What are the different types of ovarian cysts. How large can ovarian cysts typically grow. When is surgery necessary for ovarian cysts. What symptoms may indicate the presence of a large ovarian cyst.

Understanding Ovarian Cysts: Types and Sizes

Ovarian cysts are fluid-filled sacs that can develop in or on the ovaries. While most women experience these cysts at some point in their lives, the size and type can vary significantly. Understanding the different types of ovarian cysts and their typical sizes is crucial for proper diagnosis and treatment.

Functional Cysts: The Most Common Type

Functional cysts, also known as ovulatory cysts, are the most prevalent type. These cysts form as part of the normal menstrual cycle and are typically benign. There are two main subtypes of functional cysts:

• Follicular cysts: These develop when a follicle fails to release an egg during ovulation and continues to grow.
• Corpus luteum cysts: These form when the empty follicle sac doesn’t shrink after ovulation and instead fills with fluid.

The size of functional cysts usually ranges from 2 to 5 centimeters (cm), or approximately 3/4 of an inch to 2 inches. However, in some cases, they can grow up to 8 to 12 cm (3 to 5 inches) in diameter.

Dermoid Cysts: Slow-Growing Tumors

Dermoid cysts, also called teratomas, are a unique type of ovarian tumor. While typically benign, these cysts can contain various types of tissue, including skin, hair, and fat. Dermoid cysts are often present from birth but may grow during a woman’s reproductive years.

The growth rate of dermoid cysts is generally slow, increasing by about 1.8 millimeters (mm) per year. However, some case studies have reported more rapid growth rates of 8 to 25 mm annually. In rare instances, giant dermoid cysts exceeding 15 cm (about 6 inches) in diameter have been documented.

Cystadenomas: Surface Tumors with Growth Potential

Cystadenomas are benign tumors that develop on the surface of the ovaries. These cysts can be filled with either a watery or mucus-like liquid. While they may initially resemble functional cysts on ultrasound, cystadenomas continue to grow over time, unlike functional cysts which typically resolve within a few menstrual cycles.

The size range for cystadenomas is quite broad. Some may be as small as 1 to 3 cm (roughly half an inch to 1 inch), while others can grow to an impressive 30 cm (almost a foot) in diameter.

Endometriomas: Cysts Associated with Endometriosis

Endometriomas, sometimes referred to as chocolate cysts due to their dark, brownish appearance, form as a result of endometriosis. This condition occurs when uterine lining tissue grows outside the uterus, potentially attaching to the ovary and forming a cyst.

While endometriomas are typically small, they can vary in size. It’s estimated that between 17 and 44 percent of women with endometriosis will develop an endometrioma.

Recognizing Symptoms of Large Ovarian Cysts

Many ovarian cysts, particularly smaller ones, may not cause any noticeable symptoms. However, as cysts grow larger, they can lead to various signs and symptoms. Recognizing these symptoms is crucial for early detection and treatment.

Common Symptoms of Large Ovarian Cysts

• Abdominal pain: This may be dull or sharp and is typically localized to one side of the lower abdomen.
• Fullness or pressure: A sensation of fullness or pressure in the abdomen is common with larger cysts.
• Bloating: Abdominal bloating or swelling can occur as the cyst increases in size.
• Changes in menstruation: Large cysts may cause irregular periods or bleeding between periods.
• Urinary symptoms: Frequent urination or difficulty emptying the bladder may occur if the cyst is pressing on the bladder.

Are these symptoms always indicative of a large ovarian cyst. While these symptoms can be associated with large ovarian cysts, they may also be caused by other conditions. It’s essential to consult a healthcare provider for an accurate diagnosis.

When Does an Ovarian Cyst Require Surgical Intervention?

The decision to surgically remove an ovarian cyst depends on several factors, with size being one of the primary considerations. However, it’s important to note that size alone does not always determine the need for surgery.

Size Guidelines for Surgical Intervention

Generally, surgery is not recommended for ovarian cysts unless they exceed 50 to 60 mm (about 2 to 2.4 inches) in size. However, this guideline can vary depending on the type of cyst and other factors:

• Simple cysts: These may be monitored until they reach 10 cm (4 inches) in size.
• Potentially cancerous cysts: These may be removed when they are much smaller, based on their appearance and other risk factors.

Other Factors Influencing Surgical Decision

Is size the only factor in determining the need for surgery. No, several other factors are considered when deciding whether to surgically remove an ovarian cyst:

• Persistence: Cysts that don’t resolve on their own over time may require surgery.
• Appearance: Cysts that appear abnormal on ultrasound may need to be removed for further examination.
• Symptoms: Severe or persistent symptoms may necessitate surgical intervention.
• Age: Postmenopausal women with ovarian cysts may be at higher risk for ovarian cancer, influencing the decision for surgery.

Diagnostic Procedures for Ovarian Cysts

Accurate diagnosis of ovarian cysts is crucial for determining the appropriate treatment approach. Healthcare providers employ various diagnostic tools and procedures to assess the size, type, and potential risks associated with ovarian cysts.

Common Diagnostic Methods

• Pelvic examination: A manual examination to check for swelling or tenderness in the ovarian area.
• Ultrasound: This imaging technique uses sound waves to create detailed pictures of the ovaries and any cysts present.
• CT scan or MRI: These advanced imaging methods may be used for more detailed views of complex cysts.
• Blood tests: Certain blood tests can help rule out ovarian cancer or other conditions.

How accurate are these diagnostic methods in determining the nature of an ovarian cyst. While these methods are generally quite reliable, the accuracy can vary depending on the type and location of the cyst. In some cases, a definitive diagnosis may only be possible through surgical exploration and biopsy.

Treatment Options for Ovarian Cysts

The treatment approach for ovarian cysts depends on various factors, including the size, type, and symptoms associated with the cyst. While some cysts may require surgical intervention, many can be managed through other means.

Non-Surgical Management

• Watchful waiting: For small, asymptomatic cysts, regular monitoring may be recommended.
• Pain management: Over-the-counter pain relievers can help manage discomfort associated with ovarian cysts.
• Hormonal birth control: In some cases, hormonal contraceptives may be prescribed to prevent new cysts from forming.

Surgical Interventions

When is surgery necessary for ovarian cysts. Surgery may be recommended in the following situations:

• Large cysts: Those exceeding 50 to 60 mm in size may require removal.
• Persistent cysts: Cysts that don’t resolve on their own over time.
• Symptomatic cysts: Those causing severe or persistent symptoms.
• Potentially cancerous cysts: Any cyst suspected of being malignant.

The type of surgery performed depends on the size and nature of the cyst, as well as the patient’s overall health and fertility desires. Options may include laparoscopic cystectomy (removal of the cyst while preserving the ovary) or oophorectomy (removal of the entire ovary).

Potential Complications of Large Ovarian Cysts

While many ovarian cysts are harmless and resolve on their own, large cysts can potentially lead to complications. Understanding these risks is important for both patients and healthcare providers.

Possible Complications

• Ovarian torsion: Large cysts can cause the ovary to twist on itself, cutting off its blood supply.
• Rupture: A large cyst may burst, causing sudden, severe pain and potential internal bleeding.
• Fertility issues: In some cases, large cysts or their treatment may impact fertility.
• Compression of nearby organs: Very large cysts can put pressure on surrounding structures, potentially affecting their function.

How common are these complications. While these complications are relatively rare, the risk increases with the size of the cyst. Prompt medical attention for any sudden or severe symptoms is crucial to prevent or address these potential issues.

Living with Ovarian Cysts: Lifestyle Considerations

For women diagnosed with ovarian cysts, particularly larger ones, certain lifestyle adjustments may be necessary to manage symptoms and prevent complications.

Practical Tips for Daily Life

• Regular check-ups: Maintain scheduled follow-up appointments with your healthcare provider.
• Physical activity: Engage in gentle exercises as approved by your doctor to maintain overall health.
• Diet: Some women find that certain dietary changes help manage symptoms, though scientific evidence is limited.
• Stress management: Practicing stress-reduction techniques may help alleviate some symptoms associated with ovarian cysts.

Can lifestyle changes prevent the formation of ovarian cysts. While certain lifestyle factors may influence overall reproductive health, there’s no guaranteed way to prevent all types of ovarian cysts. However, maintaining a healthy lifestyle and regular check-ups can help in early detection and management of any issues that arise.

Understanding the various types, sizes, and potential complications of ovarian cysts is crucial for proper management and treatment. While many cysts resolve on their own, larger cysts may require medical intervention. Regular check-ups and prompt attention to any unusual symptoms are key to maintaining ovarian health. As research in this field continues to evolve, new insights and treatment options may emerge, offering hope for improved management of ovarian cysts in the future.

Types, What’s Normal, When is Surgery Needed?

Most women have ovarian cysts at some point during their lifetime. Some cyst types can become large in size. Surgery may be recommended for large cysts, ones that don’t go away on their own, or appear abnormal in an ultrasound.

Ovarian cysts are fluid-filled sacs that can form in or on your ovaries. Most ovarian cysts are benign (noncancerous), and are typically caused by hormonal changes, pregnancy, or conditions like endometriosis.

The most common type of ovarian cyst, known as a functional or ovulatory cyst, is completely normal. It develops every month when you ovulate. They aren’t usually harmful, have no symptoms, and typically go away on their own within a few weeks.

But this isn’t the only type of cyst that can develop in or on your ovaries. Some other types are a lot less common than the cysts that develop each month due to ovulation.

This article will look at the different types of ovarian cysts, the typical size of each, as well as potential treatment options.

There are different types of ovarian cysts, each with unique causes and characteristics. The size of an ovarian cyst can also vary depending on what type of cyst it is.

Size is also one of several factors that can help determine whether a cyst needs to be surgically removed. Generally speaking, surgery isn’t recommended for ovarian cysts unless they’re larger than 50 to 60 millimeters (mm) (about 2 to 2.4 inches) in size.

However, this guideline can vary. For instance, a simple cyst may be left alone until it’s 10 cm (4 inches) in size. And cancerous cysts may be removed when they’re much smaller.

Let’s look at each type of ovarian cyst in more detail as well as the typical size of each.

Functional cysts form when your menstrual cycle follows its normal pattern. In some cases, though, the cyst can continue growing. Two examples of functional cysts include the following:

• Follicular. Follicular cysts form when a follicle, a small sac that stores an egg and produces estrogen, doesn’t release the egg during ovulation. Instead, the follicle continues growing, producing a follicular cyst.
• Corpus luteum. Corpus luteum cysts can form when the empty follicle sac doesn’t shrink after ovulation. Instead, the sac becomes sealed off and starts to fill with fluid, leading to a corpus luteum cyst.

Most functional cysts are 2 to 5 centimeters (cm) (about 3/4 of an inch to 2 inches) in size. Ovulation happens when these cysts are around 2 to 3 cm in size. However, some may reach sizes of 8 to 12 cm (around 3 to 5 inches).

Dermoid cysts are also called teratomas. They can contain different types of tissue, such as skin, hair, and fat. Dermoid cysts are often asymptomatic, although they may cause symptoms and complications if they become large.

These cysts are actually a type of ovarian tumor. They’re almost always benign and are often present from birth. Dermoid cysts can grow during a woman’s reproductive years

These cysts often grow slowly, progressing at a rate of about 1. 8 mm (about 0.07 inches) per year.

Dermoid cysts do have the potential to become large, though. Case studies have reported that some dermoid cysts can grow more rapidly, between 8 and 25 mm (0.3 to about 1 inch) per year.

In rare cases, giant dermoid cysts over 15 cm (about 6 inches) in diameter have been reported.

Cystadenomas are benign tumors that develop on the surface of your ovaries. They can be filled with a watery or mucus-like liquid.

When viewed using ultrasound, a cystadenoma often looks like a functional cyst. However, while functional cysts typically go away after several menstrual cycles, a cystadenoma will continue to get bigger.

Cystadenomas can also become quite large. While some can be on the smaller side, around 1 to 3 cm (roughly half an inch to 1 inch), some can grow up to 30 cm (almost a foot)!

Endometriomas form due to endometriosis. Endometriosis is a condition where the cells of the uterine lining grow outside of the uterus. This tissue can attach to the surface of your ovary and form a cyst.

It’s estimated that between 17 and 44 percent of women with endometriosis will have an endometrioma. These cysts are sometimes called chocolate cysts because they can contain thick, dark blood that gives them a brownish color.

Endometriomas are typically small, but like other cysts, they can come in a range of sizes.

Many times, ovarian cysts don’t have any symptoms. When symptoms are present, they can include:

• pain on one side of your lower abdomen, which may be dull or sharp
• a feeling of fullness or pressure in your abdomen
• abdominal bloating or swelling

Other less common symptoms can include:

• pain during sex
• painful periods
• irregular periods or bleeding between periods
• feeling like you have to urinate frequently
• problems with emptying your bladder or having a bowel movement
• difficulty becoming pregnant (endometriomas)

Complications from ovarian cysts are rare. Sometimes a cyst can break open (rupture), leading to pain or bleeding.

In other cases, the ovary can become twisted around surrounding tissues (torsion), potentially cutting off the blood supply to the ovary.

Be sure to seek prompt medical attention if you experience any of the following symptoms:

• severe abdominal pain that comes on suddenly
• pain that happens along with fever and vomiting
• feeling faint or weak
• rapid, shallow breathing

Not all ovarian cysts require treatment, and many go away on their own. Because of this, your doctor may recommend a period of watchful waiting to monitor your cyst to see if it goes away after one or two menstrual cycles.

If you experience discomfort from an ovarian cyst, your doctor may suggest over-the-counter (OTC) pain medications to help with pain relief. Examples include:

• acetaminophen (Tylenol)
• ibuprofen (Motrin, Advil)
• naproxen (Aleve)

Sometimes, an ovarian cyst may require surgical removal. This may be necessary when a cyst:

• is large or continues to grow
• doesn’t go away on its own after several menstrual cycles
• causes acute pain
• appears abnormal or malignant (cancerous) via ultrasound

Surgical removal of ovarian cysts is often accomplished using minimally invasive methods like laparoscopy. However, more invasive open surgery may be necessary when a cyst is very large or cancer is suspected.

If you often get functional cysts, your doctor may prescribe a hormonal contraceptive for you. While this medication can help prevent new functional cysts from forming, it won’t shrink an existing cyst.

The bottom line                                       

Most women have ovarian cysts at some point during their lifetime. In fact, functional ovarian cysts are a normal part of your menstrual cycle. These cysts typically don’t have any symptoms and usually go away within a few weeks.

Some other types of cysts, like dermoid cysts, cystadenomas, and endometriomas, are a lot less common. These cysts can continue to grow and become large in size.

Most cysts don’t need to be surgically removed. However, surgery may be recommended for cysts that are large, don’t go away on their own, or appear abnormal by ultrasound.

Types, What’s Normal, When is Surgery Needed?

Most women have ovarian cysts at some point during their lifetime. Some cyst types can become large in size. Surgery may be recommended for large cysts, ones that don’t go away on their own, or appear abnormal in an ultrasound.

Ovarian cysts are fluid-filled sacs that can form in or on your ovaries. Most ovarian cysts are benign (noncancerous), and are typically caused by hormonal changes, pregnancy, or conditions like endometriosis.

The most common type of ovarian cyst, known as a functional or ovulatory cyst, is completely normal. It develops every month when you ovulate. They aren’t usually harmful, have no symptoms, and typically go away on their own within a few weeks.

But this isn’t the only type of cyst that can develop in or on your ovaries. Some other types are a lot less common than the cysts that develop each month due to ovulation.

This article will look at the different types of ovarian cysts, the typical size of each, as well as potential treatment options.

There are different types of ovarian cysts, each with unique causes and characteristics. The size of an ovarian cyst can also vary depending on what type of cyst it is.

Size is also one of several factors that can help determine whether a cyst needs to be surgically removed. Generally speaking, surgery isn’t recommended for ovarian cysts unless they’re larger than 50 to 60 millimeters (mm) (about 2 to 2.4 inches) in size.

However, this guideline can vary. For instance, a simple cyst may be left alone until it’s 10 cm (4 inches) in size. And cancerous cysts may be removed when they’re much smaller.

Let’s look at each type of ovarian cyst in more detail as well as the typical size of each.

Functional cysts form when your menstrual cycle follows its normal pattern. In some cases, though, the cyst can continue growing. Two examples of functional cysts include the following:

• Follicular. Follicular cysts form when a follicle, a small sac that stores an egg and produces estrogen, doesn’t release the egg during ovulation. Instead, the follicle continues growing, producing a follicular cyst.
• Corpus luteum. Corpus luteum cysts can form when the empty follicle sac doesn’t shrink after ovulation. Instead, the sac becomes sealed off and starts to fill with fluid, leading to a corpus luteum cyst.

Most functional cysts are 2 to 5 centimeters (cm) (about 3/4 of an inch to 2 inches) in size. Ovulation happens when these cysts are around 2 to 3 cm in size. However, some may reach sizes of 8 to 12 cm (around 3 to 5 inches).

Dermoid cysts are also called teratomas. They can contain different types of tissue, such as skin, hair, and fat. Dermoid cysts are often asymptomatic, although they may cause symptoms and complications if they become large.

These cysts are actually a type of ovarian tumor. They’re almost always benign and are often present from birth. Dermoid cysts can grow during a woman’s reproductive years

These cysts often grow slowly, progressing at a rate of about 1.8 mm (about 0.07 inches) per year.

Dermoid cysts do have the potential to become large, though. Case studies have reported that some dermoid cysts can grow more rapidly, between 8 and 25 mm (0.3 to about 1 inch) per year.

In rare cases, giant dermoid cysts over 15 cm (about 6 inches) in diameter have been reported.

Cystadenomas are benign tumors that develop on the surface of your ovaries. They can be filled with a watery or mucus-like liquid.

When viewed using ultrasound, a cystadenoma often looks like a functional cyst. However, while functional cysts typically go away after several menstrual cycles, a cystadenoma will continue to get bigger.

Cystadenomas can also become quite large. While some can be on the smaller side, around 1 to 3 cm (roughly half an inch to 1 inch), some can grow up to 30 cm (almost a foot)!

Endometriomas form due to endometriosis. Endometriosis is a condition where the cells of the uterine lining grow outside of the uterus. This tissue can attach to the surface of your ovary and form a cyst.

It’s estimated that between 17 and 44 percent of women with endometriosis will have an endometrioma. These cysts are sometimes called chocolate cysts because they can contain thick, dark blood that gives them a brownish color.

Endometriomas are typically small, but like other cysts, they can come in a range of sizes.

Many times, ovarian cysts don’t have any symptoms. When symptoms are present, they can include:

• pain on one side of your lower abdomen, which may be dull or sharp
• a feeling of fullness or pressure in your abdomen
• abdominal bloating or swelling

Other less common symptoms can include:

• pain during sex
• painful periods
• irregular periods or bleeding between periods
• feeling like you have to urinate frequently
• problems with emptying your bladder or having a bowel movement
• difficulty becoming pregnant (endometriomas)

Complications from ovarian cysts are rare. Sometimes a cyst can break open (rupture), leading to pain or bleeding.

In other cases, the ovary can become twisted around surrounding tissues (torsion), potentially cutting off the blood supply to the ovary.

Be sure to seek prompt medical attention if you experience any of the following symptoms:

• severe abdominal pain that comes on suddenly
• pain that happens along with fever and vomiting
• feeling faint or weak
• rapid, shallow breathing

Not all ovarian cysts require treatment, and many go away on their own. Because of this, your doctor may recommend a period of watchful waiting to monitor your cyst to see if it goes away after one or two menstrual cycles.

If you experience discomfort from an ovarian cyst, your doctor may suggest over-the-counter (OTC) pain medications to help with pain relief. Examples include:

• acetaminophen (Tylenol)
• ibuprofen (Motrin, Advil)
• naproxen (Aleve)

Sometimes, an ovarian cyst may require surgical removal. This may be necessary when a cyst:

• is large or continues to grow
• doesn’t go away on its own after several menstrual cycles
• causes acute pain
• appears abnormal or malignant (cancerous) via ultrasound

Surgical removal of ovarian cysts is often accomplished using minimally invasive methods like laparoscopy. However, more invasive open surgery may be necessary when a cyst is very large or cancer is suspected.

If you often get functional cysts, your doctor may prescribe a hormonal contraceptive for you. While this medication can help prevent new functional cysts from forming, it won’t shrink an existing cyst.

The bottom line                                       

Most women have ovarian cysts at some point during their lifetime. In fact, functional ovarian cysts are a normal part of your menstrual cycle. These cysts typically don’t have any symptoms and usually go away within a few weeks.

Some other types of cysts, like dermoid cysts, cystadenomas, and endometriomas, are a lot less common. These cysts can continue to grow and become large in size.

Most cysts don’t need to be surgically removed. However, surgery may be recommended for cysts that are large, don’t go away on their own, or appear abnormal by ultrasound.

Ovarian cyst treatment, surgery to remove an ovarian cyst, laparoscopy price

Ovarian cysts are tumor-like formations, the cavity of which is filled with various tissues, including blood, mucus and fluid.

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

1. Follicular (functional) ovarian cyst

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

Larger lesions (6-10 cm) present with the following symptoms:

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

2. Yellow body cyst

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

Factors contributing to the formation of a corpus luteum cyst:

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

The symptomatology of this cyst is mild: (slight pain, feeling of heaviness and discomfort in the abdomen from the formation, delayed menstruation or, conversely, prolonged menstruation). Often, such cysts develop within 2-3 months, after which they spontaneously disappear.

3. Paraovarian ovarian cyst

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

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

4. Mucinous ovarian cyst

This is a benign tumor with a bumpy surface and a multi-chamber cavity in which mucus is located. The main features that distinguish it from other types of cysts are its rapid growth rate and gigantic size (up to 30 cm). Most often, such cysts occur in women over 45 years of age, since the main cause is hormonal disruptions that occur during menopause.
The characteristic symptoms of a mucinous cyst are: aching pains in the womb area, an increase in the volume of the abdomen due to the rapid growth of the cyst, constant urge to urinate, a constant feeling of a full intestine, frequent constipation.

5. Ovarian dermoid cyst

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

6. Endometrial cyst

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

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

• disorders in the immune system,
• hormonal disorders (excess estrogen and prolactin, lack of progesterone and androgens, dysfunction of other endocrine organs – thyroid gland and adrenal cortex),
• surgeries (including abortions) and abdominal injuries,
• transferred stresses,
• inflammatory diseases of the female genital area,
• other somatic diseases and metabolic disorders.

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

Large cysts, squeezing the surrounding organs of the small pelvis, can contribute to impaired urination, constipation, and bloating. With prolonged existence, “chocolate” cysts can be complicated by rupture, suppuration and the formation of an adhesive process.

7. Polycystic ovaries.

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

Risk factors for polycystic disease:

• Early or late puberty.
• Late or early menopause.
• Various menstrual irregularities.
• Termination of pregnancy, miscarriage, infertility.
• Inflammatory processes of the pelvic organs.
• Hormonal imbalance due to endocrine diseases or the use of hormonal medications.
• Irregular sexual intercourse.
• Overweight or underweight.
• Diabetes mellitus.
• Genetic predisposition.
• Prolonged stress.
• Strong physical activity.

Polycystic is: primary (true) and secondary.

• Primary polycystic.

It usually occurs during puberty. The disturbed balance of hormones in teenage girls leads to a late onset of menstruation or they may be completely absent. The moment of formation of a normal menstrual cycle is intermittent, there is oligomenorrhea (scanty discharge during menstruation) or amenorrhea (absence of menstruation), which indicates anovulation (the egg does not leave the ovaries).

• Secondary polycystic.

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

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

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

Complications of ovarian cyst

Malignancy of an ovarian cyst.
Ovarian cysts initially have a benign nature. Most often, these formations are asymptomatic and resolve on their own over time, however, sometimes the cyst persists longer than the due date, causing pain and bleeding, and can develop into malignant neoplasms.
The predisposition of an ovarian cyst to degenerate into a malignant formation is determined by the type of tumor:

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

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

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

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

The presence of an oncological formation can be suspected if the following symptoms are present

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

Diagnosis of ovarian cyst

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

Ovarian cyst treatments

Conservative treatment of cysts

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

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

Surgery to remove an ovarian cyst

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

Indications for surgery:

• Any mass that exists in the ovary for more than 3 months and does not disappear without treatment or on the background of hormonal therapy.
• Ovarian masses found during menopause.
• Complications of the cyst: suppuration, hemorrhage, its rupture, as well as torsion of the leg.
• Malignant process.

Relative contraindications to surgical treatment:

• diseases associated with poor blood clotting;
• cardiovascular and neurological diseases in the acute stage;
• urinary tract infections;
• internal bleeding;
• advanced stages of obesity;
• lung injury;
• problems with persistent bloating;
• fistulas.

Methods of performing an operation to remove ovarian cysts

Laparoscopic removal of an ovarian cyst

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

Types of laparoscopic operations:

• Enucleation of the cyst capsule with preservation of intact ovarian tissue. This intervention is called a cystectomy.
• Ovarian resection. With this intervention, part of the ovary is removed along with the cyst.
• Removal of the mass and ovary in its entirety is called oophorectomy. The pipe is preserved.
• Adnexectomy involves the removal of the ovary with a pathological formation and the fallopian tube from the side of the lesion.

Postoperative period

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

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

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

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

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

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

classification, risk factors, diagnosis and treatment

Usually women are faced with such a conclusion after ultrasound of the pelvic organs. And it makes a lot of people nervous. However, ovarian cysts are different and not always, contrary to popular belief, they must be removed surgically.

Let’s understand what a cyst is. The word “kystis” in Greek means “bubble”. It is the “bubble” of the ovarian cyst that is the cyst formation in the ovary, the cavity of which can be filled with fluid, blood, mucus and various tissues.

Classification

In women of childbearing age, ovarian cysts are common, with most of them being benign neoplasms, among which functional, endometrioid cysts, dermoid cysts (mature teratomas) and serous cystadenomas predominate.

Functional cysts (follicular cyst, corpus luteum cyst) are formed from the natural structures of the ovary – the follicle and corpus luteum. Follicular cysts are the result of the fact that, for various reasons, ovulation does not occur, an unruptured follicle remains in the ovary for some time and may even increase in size. Corpus luteum cysts are the result of excess fluid accumulation in the corpus luteum that forms after ovulation. Functional cysts exist for a short time (up to 2-3 months), most often disappear on their own and do not require any treatment. At the same time, a woman is recommended sexual rest, restriction of physical activity and exposure to high temperatures (baths, saunas, etc.). In order to monitor the condition of the ovarian cyst, ultrasound of the pelvic organs is performed on the 2nd-5th day of the menstrual cycle.

Endometrioid cysts (endometriomas) are caused by endometriosis of the ovary. Monthly small bleeding from the focus of endometriosis leads to the formation of a cavity in the ovary filled with blood, which thickens over time, darkens and becomes similar in consistency and color to liquid chocolate. Therefore, such cysts are also called “chocolate”. In 0.8% of cases, endometriomas become malignant (degenerate into malignant ones). The tactics of treating endometrioid cysts is determined individually depending on its size, the age of the woman, reproductive plans, etc. Therapy may be limited to the appointment of hormonal drugs, but more often such cysts are removed surgically.

Dermoid ovarian cysts appear as a result of a violation of the course of the embryonic period, when cells of the integumentary epithelium enter the ovary of the unborn child. Therefore, such cysts contain adipose tissue, teeth, hair, bones. The dermoid cyst usually does not reach large sizes, grows slowly, about 2% degenerate into cancer. The treatment of such cysts is surgical.

Serous cystadenomas are neoplasms of a benign nature, with elastic dense walls containing a clear serous fluid. The walls of the cyst are dense, the inner surface of the capsule is smooth. The neoplasm is painless and quite mobile, according to external signs it resembles a follicular cyst. There are also papillary serous cystadenomas, which are characterized by the presence of papillary growths on the inner surface of the capsule. Such cysts can be borderline and in most cases degenerate into malignant tumors, so serous cystadenomas are always surgically removed.

Factors contributing to the formation of ovarian cysts

• hormonal disorders;

• artificial termination of pregnancy;

• inflammation of the female genital organs;

• sexually transmitted infections;

• premature puberty;

• operations on the pelvic organs in the past;

• heredity.

Ovarian cyst diagnostics

• Complaints about irregular menstruation, pain in the lower abdomen. In this case, quite often the ovarian cyst is asymptomatic.

• During a gynecological examination, pain in the lower abdomen and an increase in the ovaries are revealed.

• Ultrasound examination of the pelvic organs is the most informative method, as it allows not only to determine the presence of a cyst, but also to observe its development, assess its size and structure.

• With the help of a blood test for oncomarkers (biological substances produced by cancer cells): Ca-125, HE4 with the calculation of the RMI index and the ROMA index, a malignant ovarian tumor (cancer) can be suspected.

• With the help of magnetic resonance imaging of the pelvic organs with contrasting, the location, size and structure of the cyst are clarified.

Treatment of ovarian cysts

As mentioned above, the choice of cyst treatment depends on the type of cyst and is determined by the doctor.