Other malignant cysts include teratomas, endometriomas.

Dermoid cysts or mature cystic teratomas contain elements from all three differentiated germ layers (ectodermal, mesodermal, and endodermal) and appear complex but can have a variety of appearances due to the tissue they contain. Struma ovarii is a specialized teratoma that consists predominately of mature thyroid tissue and is present in approximately 5% of ovarian teratomas. Although mostly benign, dermoid cysts can undergo a malignant transformation in 1-2% of cases.[15][16]

Polycystic ovary syndrome is a disorder affecting 5 to 10% of women of reproductive age and is one of the primary causes of infertility.  It is associated with diabetes mellitus and cardiovascular disease most of the time. Polycystic ovary syndrome (PCOS) appears as enlarged ovaries with multiple small follicular cysts. The ovaries appear enlarged due to excess androgen hormones in the body, which cause the ovaries to form cysts and increase in size.

Endometriosis is the presence of endometrial glands and stroma at extrauterine sites, with the ovary being one of the most common sites.  Endometriomas (common in endometriosis) arise from ectopic growth of endometrial tissue and are often referred to as chocolate cysts because they contain dark, thick, gelatinous aged blood products. They appear as a complex mass on ultrasound and are described as having “ground glass” internal echoes. Endometriomas can be classified into two types. Type I consists of primary endometriomas that are small and develop from surface endometrial implants. Type II arises from functional cysts that have been invaded by ovarian endometriosis or type I endometriomas. Although the overall risk of malignant transformation is low, endometriomas increase this risk in women with endometriosis.[17][18][19]

History and Physical

Although the majority of ovarian cysts are incidental findings on physical exam or at the time of pelvic imaging, a detailed medical history with particular attention placed on gynecological history, family history, and physical examination should still be performed at each visit. Ovarian cysts can be symptomatic or asymptomatic. Symptoms that women may experience include unilateral pain or pressure in the lower abdomen. Pain may be intermittent or constant and characterized as sharp or dull. If an ovarian cyst ruptures or ovarian torsion is present, the patient may experience a sudden onset of acute severe pain, possibly associated with nausea and vomiting. The menstrual cycle can become irregular, and abnormal vaginal bleed may occur.[20]

On physical examination, palpation of the ovaries on the bimanual exam should help determine location, shape (regular or irregular), size, consistency, level of tenderness, and mobility. The ovaries can be difficult to palpate depending on the patient’s body habitus, provider experience, and the patient’s pelvic anatomy; therefore, the pelvic examination has limited ability in diagnosing ovarian cysts.[3]

Evaluation

When an ovarian mass is suspected, the provider should first determine whether the patient is pre or post-menopausal. If the former is true, the first step is to perform is a serum beta hCG or urine pregnancy test. Once pregnancy is ruled out, imaging should be done for further evaluation. A complete blood count should focus on the hematocrit and hemoglobin levels to evaluate for anemia caused by acute bleeding. Urinalysis should be obtained to rule out urinary tract infection and kidney stones. Endocervical swabs should be collected to assess for pelvic inflammatory disease. Cancer antigen 125 (CA125) is a protein present on the cell membrane of healthy ovarian tissues and ovarian carcinomas. A blood level of less than 35U/ml is taken as normal. CA15 values are raised in 85% of patients with epithelial ovarian cancer, while it is raised in 50% of patients with stage I cancer confined to the ovary. The finding of an elevated CA 125 level is most useful when combined with an ultrasound while evaluating a postmenopausal woman with an ovarian cyst.[7][11]

Due to the proximity of the transvaginal probe to the ovaries, the most common imaging modality used for an initial evaluation is transvaginal ultrasonography. It is the imaging of choice when attempting to differentiate between benign or malignant mass. Abdominal ultrasonography can be used in conjunction if pelvic anatomy is distorted due to previous surgeries. Ultrasound evaluates for laterality, size, the composition of the mass (cystic, solid, or mixed, septations, papillary excrescences, mural nodules), presence of pelvic free fluid, and assessment of blood flow and vascularity via color doppler. Ultrasound findings that are consistent with benign cysts in any age group are thin, smooth walls, and absence of septations, solid components, and internal flow on color doppler.

It is important to note that the presence of flow on the doppler exam cannot rule out adnexal torsion. This is evident in a case-control study performed with 55 confirmed cases, and 48 controls showed normal doppler flow in 27% of left ovarian torsion cases and 61% of right ovarian torsion cases. The persistence of normal Doppler flow in suspected torsion can be due to intermittent torsion or to the double blood supply of the ovary. Cyst size greater than 10 cm, complex multilocular mass, papillary excrescences or solid components, irregularity, thick septations, evidence of ascites, and increased vascularity on color doppler should raise suspicion for malignancy and requires further evaluation. Additional imaging studies like magnetic resonance imaging or computed tomography can be performed but are not recommended as part of the initial evaluation.[3][21][22][23]

Treatment / Management

There are several different treatment options available, but ultimately management depends on the age of the patient, menopausal status, the size of the cyst, and whether the cyst has characteristics suspicious for malignancy. Unilocular cysts less than 10 cm are usually benign regardless of patient age; therefore, if the patient is asymptomatic, she can be monitored conservatively with serial transvaginal ultrasound since the majority of cysts resolve spontaneously without intervention. If a cyst does not resolve after several menstrual cycles, it is unlikely to be a functional cyst, and further workup is indicated.[24]

Fetal ovarian cysts are caused by hormonal stimulation. Also, an association between fetal ovarian cysts and maternal diabetes and fetal hypothyroidism has been found. Most fetal ovarian cysts are usually small and involute during the first few months of life and are of no significance. These cysts are diagnosed in the third trimester of pregnancy, and most tend to resolve at 2 to 10 weeks postnatally.[5]

Most pregnancy-associated cysts, corpus luteal and follicular resolve by 14 to 16 weeks of gestation spontaneously allowing conservative management.[25] The resolution of cysts is less likely when larger than 5cm or complex morphology. Simple cysts smaller than 6 cm have only less than 1% risk of malignancy.[26]

In women of all ages, endometriomas should have followed up sonograms 6 to 12 weeks after initial imaging, then yearly until surgically removed.  Dermoid cysts should also have a yearly follow-up with ultrasound until surgical removal.

Indications for surgery include suspected ovarian torsion, persistent adnexal mass, acute abdominal pain, and suspected malignancy. Surgery in pre-menopausal women prioritizes the preservation of fertility, and every attempt is made to remove minimal ovarian tissue. Pregnant patients can have cysts that may require surgical management. Although laparoscopy is safe in all trimesters of pregnancy, ideally, it is recommended to perform surgery in the second trimester.[27]

Differential Diagnosis

The ovarian cyst has a broad range of differential diagnosis, and these are broadly classified into gynecological and nongynaecological subcategories

Gynecological

• Benign: Functional cyst, endometrioma, tubo-ovarian abscess, mature teratoma, serous cystadenoma, mucinous cystadenoma, para tubal cyst, hydrosalpinx, leiomyomas

• Malignant: Epithelial carcinoma, germ cell tumor, sex cord or stromal tumor, metastatic cancer

• Pelvic inflammatory disease

• Ectopic pregnancy

Nongynecological

• Appendicitis

• Diverticulitis

• Pelvic kidney

• Gastrointestinal cancer

• UTI

• Nephrolithiasis

• Psoas abscess

Prognosis

Most ovarian cysts are found incidentally, are asymptomatic, and tend to be benign with spontaneous resolution leading to an overall favorable prognosis. Overall, 70% to 80% of follicular cysts resolve spontaneously. The potential of benign ovarian cystadenoma to become malignant has been postulated but remains unproven. Less aggressive tumors of low malignant potential run a benign course. The overall survival in these cases is 86.2% at five years.[25] Malignant change can occur in few cases of dermoid cysts (associated with extremely poor prognosis) and endometriosis. If an ovarian cyst is suspected to be malignant, then the prognosis is usually poor since ovarian cancer tends to be diagnosed in the advanced stages.

Complications

There are three classic complications of ovarian cysts that commonly present to the emergency department:

The fifth most common gynecological emergency is ovarian torsion, which is defined as the complete or partial twisting of the ovarian vessels resulting is obstruction of blood flow to the ovary. The diagnosis is made clinically with the assistance of a history and physical examination, bloodwork, and imaging and is confirmed by diagnostic laparoscopy. The latest evidence supports a conservative approach during diagnostic laparoscopy, and detorsion of the ovary with or without cystectomy is recommended to preserve fertility. Ovarian cysts can also rupture or hemorrhage, with a majority of these cysts being physiological. Most cases are uncomplicated with mild to moderate symptoms, and those with stable vital signs can be managed expectantly. Occasionally, this can be complicated by significant blood loss resulting in hemodynamic instability requiring admission to the hospital, surgical evacuation, and blood transfusion.[7]

Postoperative and Rehabilitation Care

When a patient needs surgical management, laparoscopy or laparotomy can be performed, and both have significant advantages and disadvantages. Laparotomy is usually preferred when the patient is hemodynamically unstable since it allows for faster entry and direct visualization of the involved structure but results in larger incisions and increased duration of post-op pain, hospital stay, and recovery time. Laparoscopies are more lengthy procedures with smaller incisions with less risk of infection and blood loss when compared to laparotomies. However, the longer time spent in surgery leads to increased exposure to general anesthesia and increases the risk of damage to internal organs and blood vessels. When laparoscopy is performed, the hemodynamically stable patient is usually discharged home on the same day of surgery with typical post-surgical precautions and proper follow-up scheduled.

Consultations

The management of patients with the ovarian cyst is multidisciplinary, and teamwork is required in the following specialties

Patients that are high risk for ovarian malignancy should have their case reviewed in conjunction with a gynecologic oncologist for further assessment and determination of optimal surgical management. Specific guidelines can help gynecologists differentiate when to refer patients with an adnexal mass. Typically, postmenopausal women with an elevated CA-125 or premenopausal women with significantly high CA-125, ultrasound characteristics suspicious for malignancy, nodular or fixed pelvic mass, ascites, evidence of abdominal or distant metastasis should be referred to gynecologic oncology. Ultrasound findings that are suspicious for malignancy include cysts larger than 10cm, irregularity of cyst, high color doppler flow, papillary or solid components, and presence of ascites.[3]

Deterrence and Patient Education

Ovarian cysts are fluid-filled sacs that can present within the ovary and are most commonly benign functional cysts that regress spontaneously. They are commonly found incidentally on examination or imaging. In certain instances, they may become so enlarged that the increased weight may cause the ovary to rotate on itself, cutting off the blood supply and resulting in a gynecologic emergency known as ovarian torsion, which requires surgical management. Ovarian cysts can also rupture and cause life-threatening hemorrhage. Large cysts should be removed to prevent complications. If one may experience a sudden onset of unilateral moderate to severe sharp lower abdominal pain, associated with or without nausea and vomiting and strenuous activity such as sexual intercourse or exercise, prompt evaluation is mandatory.

Enhancing Healthcare Team Outcomes

Although ovarian cysts are mostly benign and resolve spontaneously, they can sometimes lead to complications such as rupture, hemorrhage, and torsion that require urgent medical or surgical treatment. The purpose of the evaluation is to determine the most likely etiology of the patient’s symptoms whenever an ovarian cyst is present. Acute lower abdominal pain is a common presentation to the emergency room and can be associated with a variety of generalized symptoms. The differential diagnosis is broad, and it can be difficult to determine the exact cause without proper imaging studies. Transvaginal ultrasound is the recommended first-line imaging modality for a suspected or an incidentally identified pelvic mass. [Level 1]

Findings that raise the level of suspicion for malignancy include cyst size more than 10 cm, presence of ascites, papillary excrescences or solid components, irregularity, and high color doppler flow. [level 1]. Surgical intervention for mature ovarian teratomas or endometriomas is warranted in the masses are large, symptomatic, and growing in size on serial imaging studies or if malignancy is suspected. If, however, expectant management is employed, follow-up surveillance is warranted.[22][23] [Level 2]

Figure

Ovarian follicles, oocytes and a small primary follicle in development. Contributed by Fabiola Farci, MD

Figure

Ovarian follicle in maturation, cystic mature follicle. Contributed by Fabiola Farci, MD

Figure

Cystadenofibroma of the ovary. Contributed by Fabiola Farci, MD

Figure

Dermoid cyst of the ovary. Ovarian teratoma, mature teratoma with epidermic and and dermic appendages, pilar structures and hairs. Contributed by Fabiola Farci, MD

Figure

Dermoid cystic teratoma of the ovary. Contributed by Fabiola Farci, MD

References

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Ovarian Cyst – an overview

Ovarian Cysts

Ovarian cysts in childhood are not uncommon, and therefore an understanding of the normal physiology of the ovary is essential to prevent inappropriate intervention.

Based on ultrasound data, the incidence of antenatally diagnosed ovarian cysts is estimated at 1 in 2625 female births. However, data from stillbirth and neonatal death autopsies suggest that the incidence of cysts smaller than 1 cm in diameter may be as high as 30% of all female births. Fetal ovarian cysts are typically functional because the ovary is stimulated by fetal gonadotropins, maternal estrogen, and placental human chorionic gonadotropin. The diagnosis is usually established in the third trimester of pregnancy, and improvements in ultrasound technology have resulted in this diagnosis being made more frequently. The differential diagnosis includes mesenteric and urachal cysts, mesonephric cysts, hematometra with vaginal agenesis, and gastrointestinal duplication cysts. Therefore, antenatal ultrasound examination must detail female external genitalia, a normal urinary tract (i.e., kidneys, ureter, and bladder), and a normal gastrointestinal system (i.e., stomach, large and small bowel) to confirm this diagnosis.

Because the incidence of malignancy in neonatal cysts approaches zero, postnatal management for asymptomatic, simple cysts involves observation with regular ultrasound review. Expected cyst resolution is 50% by 1 month, 75% by 2 months, and 90% by 3 months of age. Postnatal surgical intervention is reserved for cyst persistence, enlargement, symptoms, or a complex appearance on ultrasound examination. These factors are suggestive of a cyst complication such as hemorrhage or torsion.

The ovaries are active during both infancy and childhood. Cysts in patients of this age group are the result of gonadotropin stimulation producing follicular activity. The incidence decreases in early childhood and increases as puberty approaches. Ovarian cysts (mean < 7.5 mm in diameter) have been demonstrated in up to 80% of girls between 1 and 24 months of age and 68% of girls between 2 and 10 years old. In general, 90% of these are 9 mm or less in size, with an ovarian volume of 1 cm.³

In prepubertal patients, normal pelvic organs are usually not palpable, and “pelvic masses” are usually felt abdominally. A rectal examination may be helpful in further characterizing a mass; however, pelvic ultrasound is likely to provide the most useful information.

Ovarian cysts are occasionally functional, secreting estrogen and resulting in vaginal bleeding or breast development. This clinical presentation creates concern for precocious puberty. If ovarian cysts are associated with large café‐au‐lait spots and vaginal bleeding, McCune‐Albright syndrome, involving gonadotropin‐independent hormone secretion, should be considered. Enlarged, multicystic ovaries should prompt investigation for hypothyroidism. In both these conditions, treatment should be directed toward the underlying medical condition and not the ovarian cyst. However, ovarian torsion or a solid ovarian mass in this age group should prompt primary management of the ovarian mass.

Ovary pain? Understanding ovarian cysts

Symptoms

Most ovarian cysts don’t have any symptoms. That being said, if you have a larger ovarian cyst you may notice the following symptoms:

• Bloating
• Heaviness in your abdomen
• Pelvic pain consisting of a dull or sharp ache in your lower abdomen
• Nausea or vomiting
• Painful bowel movements
• Pain during sex

Types of cysts

Not all ovarian cysts are the same. Your cyst might function or even look different, depending on how it was formed.

Follicular cysts

Most follicular cysts will go away on their own within three months. During ovulation, one of your ovaries will release an egg from a tiny sac called a follicle. A cyst can happen if the follicle grows an egg, but doesn’t release it for ovulation. This type of cyst can also happen if a mature follicle collapses on itself. These types of cysts grow up to 2-3 inches in diameter. You probably won’t experience pain with a follicular cyst, but if you do it can cause a sharp, severe pain on the side of your ovary when it ruptures.

Corpus luteum cysts

After your ovary releases an egg during ovulation, the empty follicle the egg was released from typically shrinks back down. However, sometimes a follicle will close and start to collect fluid inside. This fluid-filled follicle is called a corpus luteum cyst. In most cases, these types of cysts are only found on one ovary at a time and produce few to no symptoms. In some cases, a corpus luteum cyst will bleed or cause pain.

Nonfunctional cysts

A nonfunctional cyst can grow on your ovaries whether or not you’re ovulating. These types of cysts might be one of the following:

• Endometriomas are cysts that develop due to a condition called endometriosis, in which uterine endometrial cells grow outside of your endometrium and can present as endometriomas. Endometrioid cysts are usually filled with dark, reddish-brown blood. They can grow up to 8 inches in diameter.
• Dermoid cysts, also called teratomas, are formed from embryonic cells, and can contain tissue like hair, skin, or even teeth. Dermoid cysts aren’t typically cancerous. These cysts usually affect younger women; they can grow up to 6 inches in diameter.
• Cystadenomas grow on the surface of your ovary. They may be filled with serous fluid or mucous.
• Polycystic ovaries occur in women with polycystic ovarian syndrome (PCOS). If you have PCOS, you’ll have many small cysts on the surface of your ovary. But these types of cysts aren’t painful.

Risk factors

Although it’s difficult to predict when or if you’ll develop an ovarian cyst, certain factors put you at risk. They include:

• A history of ovarian cysts
• A diagnosis of endometriosis or polycystic ovary syndrome
• Hormonal problems (some fertility drugs can contribute to the development of ovarian cysts)
• Pregnancy
• A pelvic infection

Diagnosis

Your doctor may be able to detect the presence of an ovarian cyst — if it’s large enough— during a pelvic exam. When an ovarian cyst is suspected, your doctor will likely order a transvaginal ultrasound and/or some blood work. These tests will allow your doctor to confirm the presence and characteristics of an ovarian cyst.

Treatment

The good thing about most ovarian cysts is that they typically go away on their own. When you have an ovarian cyst, your doctor may recommend the following treatments:

• Watchful waiting. It might seem hard to wait, but unless your cyst doesn’t go away, is large, or is causing you problems, waiting is usually the best answer. Keep in contact with your doctor so he or she can monitor the situation, especially if you’re having severe pain.
• Your doctor may prescribe birth control pills to help prevent the growth of new cysts.
• Surgery. Large cysts, or cysts in women who are experiencing menopause (when the risk of a cyst being cancerous is higher), may need to be surgically removed. Your doctor can use laparoscopy for most cysts. This type of surgery is less invasive and allows you to go home quickly. However, if you have a cyst that may be cancerous, your doctor may refer you to a gynecologist oncologist.

When to see a doctor

Although most ovarian cysts go away on their own, you should see your doctor immediately if you experience these symptoms:

• Feeling faint, dizzy, or weak
• Fast breathing
• Fever with pain
• Throwing up
• Severe belly pain that comes on quickly

These symptoms could mean your ovary has twisted because of an ovarian cyst.

The Difference between PCOS & Ovarian Cysts explained

28 August 2019    by – Dr Pandelis Athanasias

Ovarian cysts and PCOS are related conditions with many of the same symptoms, meaning that women often confuse the two, or wrongly believe that they have PCOS when they do not.

The most significant difference between the two conditions is that PCOS results in a substantial hormonal imbalance, which is not generally the case with ovarian cysts. It is also possible for women to have multiple ovarian cysts without suffering from PCOS.

Polycystic Ovary Syndrome (PCOS)

PCOS is a metabolic condition which affects 1 in 10 women and means that the ovaries have an abnormally large number of follicles on them.

These follicles are not harmful, but they can cause a hormonal imbalance, often resulting in several problems, such as irregular or no periods, weight gain, difficulty falling pregnant, excessive body hair, thinning of head hair and acne or oily skin. These symptoms will usually present themselves during their teenage years.

In order for a woman to be diagnosed with PCOS, she needs to have at least two of the following three features:

• Irregular or lack of periods
• High levels of male hormones
• Polycystic ovaries, i.e. where ovaries are enlarged and contain several fluid-filled sacs (follicles)

More than half of the women affected do not have any symptoms, so it can be difficult to diagnose at the early stages. It is important to note that despite the name of the condition, women with PCOS do not usually produce cysts, but rather follicles.

The exact cause of PCOS is unknown, but it is often a hereditary trait and related to abnormal hormone levels, including high levels of insulin. Although PCOS has no known cure, the symptoms of PCOS can be treated. Medication will usually be prescribed to treat symptoms such as irregular periods, infertility and excessive hair growth. In more severe cases, a surgical procedure called laparoscopic ovarian drilling (LOD) may be required.

Ovarian Cysts

Ovarian cysts are sacs filled with fluid which are present in or on the ovaries. They are very common, and as such, many women will develop them at some point in their lifetime.

Most ovarian cysts occur naturally as a result of the normal menstrual cycle (functional cysts) and during the childbearing years. Usually, these cysts are harmless and will disappear naturally on their own after a few months, without the need for medical attention.

Ovarian cyst symptoms are very similar to those found in women with PCOS, such as irregular or non-existent periods, acne and weight gain. Other ovarian cyst symptoms may include pelvic pain, high blood pressure, lower back pain, abdominal pressure and nausea.

It has been found that women with ovarian cysts usually do not have much difficulty getting pregnant, whereas it is common for those with PCOS to struggle.

Ovarian cysts can be identified during an ultrasound scan. Treatment for ovarian cysts will be dependent on:

• The size and appearance of the cysts
• The symptoms you are feeling
• Whether or not you have been through menopause

Cysts often disappear without intervention or treatment, but in the more serious cases, such as if they are large or potentially cancerous, a procedure will be used to surgically remove the ovarian cysts.

90,000 What is an ovarian cyst and how is it dangerous?

Every woman wants to hear “You are healthy!” At any age, women’s health is important, and visits to a gynecologist should be regular (at least once a year). What if ovarian cyst is formed? What is education? What symptoms might indicate a problem and how is a cyst treated? In this article, we will answer all the questions that will help you get to know your body better and respond to painful symptoms in time.

What is an ovarian cyst? This is a formation that forms in the structure of the ovary. There is liquid inside the formation. The cyst is classified as benign and pathological cell growth is excluded.

Symptoms of an ovarian cyst

Most often, education does not make itself felt in any way. Everything proceeds without symptoms, and at the reception of a gynecologist, a woman is surprised to hear the diagnosis: “Ovarian cyst”. Nevertheless, if we talk about specific symptoms that can manifest themselves, then here are the main ones:

• Pain in the lower abdomen.Usually it has a pulling and aching character. Can give to the lower back.
• Abdominal enlargement. This can happen if the cyst is large. At the initial stage, the symptom is not observed.
• No ovulation.
• The menstrual cycle is disturbed. Your period may be too heavy and last longer than usual. A long delay is also possible.
• A woman feels discomfort while urinating.

The above signs of an ovarian cyst will allow you to pay attention to changes in women’s health in a timely manner and consult a doctor for advice and examination.As in the treatment of any disease, speed is important here. The sooner the formation is detected, the more effective the treatment.

What causes an ovarian cyst?

One of the main reasons is hormonal. The balance between follicle-stimulating and luteinizing hormones is disturbed. This leads to disruption of the processes of normal ovulation with the formation of cysts. A cyst can also form against the background of endocrinological diseases, genetic predisposition (if such a problem happened in women of your kind), in violation of metabolic processes in the body.Also, a cyst can form in the presence of pelvic inflammatory disease. You may have heard that hypothermia is the cause of this disease. And this, indeed, can be the impetus for the development of a cyst.

How to treat an ovarian cyst?

Cysts often resolve on their own and there is no need for surgical intervention. If the diagnosis revealed an asymptomatic cyst no more than 6 cm, in this case, the doctor can monitor and not take drastic measures in the form of an operation for 60 days.If the education does not go away within a few months, of course, surgery is indicated. Cysts that have regressed during this period require a follow-up ultrasound scan.

Why is a cyst dangerous?

Despite the fact that it is a benign formation, there is a danger. A cyst can cause infertility, and a ruptured cyst leads to hemorrhage inside the abdominal cavity. Among the complications are: torsion of the cyst, suppuration. All of these complications require immediate surgical intervention.

What is important for every woman to know? Considering that the cyst may not make itself felt at all, but at the same time its development is both not very active and too fast, it is important to be examined by a gynecologist at least once a year. If there were diseases of the small pelvis before, it is best to be examined at least 1 time in six months.

In addition, to prevent the likelihood of developing a cyst, monitor the hormonal balance. Hormones literally control a woman’s body.The function of childbirth, the regularity of the menstrual cycle, general well-being and even the health of the whole organism depend on the hormonal balance. Hormonal disorders are not only a high probability of developing diseases of the small pelvis, but also other organs, as well as body systems. Typically, cysts form in women before menopause. But this does not mean that with the onset of menopause, a visit to the gynecologist is not required. Take care of women’s health, regularly visit a gynecologist and promptly respond to the body’s signals about possible violations.

Ovarian cyst (cystadenoma) – Medical center

Ovarian cyst (cystadenoma) – symptoms, treatment

Cyst is a benign formation located on the ovaries. As a result of hormonal disruption, a bubble filled with liquid forms.

Cysts are benign, there are malignant (cancer), or cysts are initially benign with subsequent malignancy (the longer the duration of a simple cyst, the greater the risk of degeneration into cancer.

Causes of ovarian cysts.

• Inflammatory processes
• Modern style of clothing in our harsh winter conditions (short skirts, jeans with a low waist, light clothes)
• Violation of the harmonious background
• Endometriosis

Symptoms, Complaints

• Pain in the lower abdomen left or right
• Menstrual irregularities
• Soreness during intercourse.
• Temperature rise.
• Insomnia.
• Taking hormonal drugs that affect the appearance of cysts.
• Infertility.
• Obesity.

To make a diagnosis, you first need to visit a gynecologist. It is necessary to be tested for hormones in order to find out the cause of the cyst formation. Make an examination for the CA-125 tumor marker – this indicator will reveal whether there is a cancerous tumor instead of a normal cyst.

The very fact of detecting the hand is simple, it is necessary to perform an ultrasound scan, especially an ultrasound scan with a transvaginal probe.In our center there is a latest generation ultrasound machine with various sensors and a transvaginal one as well. This is not the main thing, the main thing is to distinguish a benign cyst from a malignant one. Either the patient needs to be urgently referred to an oncological dispensary, or to observe, to prescribe conservative treatment, or to operate. The treatment of a woman will be further considered by a gynecologist.

Cysts are of different types. And the sizes are different from a few millimeters to gigantic, occupying the entire small pelvis (containing several liters of fluid).

Follicular cysts – hormonal cysts.

Subject to the supervision of a gynecologist and conservative treatment. They can pass on their own.

Dermoid cyst – not self-limiting, usually requires surgery

The smaller this formation, the easier it is to remove it. Well diagnosed by ultrasound and often benign. It can grow to gigantic proportions with compression of the rectum, bladder and vessels of the lower extremities.Often, with large sizes, this is accompanied by swelling of the left or right leg, convulsions, and sometimes the appearance of varicose veins.

Endometriotic cyst – when women are diagnosed with endometriosis. It is accompanied by inflammation of the lining of the uterus. Against the background of the disease, such a complication may develop as – Endometrioid cyst, leading to infertility

Paraovarian cyst – a cyst formed with endocrine disorders, untimely puberty and frequent abortions.

Mucinous cyst – These cysts grow large and can degenerate into cancer.

Complications of appendage cysts

• Torsion of the cyst. During the twisting of the cyst with the appendage, the blood supply to the ovary is disturbed, an urgent removal of the cyst is required, and often, when a lot of time has passed since the moment of torsion, the ovary dies and the removal of the ovary itself.
• Inflammation. Cysts may suppurate with the formation of abscesses in the small pelvis.Often, urgent operations are required to remove the cyst and, unfortunately, the entire ovary with a tube.
• Ovarian rupture. This is primarily acute pain in the midst of complete health and emergency surgery.

Emergency operation in case of complications. Abdominal surgery consists in cutting the abdomen, removing the cyst. Hospital for about 10 days and a month of disability. Laparoscopic removal of such cysts reduces the rehabilitation period by three times.

If the cyst is removed, the reproductive function is not in danger.After recovery, a woman can become a mother.

The most important thing is not to lead to complications, you may find yourself in different life situations and high-quality medical care may not be available. Planned operations usually proceed safely, and there is no need to be afraid of these operations. It is better to do this in a planned laparoscopic manner and in a few hours be at home with the family.

Ovarian cyst treatment

If the ovarian cyst does not disappear and does not change in size within 2 months, or, on the contrary, increases in size, then there is only one way of treatment – this is the removal of the ovarian cyst.

In our clinic, the safest operation of all is performed – ovarian cyst laparoscopy.

With just a few centimeter holes in the abdomen, doctors remove the tumor. After such a procedure, women recover much faster than after abdominal surgery. In our clinic, this kind of intervention has been performed for 40 years by Yuri Innokentyevich Malygin, a gynecologist of the highest category. Yuri Innokentyevich is the founder of laparoscopy in gynecology in the Irkutsk region, he was the first to perform laparoscopic surgery for ovarian cysts in the Irkutsk region.

A few days after laparoscopy, the ovary is restored, takes on a normal shape and begins to function.

The main task of a gynecologist is to prevent a situation when a woman needs to be sent to a gynecological oncologist. That is why Nowadays, when there is a good ultrasound scan and a low-traumatic laparoscopic approach, this can be avoided. The main thing is to contact a competent gynecologist in time.

The ovarian cyst must be removed, as it can degenerate into cancer, reach large sizes and squeeze adjacent organs, suppurate, lead to infertility.

Ovarian cyst. Is there a cause for concern?

The problem of reproductive health in women with ovarian cysts remains relevant both in connection with the high frequency of this pathology, and with an increase in the number of women with infertility.

An ovarian retention cyst is a cystic formation of the ovary in the form of a fluid-filled tumor. The increase in the size of such cysts is associated with the amount of fluid accumulation in their cavity. This neoplasm is associated with a tumor only by its appearance.A retention cyst is the most common and in most cases a type of cyst, harmless in relation to malignancy.

These mainly include:

1. Follicular cysts (in the event that ovulation does not occur and the follicle continues to grow) – often develops in young women, manifesting itself as a violation of the menstrual cycle, against a background of delayed menstruation is not rare profuse bleeding occurs. Disturbed by pulling pains in the lower abdomen. In most cases, this type of cyst is asymptomatic and does not require treatment.They disappear on their own within 3-6 months.

2. Cysts of the corpus luteum (in the event that the corpus luteum does not reverse development and it continues to grow. It is formed when the corpus luteum of the ovary continues to grow after the ovulation period. It is characterized by a delay in menstruation, engorgement of the mammary glands, with time there are scanty spotting from the genital tract. The whole complex of doubtful signs of pregnancy is possible.

3. Paraovarian cysts (that is, cysts located next to the tubes and ovaries). It is a simple (only fluid-filled) ovarian cyst that occurs in women in 10% of cases of all such diseases.

Possible complications include rupture of the cyst, with the clinic “acute abdomen”, torsion of the ovarian cyst leg, requiring urgent surgical treatment.

The most common causes of retention cysts are pelvic inflammatory processes, hormonal disorders.Hormonal disorders can be associated with obesity, endocrine diseases, inadequate regimen of hormonal drugs. Chronic inflammatory diseases of the intestines, bladder, pelvic organs can also be a provoking factor for the formation of a cyst.

Only a specialist can diagnose a cyst. To determine the type of cyst, an ultrasound examination of the pelvic organs is required. The scope of examinations and treatment tactics are determined individually and depends on the age of the woman, the size and type of cyst, the general condition of the woman, and the complaints.

It is mandatory to examine general clinical parameters, ultrasound of the pelvic organs, hormonal profile, tumor markers, for women with infertility – an assessment of the ovarian reserve.

Treatment can be both conservative (medication) and surgical. Conservative treatment is aimed at reducing the volume of the cyst, or its complete reduction by correcting the hormonal background, if necessary, carrying out complex anti-inflammatory therapy, physiotherapy, dynamic monitoring of the state of the ovarian cyst in dynamics after 1-3 months.

In the absence of an effect from the conservative therapy, or negative dynamics (according to ultrasound, an increase in the volume of the cyst), the woman prepares for surgical treatment, followed by a histological examination of the tissue of the cystic formation.

Since the cyst is not always manifested by a vivid clinical picture, for timely diagnosis and treatment, it is necessary to undergo an annual examination by a gynecologist, with an ultrasound of the pelvic organs.

From a preventive point of view, I would like to recommend that all women take care of themselves and their health, prevent the development of chronic diseases, lead a healthy lifestyle, give up bad habits, in case of complaints, do not self-medicate, but consult a doctor in a timely manner.

Your health is the result of self-love!

Still have questions? Make an appointment with a gynecologist!

Phone for making an appointment (391) 255 – 97 – 79

18+. THERE ARE CONTRAINDICATIONS. A SPECIALIST’S CONSULTATION IS NECESSARY.

May 31, 2018

Epididymal cyst (spermatocele) – diagnosis and treatment

03.11.2021

The article was checked by a urologist, Ph.D. Mazurenko D.A. , is of a general informational nature, does not replace the advice of a specialist.
A doctor’s consultation is required for recommendations on diagnosis and treatment.

In the urology department of the Clinical Hospital on Yauza, patients undergo comprehensive diagnostics and treatment of epididymal cysts, as a result of which the reproductive function of men is restored and the problem of infertility is solved.

Cyst of the epididymis (spermatocele) – a pathology that can proceed without obvious manifestations, so that the patient is not even aware of it.Meanwhile, it can have serious consequences such as infertility.

The epididymis are paired organs that are located in the scrotum. They are ducts that are repeatedly folded and are located in the immediate vicinity of the testicles. For a number of reasons, a dense fluid-filled bubble can form in any of the ducts. If the cyst is actively growing, it can compress the vas deferens and cause a decrease in male fertility.

Causes and pathogenesis of the cyst of the epididymis

The cause of the formation of a cyst of the epididymis can be congenital features of the formation of the epididymis, as a result of which a cavity is formed between the tissues, which is then filled with fluid.

Among the acquired causes of cyst formation are trauma or inflammatory diseases of the testicles and epididymis.

Symptoms of the cyst of the epididymis

In most cases, a cyst of the epididymis does not bother patients, so the neoplasm is discovered by chance – for example, during a routine medical examination. On palpation, the formation also does not bring any negative sensations.
In some cases, patients complain of pain in the scrotum, which radiates to the groin area.
Pain may increase during intercourse.

Diagnosis and treatment of epididymal cysts in the Clinical Hospital on Yauza

Due to the fact that the cyst often does not bother patients, it is necessary to emphasize the importance of preventive examinations by urologists of the Clinical Hospital on Yauza. After visual examination and palpation to confirm the diagnosis, the urologist performs an ultrasound examination of the scrotum. A small cyst that does not bother the patient does not require special treatment.If the cyst reaches a large size, accompanied by discomfort, pain and impaired spermatogenesis, then it is necessary to remove it surgically. After the operation, the removed tissue must be sent for histological examination.

Specialists of the urology department of the Clinical Hospital on Yauza draw up an individual plan of treatment and rehabilitation procedures for patients.

You can look at prices for services in the price list or check the phone number indicated on the website.

Literature:

3. Zubarev V.A., Arkhangelsky A.I., Kovyrshina L.A., Kalugin A.F. Innovations in endoscopic urology [Electronic resource] // Health is the basis of human potential: problems and solutions. 2012.
   https://cyberleninka.ru/article/n/innovatsii-v-endoskopicheskoy-urologii.

4. Schultz V.E. Complications in laparoscopic urology and their prevention // MIA. 2007.

5. Khinman, F.A. Operative urology // GEOTAR-Media. 2007.

Drug treatment of ovarian cysts – effective methods in the MC “Health” Moscow.

Specialists of the Health Center in Moscow diagnose and treat ovarian cysts without consequences, taking into account the type of cystic formation, the patient’s age and her reproductive health.Qualified doctors of the clinic will diagnose and prescribe medication for ovarian cysts.

How to identify an ovarian cyst

A gynecologist will make an appointment and prescribe the following examinations:

• Ultrasound of the pelvis and ovaries. This will identify cystic formation at an early stage
• Biochemistry blood test
• Pregnancy test (uterine or ectopic)
• Tests to determine the level of sex hormones
• Blood test for tumor markers
• Urinalysis

Types of ovarian cysts

Allocate functional and organic neoplasms.Organic cysts often require surgical intervention, functional cysts are primarily treated with medication.

Functional cysts:

• Follicular
• Luteal (yellow body cyst)

Organic cysts:

• Endometrioid
• Mucinous
• Dermoid

The doctor of the MC “Health” will identify the type of cyst and select a complex medication method of treatment after a gynecological examination and additional research methods.First of all, the methods of non-surgical treatment are used, and only in the absence of a positive reaction from the body to medications, the patient is recommended to have surgery.

Symptoms of an ovarian cyst

The cyst can grow asymptomatically until it grows large. But you can suspect its development if you pay attention to the following factors:

• Foreign body sensation to the right or left
• Drawing pains, especially when bending and turning the body
• Pain in the ovarian region during intercourse
• Bloating and tension of the anterior abdominal wall
• Weakness, exhaustion, digestive problems
• Temperature rise to 37 * C
• Lack of menses or delayed
• Severe pain during PMS

In order not to miss the development of cystic formation, it is extremely important for a woman to undergo regular medical examinations by a gynecologist and diagnostic procedures at a medical center.

Drug treatment of ovarian cysts

For the treatment of functional cysts, the following are used:

• hormonal preparations
• COC (combined oral contraceptives)
• anti-inflammatory therapy
• antibiotic therapy
• candles
• physiotherapy (variable and constant low voltage electric current, electrophoresis and galvanization)

In the course of treatment, it is important to observe the dosage of medications prescribed by your doctor.Self-medication can result in a deterioration in health and the progression of the growth of cystic formation.

Make an appointment with qualified gynecologists at the Healthcare Center in Moscow and get advice on all issues of drug treatment of ovarian cysts. Our services are affordable. The appointment is open at any time in a branch of our center convenient for you.

Kidney cyst – symptoms and treatment

Kidney cyst is a fairly common disease, and with the widespread introduction of prophylactic ultrasound into the practice, the number of patients who have a kidney cyst in the early stages has increased significantly.

This disease affects the renal parenchyma most often at the age of 40-50 years and older, and is a spherical cavity filled with fluid, being in most cases a benign tumor. A kidney cyst, like many neoplasms detected at an early stage, can be successfully treated without surgery. The appearance of a kidney cyst can occur even in the prenatal period or be a consequence of external factors of a person’s lifestyle. So, the causes of kidney cysts include:

• Smoking
• Alcohol
• Infection
• Radioactive exposure
• Injury of the lumbar region
• Hormonal changes
• Impaired circulation

How a kidney cyst manifests itself

• Persistent or intermittent pain in the lumbar region compels a person to see a doctor.After carrying out diagnostic procedures in such patients, a kidney cyst is most often detected.
• Arterial hypertension , that is, increased pressure in the hollow organs or blood vessels, is often a harbinger of the appearance of a kidney cyst. Symptoms of this disease can be severe headaches in the back of the head, insomnia, decreased performance, nervousness and irritability, and blurred vision.
• Another sign that accompanies the presence of a kidney cyst is blood in the urine , which can be seen both with the naked eye and during a blood test, when the outward color of urine is not changed, but an increased content of red blood cells is detected.

Diagnosis of renal cysts

For the diagnosis of a renal cyst, the following tests are necessary: ​​

• General blood test (to determine the number of erythrocytes)
• Determination of the concentration of glucose, creatine, urea and protein in the blood
• Kidney ultrasound
• Computed tomography of the retroperitoneal organs with contrast
• Study of renal function

Not all studies are necessary at primary detection of kidney cysts and at an early stage, but they will be necessary to exclude oncology or when a patient is admitted to the hospital for surgery: specialists need to take into account and foresee all the risks before and after the operation.

Operations for a renal cyst

The need for surgical intervention in the Semeynaya clinic is determined by high-level specialists. Most often, with a cyst with a diameter of less than 5 cm that does not manifest itself clinically, that is, does not cause disturbances in the blood circulation of the kidney and outflow of blood, operations are not recommended. Such cysts require observation with ultrasound. The most common method of treatment in such cases is puncture under the control of ultrasound. Such operations are successfully carried out in the Semeynaya clinic, but, unfortunately, not all types of renal cysts can be punctured, and besides, after this operation, the probability of a relapse of the disease remains.

Laparoscopic surgery for renal cysts

In the Semeynaya clinic, an operation for a kidney cyst is performed using high technologies, successfully applying laparoscopic surgery, which guarantees successful operations for any size and localization of a neoplasm.This is a radical operation, involving excision of cyst with histological examination, preserving minimally invasiveness, that is, 3 sizes of 5 mm remain on the abdominal cavity. During laparoscopic surgery, the surgeon sees thin anatomical structures on the monitor, which makes the surgical intervention safe and delicate. In addition, the Semeynaya clinic uses modern surgical equipment and techniques, including ultrasonic surgical scissors, which allow bloodless surgeries to be performed.For the prevention of relapses, argon-enhanced plasma (made in the USA) can be used, with the close arrangement of the vessels, modern hemostatic agents of the leading European manufacturers are used. In order to prevent adhesive disease and thrombosis, synthetic absorbable suture materials, modern anti-adhesive barriers and compression hosiery are also used.

After laparoscopic kidney surgery patients on the first day can get out of bed and drink on their own, eat on the second day, and on the third day the patient can be discharged from the hospital.You can start work in 10-14 days. In the future, it is necessary to regularly monitor the urologist and conduct ultrasound and CT as prescribed by the attending physician.

Consultation with a urological surgeon for kidney cysts

At the Semeynaya clinic in Ryazan, urological surgeons with extensive experience are employed on renal cysts, who will help to deal with each specific case. When prescribing treatment, it is important to know all concomitant diseases and the condition of the kidney cyst at the moment. Many patients require the right nonsurgical treatment, while others urgently need surgery.The decision on surgical intervention is made at a council that includes doctors of all related specialties. For a detailed study of your case, sign up for a consultation by phone. 8 (4912) 50-60-20 . For questions about the possibility of free surgical treatment within the framework of the High-Tech Assistance Program, sign up for a consultation with the chief physician Kondrashov Vladimir Ivanovich.

Laser removal of the epididymis cyst in Kiev ♻️

Valery

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Good afternoon.Operations are being carried out now.? stay time?. price?

Administrator of MED CITY

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Good afternoon, Valery.
All operations are already in progress. This operation is performed under general anesthesia. The cost of laser removal of the epididymis cyst is 11000 UAH, general anesthesia, ward (discharge in the morning before 9.00), consultation of a urologist and anesthesiologist (about 6500 UAH) are paid separately.

Denis

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Good afternoon.Could a 3 mm epididymis cyst be the cause of pain?

Administrator of MED CITY

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Good afternoon, Denis.
This option is possible, the cyst can also become inflamed. In order for the doctor to be able to correctly answer your question, you need to undergo an in-person consultation and possibly additional diagnostics (ultrasound, tests).

Larisa

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Good evening! Is local anesthesia possible with this type of removal? Thanks.

Administrator of MED CITY

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Good evening, Larissa! This surgery can be performed under local anesthesia. The cost of surgical removal is 6800 hryvnia. the cost of laser removal is 11,000 hryvnia. Anesthesia itself is paid additionally. The cost is 1400 hryvnia.

Vladimir

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Good day.Are patients from other cities supported?

Administrator of MED CITY

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Good afternoon, Vladimir.
We serve patients from other cities and countries.
Preliminary registration by phone: 044 338 55 00

Artem

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Good afternoon, I have a small cyst of the epididymis of the right testicle, the doctor says that you can live with this and not grieve, tell me what to do?

Administrator of MED CITY

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Good afternoon, Artem.
If there is no tendency to increase in a dynamic ultrasound study, then it can be observed.

Ekaterina

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Hello, I have an endometroid ovarian cyst 5 cm.
I live far from Kiev, is it possible to undergo tests for an operation in my city and come to you purely for removal?
How much does laser removal cost? Do incisions need to be made for the operation? How long does it take to recover?

Administrator of MED CITY

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Good afternoon, Ekaterina.
Sorry, we are not removing the ovarian cyst.

Roman

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After an operation with the removal of an inguinal hernia, we began to feel heaviness in the scrotum on the left. A recent ultrasound of the scrotal organs showed the presence of an epididymis cyst.
1. Is it possible to do without consulting an onco-urologist, as an ultrasound urologist recommends checking for onco at the beginning? 2. Is it necessary to have CT scan before the cyst removal operation?

Administrator of MED CITY

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Good afternoon, Roman! To clarify your questions, we can sign up for an in-person consultation.Now there is an action, a consultation with a urologist 150 UAH.
Registration by phone: (044) 338-55-00, (068) 952-38-23.

Yuri

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I was diagnosed with a cyst of the epididymis of the right testicle 6.1 x 3.6 x 4.5 cm.
How much will the operation cost in your clinic and what is the need for such an operation?

Administrator of MED CITY

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Good afternoon, Yuri.
Laser removal of the epididymis cyst 9600 UAH, additionally paid for 1500 anesthesia and urologist’s consultation 150 UAH

Anatoly

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Good afternoon, can I find out if this is normal or not … Several years ago, a testicular cyst was found on both sides, one 2.7 mm, the other 4.7 mm. There were no other problems. The size of the cysts is now found to be about the same! So sometimes I walk all right and nothing hurts, but it happens that the one who is 4 starts to hurt a lot.7 mm, then if you lie down for a week passes. I heard that these are small cysts and they cannot get sick and the operation is not required, but when it hurts you can go crazy what to do next, if anything, is such pain normal?

Administrator of MED CITY

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Good afternoon. On this issue, we can make an appointment with a urologist. Until the end of May, the cost of a consultation is 150 UAH.
Tel .: +38 (044) 338-55-00, +38 (068) 952-38-23

Roman

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Good evening, I’m from Vladimirovka, Volnovakhsky district.I didn’t do an ultrasound, but upon self-examination I found out that the right testicle was enlarged and some kind of growth was felt to the touch. Please tell me how much a complete analysis and examination of the disease will cost?

Administrator of MED CITY

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Good afternoon, Roman. The cost of consulting a urologist is 150 UAH for the promotion until 31.05. The cost of the examination is individual, it will be announced to you by the doctor at an in-person consultation, depending on what will be shown to you.Make an appointment by calling the clinic: 044 338 55 00, 050 313 13 27.

Felix

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Good evening. Ultrasound revealed three cysts on both appendages, two on the left and one on the right 4-6 mm. I am from Uzhgorod, I am interested in the cost of the operation and the rehabilitation period, how long you need to stay in your clinic after the operation, I can send you the results. Ultrasound to the post office for consultation with a doctor.

Administrator of MED CITY

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Good afternoon, Felix.
We cannot operate on such small cysts.

Alexander

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Hello, tell me the full cost of the operation to remove the epididymis cyst, taking into account local anesthesia, if everything is taken into account from A to Z. Thank you.

Administrator of MED CITY

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Good afternoon, Alexander.
The cost of removing the epididymis from 4.900 to 7.200, the cost of anesthesia is approximately 1.400 UAH, consultation of a urologist is 300 UAH. Suggest a time for a consultation? Pre-registration by phone: 044 338 55 00.

Krystyan

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And if there is a cyst on both testicles, is the price double or is it included in the same price?

Administrator of MED CITY

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Good afternoon.
Price is for one epididymis cyst. Anesthesia in case of two cysts is applied one.

Igor

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What is the duration of rehabilitation after surgery to remove cysts of the epididymis and inguinal hernia?

Administrator of MED CITY

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Good evening, Igor
Duration of rehabilitation 2-3 weeks
Preliminary registration by phone: 044 338 55 00, 050 313 13 27.

Ivan

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I live very far from Kiev. 1. Is it possible to make an appointment somehow and go through all the examinations and the operation in one day, or will it be necessary to be examined first, and after a while come for the operation itself? 2. How noticeable is the difference between a person who did not perform operations (and did not have any problems with this) and a person after surgery to remove an epididymis cyst?

Administrator of MED CITY

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Good afternoon, Ivan.
Laser removal of the epididymis cyst is performed under general anesthesia. In this case, you must first undergo an in-person consultation with a doctor in order to discuss all the details of anesthesia, analyzes and undergo a full examination. You will receive more detailed information at an in-person consultation with a doctor. Pre-appointment at the clinic by phone: 0443385500, 0503131327.

Zakhar

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A friend has a cyst of 8 mm after an injury at school.He has been walking with her for about 25 years and does not delete. What color can it be? Do they only come in one color?

Administrator of MED CITY

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Good afternoon, Zakhar.
The clinic performs laser removal of the epididymis cyst. The color and content can only be seen during the operation. On this issue, you need to consult a doctor. Registration in the clinic is preliminary by phone.: 044 338 55 00.

Sergey Stepanovich

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After laser surgery, is the difference clearly visible on the scrotum compared to the scalpel? Do the blue microvessels also burst near the laser incision? Can you describe the difference in words or post a photo?

Administrator of MED CITY

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Good afternoon, Sergey Stepanovich.
During laser surgery, vessels are immediately coagulated, that is, the operation is practically bloodless, a small precise incision is made and cosmetic sutures are applied. There are no bruises after the incision. Before the operation, you need an in-person consultation with a urologist, where the doctor will show you a photo. Preliminary appointment at the clinic by phone: 044 338 55 00.

Artemy

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Have cysts recur in your practice? If so, about what percentage? Interested in the percentage when removing in the classical way – with a scalpel and separately the percentage when removing with a laser? Or have there been no relapses in your practice?

Administrator of MED CITY

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Good afternoon, Artemy.
The epididymis cyst is removed only with a laser, all cysts were removed without opening in a single block. Therefore, there were no relapses in our practice. A consultation with a urologist is required before the operation. Preliminary appointment at the clinic by phone: 044 338 55 00.

Valera

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Can I come and have a laser operation to remove a cyst and in a few hours go to the railway station and go home to another city by train? Or do you have to pay at least a day for the hospital and without it in any way?
Will this work in most cases?

Administrator of MED CITY

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Good afternoon, Valery.
The stay in the clinic after the operation depends on the type of anesthesia (local or general anesthesia). After local anesthesia, you can immediately go home; after anesthesia, you need to stay in the clinic overnight. The type of anesthesia is determined by the doctor at an in-person consultation, as it depends on the size of the cyst. Pre-appointment at the clinic by phone 044 338 55 00.

Petya

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Good afternoon.
Can a cyst be removed normally without an incision in the scrotum? Do you do that? If you don’t do it without an incision, what is the usual length of an incision on the scrotum itself?

Administrator of MED CITY

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Good afternoon, Petya.
When the cyst is removed, an incision is made in any case. The length of the incision depends on the size of the cyst. Before the operation, a doctor’s consultation is required. Pre-registration by phone 044 338 55 00.

Nikita

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When a cyst is removed with a laser, does not a scar remain? Is there a scar on the testicle or on the skin of the mosquito? And when removing with a scalpel on the testicle, will it be possible to feel a scar?

Administrator of MED CITY

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Good afternoon, Nikita.
For laser and surgical removal of the epididymis cyst, a tissue incision is made and sutures are applied. Laser surgery has a number of advantages over surgery. This is the coagulation of blood vessels (the operation is practically bloodless), the incision site is additionally disinfected, the rehabilitation and healing period passes much faster, the scar is almost invisible. Before the operation, a consultation with a urologist is required, who will answer in detail all your additional questions.Pre-appointment at the clinic by phone 044 338 55 00.

Galina

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Cyst on the left ovary 6 cm mucinous? Is it possible to do the operation with a laser?

Administrator of MED CITY

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Good afternoon, Galina.
This surgery is performed by the laparoscopic method. It is not performed in our clinic.

Serge

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Good afternoon.
Are there any analogues of your laser for the removal of testicular cysts in Odessa? In Odessa, who knows how to operate with a laser? No need to advertise. But is there or not?

Administrator of MED CITY

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Good afternoon, Serge.
Our clinic is located only in Kiev at st.Pavlovskaya, 26/41. We can provide information only about the specialists and equipment of the Med City clinic. Appointment to the clinic is preliminary: 044 338 55 00.

Vanya

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Good afternoon,
What is the best way to remove the epididymis cyst? Laser? Or the Surgitron radio wave apparatus? They say that the laser does not allow you to control the depth? And something superfluous can accidentally stick.

Administrator of MED CITY

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Good afternoon, Ivan.
In the clinic, the epididymis is removed using the latest laser equipment. The advantage of the laser technique is that with the help of the laser the depth of exposure is controlled exclusively on the affected areas. The laser method is the gold standard in methicine. A preoperative examination by a urologist is preliminarily required, who prescribes tests and studies to clarify the diagnosis of the disease and possible concomitant pathologies. An appointment at the clinic is preliminary by phone: (067) 447-39-62, (044) 338-55-00, via Viber (0937892919), Skype (administrator_medcity) or feedback on our website.

Borya

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Is your laser better than Surgitron for epididymal cyst removal?

Administrator of MED CITY

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Good afternoon, Boris.
The Surgitron apparatus is an apparatus for radio wave surgery. In our clinic, surgery to remove the cyst of the epididymis is performed using a carbon dioxide laser.Its advantage is that the operation is practically bloodless, an accurate tissue incision is made, the incision site is additionally disinfected and the healing process is faster. The doctor will tell you in more detail about the advantages of a laser during an in-person consultation. Appointment to the clinic is preliminary by phone 044 338 55 00.

Borya

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How many do not recommend having sex after removal in the usual way? How many do not recommend after laser?

Administrator of MED CITY

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Good afternoon, Boris.
After removal of the epididymis cyst by the laser method, it is possible to have sexual intercourse a week later, after surgery it takes a little longer, depending on the speed of wound healing.

Dmitry

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Good evening! I am 20 years old, I have a number of health problems. 1) There is a cyst on the left testicle, for a long time already. The size of the cyst is slightly larger than a pigeon’s egg, recently I have felt a tight tingling pain.Sometimes the liquid disappears, then it comes back. 2) We also have a problem in the form of phimosis, which stage I cannot say for sure. In a calm state, the head of the penis can bare, but with an erection – no. At the same time, I have no sex life (((. No need to ask why at the age of 20 there are such problems and where did my parents look. I will answer briefly: I have no parents. I am interested in the cost of this treatment and the time of rehabilitation. What are the consequences and risks in the future) sex life. Thank you for your attention!

Administrator of MED CITY

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Good afternoon, Dmitry!
This situation is common in men today.At a cost of laser removal of testicular cysts from UAH 5600, this operation is performed under general anesthesia. Laser dissection of a short frenum from 4000 UAH A consultation with a urologist is required beforehand. The doctor will collect anemnesis, conduct an examination. It is also necessary to conduct an ultrasound scan, the doctor prescribes to pass the necessary tests. There are no consequences after operations, it is necessary to follow the recommendations of the urologist. Rehabilitation is going well. If you have additional questions for us, an appointment at the clinic is preliminary by phone: 044 338 55 00, 050 313 13 27

Andrey

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Hello, I am wondering how long the postoperative recovery process takes, what should be done in this case? I am from Kherson and would like to know how long it takes to prepare for the operation and whether it will be necessary to stay in the hospital, or can it all be resolved in one day? Thanks in advance for your reply.