How is a cyst removed? Non-surgical and surgical treatment of ovarian cysts

An effective remedy for CYSTS without surgery and hormones, recommended by Irina Yakovleva!

Ovarian cyst is a common disease in gynecology. A cyst is a cavity containing liquid or semi-liquid contents. Some types of formations are absolutely harmless, and surgery is not prescribed. Others require thorough treatment. It involves taking hormonal drugs. In some cases, the bush needs to be removed in order to avoid danger.

The advanced form of this disease causes complications such as infertility, menstrual irregularities, and oncology.

A cyst is dangerous if it becomes twisted, damaged or suppurates.

Fortunately, in most cases it appears as a small formation that resembles a bubble.

Cysts are divided into the following types: functional, dermoid, true and endometrioid.

Main manifestations of the disease

Symptoms of this disease are:

1. pain in the lower abdomen, which intensifies before menstruation and during sexual intercourse;
2. disruptions in the menstrual cycle;
3. When the cyst ruptures or torsions, vomiting, nausea, and acute pain in the lower abdomen are observed.

The detection of several of the above manifestations indicates the presence of the disease. Therefore, you should not delay your visit to the doctor.

At the clinic, the gynecologist performs a gynecological examination to detect cysts and changes in the appendages. One of the most informative methods is the ultrasound research method. This method uses transvaginal and transabdominal sensors. The cyst can be diagnosed using laparoscopy and computed tomography.

Disposal options

There are conservative and surgical methods of treatment.

In most cases, surgical removal of the cyst is prescribed for patients who have reached a post-climactic state. Between the ages of 50 and 70, the risk of tumors increases significantly. During examination, doctors insist on immediate removal of the formations in order to prevent the development of oncology.

In women of childbearing age, the operation is performed extremely rarely. For treatment, medications and special procedures are prescribed.

Conservative method

In the case where an ovarian cyst is the main factor in hormonal imbalance, treatment should be carried out with hormonal agents. The doctor makes their choice for each patient separately. This method of treatment is considered effective for the functional type of cyst. It completely disappears after six months.

However, you cannot delay drug treatment if there is no result. For conservative treatment, a period is set (three menstrual cycles), during which dynamics in size reduction should be visible. If no improvement is observed, the doctor prescribes surgery.

Drug treatment can be combined with folk remedies. Herbal infusions and decoctions of chamomile, mint and string can be helpful. Herbal medicine has a general positive effect. Proper use of herbal medicine promotes a positive effect not only on the ovaries, but also on the entire body. But such therapy is only an addition to the main treatment.

Surgical intervention

If the cyst does not disappear within the time allotted for treatment, surgery is prescribed. Very often, in addition to therapy, physiotherapy and medications that help strengthen the immune system are prescribed.

Surgery also occurs for non-functional types of cysts.

The method of performing the operation depends on the age, general condition of the patient, and the type and size of the formation. In most cases, a benign cyst is removed using laparoscopy. This is the most advanced treatment method. This operation involves an incision of several centimeters. The affected areas are removed through it. This surgical intervention does not damage healthy ovarian tissue and allows you to preserve the ability to reproduce. After three days the patient can return home.

In the case of a true tumor, hysterectomy and oophorectomy are used.

During a hysterectomy, the uterus and appendages are removed. Ovariectomy involves removing the cyst along with the ovary. must be treated surgically.

Only in 15% of cases an ovarian cyst is characterized as an oncological manifestation.

The likelihood of a non-dangerous form of formation turning into a malignant tumor does not disappear anywhere. This is why scheduled visits to the gynecologist are so important.

A malignant cyst must be removed as quickly as possible.

Removing an ovary will cause some difficulties when trying to get pregnant. Therefore, it is not necessary to wait until problems begin, but you should immediately seek help. Consultation with a doctor will be required.

Is surgery necessary?

This question worries every woman faced with this disease. The main reason for this issue is the absence of obvious symptoms of the disease. It must be remembered that the conservative method is not highly effective. During the time that a woman spends on conservative treatment, complications arise. They can subsequently lead to loss of the ovary or the development of cancer.

The main thing, like any other disease, is that the cyst should not be neglected. In its advanced form, it is impossible to do without removing the ovary. A small cyst can be easily removed from the body and still preserve the ovary, which is very important for women who want to have children. After such an operation, they are able to become pregnant and bear a fetus.

However, most women try to avoid surgical intervention and find alternatives to surgery in traditional methods and drugs. It is important to remember that time is against a woman and every minute must be used for treatment. Be healthy!

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• Incredible... You can cure a cyst without surgery!
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A cyst is a neoplasm that is a capsule filled with contents. An ovarian cyst is a fairly common disease that can occur constantly or on certain days of the cycle. If a neoplasm occurs as the dominant follicle grows, they try to get rid of it using non-surgical methods. A woman takes hormonal drugs for some time, which cause temporary menopause. As a result, the cyst resolves.

• cystectomy;
• partial resection of the ovary;
• oophorectomy.

If the cyst is functional, the doctor will try to get rid of it using conservative methods. Typically, a woman is prescribed oral contraceptives and vitamin preparations. Women who are overweight are advised to follow a diet that, thanks to weight loss, normalizes the balance of hormones in the body. Normalization of hormonal levels contributes to the resorption of the cyst.

An ovarian cyst is a liquid formation filled with secretion, which belongs to tumor-like processes and is not a true tumor. Therefore, it should be treated non-operatively whenever possible. Surgical intervention is resorted to only in the presence of any complications, which include, for example, torsion of the cyst.

Ovarian cyst in most cases it occurs in women under fifty years of age, and often their course does not manifest itself with any symptoms. The presence of a formation is determined using ultrasound, a vaginal probe, vaginal examination or laparoscopy. Often the formation is discovered by chance during the next examination.

Folk remedies against cysts

You can make local baths for medicinal purposes, for which preparations are prepared from herbal infusions.

For example, you can mix equal amounts of pine uterus, birch leaves, blueberries and cuffs, and tansy flowers.

The second collection is oak bark, wormwood grass, violets and geraniums, chamomile flowers.

Another one is calendula flowers, knotweed root, plantain leaf, bird cherry fruits, and herbs agrimony, yarrow and thyme.

A good composition of equal amounts of marshmallow root, aspen bark, and wormwood herb.

You can try a mixture of fireweed leaf, bergenia root and herbs lavender and tricolor violet.

More like this popular fees for the treatment of cysts prepared with an equal ratio of ingredients:

• flax seeds, viburnum bark, clover flowers, celandine grass and horsetail;
• birch and coltsfoot leaves, nettle grass, juniper and bird cherry fruits;
• angelica root, mint and St. John's wort, calendula and meadowsweet flowers, blueberry leaf and dandelion root;
• mint and sweet clover herbs, and eucalyptus leaf;
• licorice root and elecampane, wormwood herb.

To prepare the infusions that are necessary for local baths, you should brew tablespoons of the crushed collection with two glasses of boiling water and then keep it in a boiling closed water bath for a little more than a quarter of an hour, leave for an hour. The finished infusion should be filtered and brought to two liters with boiled water. This infusion is used for sitz baths; the procedure should last about a quarter of an hour. The baths are done once or twice a day, and the full course is ten to twelve baths. Herbal medicine allows you to achieve improvement after a couple of weeks of regular use, but a lasting effect is achieved by regularly repeating courses for about a year.

Painful sensations, discomfort in the lower abdomen, disruption of the menstrual rhythm, urination disorders are just some of the symptoms of the appearance of a tumor on the organ responsible for the ripening of the egg. An ovarian cyst is a cavity filled with fluid. Education tends to increase in size. Often the cyst stalk becomes twisted and the fluid-filled capsule bursts, causing peritonitis. To avoid such complications, as well as to improve the woman’s condition, minimally invasive or abdominal surgery is prescribed to remove the ovarian cyst.

Why is surgical removal necessary?

In many cases, a neoplasm that appears on the ovary does not cause concern to the woman. It can arise and disappear asymptomatically. Removal of an ovarian cyst is prescribed if it progresses rapidly, becomes too large, and is accompanied by pain. It is necessary to get rid of the cavity with fluid when it degenerates from benign to malignant.
A woman who seeks help is examined for an ovarian cyst and its type is determined. Only after this the doctor prescribes a method of removal. In this case, the specialist takes into account the following factors:

• general condition of the patient;
• the cause of the cyst;
• size and type of tumor;
• risk of complications during and after surgery.

Surgery is performed to keep the ovary healthy by removing the cyst along with its contents. During the procedure, it is possible to exclude or confirm the presence of an oncological process, as well as identify the cause of the cyst.

Indications for surgery

Removing a cyst is possible in two ways. Minimally invasive intervention is often prescribed. During laparoscopy, the tumor is excised through small incisions in the peritoneal wall. This treatment is advisable when the cyst is small in size and its benign nature is confirmed.
Abdominal surgery is used for large tumors. This type of surgery is indicated when:

• the cyst does not disappear after conservative treatment for more than 3 months and progresses rapidly;
• the tumor occurs during the period of decline of reproductive function;
• suppuration or twisting of the cyst stalk, hemorrhage into its cavity, rupture of the capsule were detected;
• there is a suspicion that the pathology is malignant.

Important! Ovarian resection is carried out in such a way as to minimize damage to healthy tissues of the reproductive organ.

Contraindications to cavity removal of ovarian cysts

Any surgical intervention has a list of contraindications. The same rule applies to abdominal surgery to remove an ovarian cyst. The procedure is not performed if the patient has hematological problems (hemophilia, other blood diseases).
Other contraindications for surgery to remove a cyst include:

• hypertension;
• diabetes;
• acute heart failure;
• infections and chronic pathologies of the respiratory system;
• oncological diseases of the urinary and genital organs, melanoma therapy.

Read also The procedure for cauterization of the paired reproductive glands of a woman

Preparing for surgery to remove an ovarian cyst

Before removing the tumor, the patient must undergo a thorough diagnosis. It helps identify possible diseases that may interfere with surgery. The list of mandatory diagnostic procedures includes laboratory and instrumental research methods.
Before surgery, a woman is given a general and biochemical blood test. A clinical study makes it possible to detect hemoglobin levels and establish the presence of diseases of an inflammatory nature and an infectious nature, even in the absence of symptoms.

Biochemistry evaluates the functional state of internal organs and systems. A coagulogram before surgery is done to determine clotting. It is necessary to establish the patient’s blood type and the presence of the Rh factor. To exclude pathology of the urinary system, a woman undergoes a general urine test.
Before removing an ovarian cyst, it is necessary to undergo a cardiogram. The patient is prescribed an ultrasound examination of the pelvic organs. In some cases, it is necessary to do a magnetic resonance imaging scan.

The patient should consult a therapist. In the presence of extragenital pathologies, it is necessary to be examined by other specialists in order to avoid deterioration of the condition during the operation and after surgery.

On the eve of the intervention to remove the cyst, the woman is advised to refuse food and drinks. The evening before surgery, it is necessary to cleanse the intestines. To do this, you can take a laxative or do an enema (the same procedure is repeated in the morning).

Method of performing abdominal surgery

Shortly before the operation, the woman is given premedication - sedatives are administered. They help relieve anxiety and excitement, as well as avoid unwanted reactions from the patient during the procedure and after its completion.
Abdominal surgery is performed under general anesthesia. The patient is in a state of sleep and does not feel anything. Pain in the incision area does not bother her as long as the anesthesia is in effect.
The operation begins with treating the surgical field - the lower abdomen - with an antiseptic solution. This helps prevent pathogens from entering the abdominal cavity.
The algorithm for removing a cyst is as follows:

1. The surgeon cuts through the skin, subcutaneous fat, muscle layer and peritoneum layer by layer, gaining access to the abdominal cavity. Often a lower middle laparotomy is used, in which case an incision is made from the navel to the pubis. Sometimes doctors resort to incision above the pubic area, at the location of the fold of the abdomen (as with a caesarean section).
2. The surgeon draws the edges of the wound apart and performs a thorough examination of the organs. The doctor must make sure that no processes are developing in the abdominal cavity that could go unnoticed during the examination. Sometimes, upon examination, uterine cancer and malignant tumors of nearby organs are detected.
3. Then they move on to the main stage of the operation - removal of the cyst. If the neoplasm is small in size, then only a small fragment of ovarian tissue is excised. When the cyst has grown so large that it envelops almost the entire organ, its complete removal is necessary.
4. At the final stage, the edges of the abdominal wall are sutured. Drains are temporarily installed in the wound.
5. The removed tumor and a fragment of the ovary are placed in a plastic container and sent for histological examination.

Read also Why are incisions made on the ovaries?

Surgery to remove an ovarian cyst is considered simple. It usually lasts about 40 minutes. But if a large formation or a cancer tumor with metastases is detected, more time is required. Doctors have to remove the affected tube and nearby lymph nodes.

Features of the endoscopic procedure

In many cases, women are prescribed laparoscopic treatment for cysts. This minimally invasive operation is performed under general anesthesia for patients who plan to become pregnant after removal of the cyst, as well as for small-sized tumors.
The endoscopic technique has some advantages compared to abdominal surgery:

• low degree of tissue trauma;
• no need for long-term hospital stay;
• short recovery period;
• almost invisible scars at the puncture sites.

During the operation, gas is pumped into the woman's abdominal cavity using laparoscopy. After this, after 2 or 3 punctures, a surgical instrument equipped with a laser or electrocoagulator, as well as a video camera, is inserted inside. The image from it is fed to a monitor located in the operating room.

Recovery and rehabilitation

When excision of a cyst with a fragment of the ovary, the recovery period lasts up to 2 weeks. If a complete organ removal is performed, rehabilitation will take 6 to 8 weeks.
In the first two days, sometimes longer, the operated woman remains under the constant supervision of medical staff in the intensive care unit.
This is associated with the risk of developing possible complications after removal of the cyst. The most dangerous of them is blockage of the pulmonary artery by a thrombus (embolus). In women, wound suppuration and internal bleeding may begin. Sometimes the seams come apart. Such consequences can be avoided by the use of highly effective drugs and the use of special equipment in the early postoperative period.
Many women notice pain in the surgical wound after the anesthesia wears off. Patients complain of a sore throat, dry mouth, nausea, and mild chills. These sensations are considered normal and do not require treatment.
In order not to provoke divergence of the seams, it is recommended to observe bed rest for 1-2 days. This time is enough for the edges of the wound to begin to heal.

To ensure that the seam does not become inflamed or fester, it must be monitored. The wound surface is examined daily by the operating doctor. With the same frequency, nurses clean the suture and change the dressings to avoid infection and complications.
From the moment of transfer from intensive care to the ward of the gynecological department, the rehabilitation period begins. The load on the abdominal muscles should gradually increase. But there is no need to train them too sharply and diligently - a hernia may develop. Then a repeat operation will be needed.

An ovarian cyst is a cavity that is limited by a capsule and filled with fluid. Many cysts are completely normal and perform specific functions in the body. Such cysts are formed as a result of the processes of ovulation, shrink over time, and subsequently dry out completely. The whole process takes about three months.

The question of whether it is necessary to remove an ovarian cyst can only be answered by a gynecologist, and then with the help of a special gynecological examination. If a functional cyst is detected, in most cases, a repeat examination is scheduled after three months. This is done to make sure that the cysts are decreasing in size. In some cases, even after the first examination, the doctor may recommend taking birth control pills that prevent ovulation, without which new functional cysts will not form.

In what cases and is it necessary to remove an ovarian cyst?

In a woman who has already reached menopause, menstruation stops, as well as the process of forming a functional cyst - ovulation. If a cyst is detected in a woman of this age, she must be sent for an echogram. The doctor’s subsequent recommendations fully depend on the patient’s age category, the presence of various symptoms, as well as the type of cyst on the sonogram.

A sonogram is a graphic representation of the sound vibration of a particular organ. In fact, it is a spectrotemporal representation of sound. Thanks to this procedure, specialists can carefully examine the ovaries and obtain the necessary information about their condition. Ovarian sonograms are currently performed in two ways – through the vagina and the abdominal cavity. Both one and the other method are completely painless, and the procedure itself takes no more than half an hour. With the help of such an examination, the doctor can determine and prescribe the most effective treatment.

The degree of need for surgical intervention to remove a cyst, as mentioned above, is determined primarily by the patient’s age, the size of the cyst, the symptoms of the disease, as well as the menstrual cycle. So, for example, in cases where the menstrual cycle is not disrupted and the cyst is functional, there is no need to remove it, since it will resolve on its own within three months. But in the case when, after the above period of time, the cyst only increases in size, and the sonogram performed indicates that this cyst is not functional, it must be removed. The fact is that women who have reached childbearing age very often develop types of cysts that require mandatory removal. At the same time, at a young age, the risk of developing a malignant cyst is minimal, which means that such women are not at risk of ovarian cancer.

In almost all cases, the formation of an ovarian cyst for women who have reached postmenopausal age ends with surgical intervention. The reason is that women between the ages of fifty and seventy are most susceptible to ovarian cancer.

Depending on the size of the detected cyst, a certain type of operation is prescribed. So, for example, to remove a cyst no larger than a plum, gently perform laparoscopy, which does not involve large incisions and is performed using a special device - a laparoscope. To perform an operation to remove larger cysts, a laparotomy is performed, which consists of hiding the abdominal cavity and removing the cyst or the entire ovary.

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Surgery to remove an ovarian cyst

A pathology such as an ovarian cyst is a fluid-filled bladder located inside the ovary, which may differ in size, histological structure of the cyst capsule and the nature of the internal contents.

Do I need to remove an ovarian cyst?

Most ovarian cysts do not pose a health risk and may appear and disappear spontaneously without causing any symptoms. Doctors recommend removing an ovarian cyst if it is constantly growing and reaches a large size and causes pain. It is worth removing the cyst even when there is a suspicion that the process is malignant.

Methods for removing ovarian cysts

Most often, an ovarian cyst is removed endoscopically. To do this, three small punctures are made on the front wall of the abdomen. The advantages of this method include: low level of trauma to the patient, no need to spend a long time in the hospital, no scars and pain after surgery, and quick recovery.

A laser can be used to carry out this operation if the medical institution is equipped with such equipment, but in most cases the electrocoagulation method is used.

Endoscopic or laparoscopic removal of an ovarian cyst is performed using general anesthesia. Before surgery, the patient’s abdomen is filled with gases and only after that the cyst is removed by inserting the necessary instruments through punctures.

After removal of an ovarian cyst by laparoscopy, thanks to optical magnification and more careful handling of internal organs, it is most often possible to avoid such consequences of the operation as adhesions in the pelvis, which is an important factor for women planning pregnancy.

Sometimes, to remove an ovarian cyst, abdominal surgery or laparotomy is necessary, which involves making a large incision on the abdomen. In such situations, the patient takes much longer to recover.

The choice of method for removing an ovarian cyst is determined by the doctor based on certain factors:

• the patient's health status;
• type of cyst and its size;
• the equipment of the medical institution where the operation will be performed;
• the risk of various kinds of complications.

The main purpose of surgical intervention is as follows:

• confirm the diagnosis and establish the nature of the cystic formation;
• exclude cancer;
• remove the ovarian cyst and its contents, preserving the healthy tissue of this organ.

Preparing for removal of an ovarian cyst involves avoiding drinking and eating on the day of surgery. Before the cyst removal procedure, it is also recommended to stop smoking for a certain period of time to prevent the development of infections. Before the operation, the patient may also be given special agents that prevent the formation of blood clots.

Postoperative period

After surgery, the patient should rest until the anesthesia wears off. If a woman feels pain, she may be prescribed analgesics.

For two days after removal of the cyst, it is not recommended to drive or perform work that requires increased concentration.

The recovery period after cyst removal is usually 7-14 days.

Side effects of surgery to remove ovarian cysts

Side effects, as a rule, boil down to painful sensations in the abdomen or shoulder, which disappear within two days. Sometimes the following may occur: infection, abnormal reaction to anesthesia, heavy bleeding, blood clots.

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Is it worth removing an endometrial ovarian cyst or not?

A functioning female reproductive system without deviations is the key to full life sensations, because the opportunity to have children is a gift from nature itself. Unfortunately, the modern world is not without specific diseases associated with women's health. Pathologies of the reproductive organs are quite common. Endometrioid ovarian cyst is a disease that negatively affects the possibility of conception. Its complications can be so serious that removal of the endometrioid ovarian cyst is the only option to avoid severe consequences.

How does an endometrioid ovarian cyst occur?

The cyst is formed during the implantation of endometrial cells into the ovarian tissue. How do these cells, which form the basis of the inner uterine layer, end up outside the uterus? The reason for this is endometriosis, a gynecological hormone-dependent disease of unknown etiology. A cystic formation is formed against the background of this pathology, the essence of which is the movement of cells of the internal uterine layer outside the boundaries of the uterus. Cells of a healthy uterus retain its layer-by-layer structure and do not allow cells to move from layer to layer and beyond the outer boundaries of the organ.

But with endometriosis, an anomaly occurs, expressed in the migration of cells from the endometrial (inner) uterine layer to other tissues. This causes the formation of structures uncharacteristic for such tissues in the form of foci that function like the lining of the uterus, growing and being rejected in a cyclic cycle with bloody discharge, as happens during menstruation.

If endometrial cells enter the ovary through the fallopian tubes, then its loose structure, due to the periodic maturation of follicles, poorly prevents their penetration. These cells in the thickness of the ovarian tissue gradually form a capsular cavity, which, functioning like the uterine layer, is filled with blood.

Clinical signs of cysts and complications

In terms of its symptoms, the course of the disease manifests itself differently, depending on the stage of the pathological process. If hormonal parameters do not deviate from the norm and the cystic formation grows slightly, then no pronounced symptoms are observed. The progression of the disease leads to:

• to the appearance of aching painful sensations in the lower abdomen, which are more intense on the right, if it is an endometrioid cyst of the right ovary, and on the left, if the left ovary is affected;
• to pain along the entire line of the lower abdomen with bilateral development of the process;
• to heavy blood loss during menstruation and spotting during the intermenstrual period;
• to general weakness, malaise, mild nausea;
• to frequent urination;
• to unsuccessful attempts to get pregnant.

Untimely treatment of the pathology provokes secondary complications:

• problems with the maturation of eggs in the ovaries that have undergone structural changes due to the functional activity of the endometrioid cyst;
• compression and deformation of the ovarian body due to a growing tumor;
• inflammation and development of suppuration at the location of the cyst;
• scarring of the ovarian region of the ovaries due to the proliferation of cystic structures;
• the appearance of adhesions in closely located tissues of neighboring pelvic organs.

All these abnormal processes lead to disruption of a woman’s reproductive functions and interfere with the normal process of conception, which results in infertility.

But the most dangerous condition can develop when the cystic capsule ruptures, when its bloody contents leak into the abdominal cavity. The woman feels a paroxysmal acute pain in the abdomen, a sharp drop in pressure is recorded, the body temperature rises significantly, and the condition is close to fainting. In this case, emergency medical care in a hospital through surgical intervention is indicated.

Diagnostics

An endometrioid cyst is not easy to recognize. An examination by a gynecologist provides general information about the presence of a formation on the ovary and its approximate size. To obtain a more detailed picture, an ultrasound examination is prescribed. Ultrasound scanning makes it possible to accurately identify the location of the capsule with its contents, determine the size of the tumor, examine the pelvic organs, and monitor the development of the process over time.

However, ultrasound cannot always reliably determine the origin of the tumor and differentiate the endometrioid type from other variations. In particular, the MRI method allows, in special modes, to recognize the presence of fatty inclusions in the cystic contents along with blood, which is typical for a dermoid cyst.

The patient is recommended to undergo laboratory blood tests for hormone levels and the tumor marker CA-125, the level of which is sometimes elevated in the presence of an endometrioid cyst. The results of cyst puncture, carried out with a special instrument with a needle for puncturing the capsule and the ability to suction out the cystic contents, are also examined in the laboratory.

The only modern method that determines the nature of the disease with absolute reliability is laparoscopy. It gives the doctor the opportunity to visually assess the degree of pathology by introducing a special sensor with a mini-video camera through a puncture in the peritoneum, and, if necessary, begin treatment immediately. Therefore, laparoscopy has not only a diagnostic, but also a therapeutic direction.

Timely diagnosis of an endometrioid ovarian cyst will make it possible to begin comprehensive treatment and eliminate disturbances in the functioning of the woman’s reproductive system.

How does an endometrioid cyst affect pregnancy?

The onset of pregnancy with this type of cyst is a big problem, since the ovarian tissue suffers, and, as a result, the process of egg maturation is disrupted. We must not forget that the appearance of the tumor is caused by endometriosis, often accompanied by hormonal dysfunction. And this, in turn, leads to problems with ovulation.

What to do if a woman has not regularly visited the gynecologist, pregnancy has already occurred, and upon examination a small cyst is discovered? When positive dynamics of her growth are not noted, then the woman must be observed by a gynecologist throughout the entire period of pregnancy. However, if the cyst grows rapidly, its removal is indicated, as this may negatively affect the pregnancy of the baby. Therefore, the surest way is to regularly visit your doctor and solve the problem before conception.

Development of treatment tactics

Women who are diagnosed with an endometrioid cyst ask the question: should they remove it or not? Among patients with this diagnosis, there is a common misconception that removal of the tumor is always carried out together with the ovary. In reality, this is not the case. Small cysts that do not affect the functions of other organs often disappear after competent complex therapy. Drug treatment of a hormonal, immunostimulating and restorative nature is prescribed.

The expediency of surgical intervention often depends on the timeliness and correctness of treatment tactics. Experts recommend the drug Visanne. Its active substance, dienogest, can inhibit the growth of endometrioid tissue and restore hormonal levels. However, the success of such treatment is not yet an indicator of complete recovery. Endometriosis is a recurrent pathology, so there is a risk of the formation of new lesions.

Radical surgery methods

If the conservative method does not produce positive results, and further growth of formation is noted, surgical intervention cannot be avoided. But women need to know that even if surgery is necessary, gentle options are possible that will eliminate the cyst but preserve part of the ovary. The determining factors in the development of therapeutic measures are:

• type and size of cystic formation;
• severity of symptoms;
• age category of the woman;
• the feasibility of preserving reproductive function.

The extent of the surgical intervention is assessed by the doctor. Depending on the course of the disease, the following are possible:

• surgery to excise the cyst while preserving the ovarian tissue of the appendages;
• elimination of cystic formation without interfering with the functional activity of the ovaries;
• removal of the cyst together with the affected ovary.

Previously, access to the affected organ was provided through an incision in the abdominal wall, but modern laparoscopic techniques are a minimally invasive intervention. After 3-4 punctures in the peritoneum, special manipulator tubes with instruments and a video camera are inserted, and the whole process is displayed on the monitor. For spatial freedom of movement and complete visualization, gas is injected into the peritoneal cavity, the action of which contributes to the elevation of the abdominal wall.

The removal operation is performed taking into account the following features:

• the endometrioid cyst is removed, taking care not to touch the follicles with maturing eggs “soldered” to it, so as not to reduce the volume of the follicular reserve;
• the ovarian cyst is excised with care, without damaging the nearby blood supply vessels, since this can disrupt the nutrition of the appendage and negatively affect its function;
• In addition to the cyst itself, it is necessary to determine the localization of existing endometrioid foci, eliminating them by coagulation (cauterization).

A proven gentle technique is laparoscopy, which involves opening the capsular part with subsequent evacuation of the contents through a special suction. Capsular tissues freed from liquid filling must be removed, since they can subsequently become the source of a new focus of pathology.

In complicated cases, surgery is performed to remove the cystic formation without preserving the ovarian tissue:

• Endometrioid cysts that have reached large sizes in their growth, as a rule, lead to structural changes in the ovary that are irreversible. Therefore, preserving an ovary that has lost its basic functions is considered inappropriate.

• At an age close to perimenopause, a woman’s hormonal background undergoes changes. Because of this, the body cannot cope with the pathology of proliferative processes. It is possible that, against the background of hormonal dysfunction, such a formation can trigger the onset of a malignant process.

Experts always notify women that eliminating a cyst does not lead to a complete recovery. After removal of an endometrioid ovarian cyst, it is necessary to restore the normal balance of hormones, which is achieved by subsequent courses of well-chosen individual hormonal therapy.

Solving the problem of endometrioid cyst recurrence

Recurrence of an endometrioid cyst is a problem that must be solved with the participation of a competent gynecologist and an experienced surgeon. The highly qualified doctor performing laparoscopy will make it possible to perform an operation not only to remove the cyst, but also to eliminate during the intervention all foci that contribute to the development of recurrent phenomena. After the operation, it is necessary to regularly visit the treating gynecologist and conscientiously follow all his instructions, which will be the key to getting rid of chronic endometriosis.

For patients of childbearing age, after laparoscopy and complete postoperative recovery, it is preferable to plan pregnancy. The course of pregnancy and the associated restructuring of the female body contribute to the restoration of the structure of the endometrium of the uterus and do not allow the formation of new endometriotic foci. But you need to take into account that you need to try to get pregnant on your own within a year or a year and a half. If such attempts are unsuccessful, after agreement with the doctor, you can resort to IVF.

The main task of preventing relapses is the removal of all existing endometriotic lesions and individual adequate hormonal treatment.

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Ovarian cyst - does it need to be treated?

The diagnosis of an ovarian cyst usually sounds scary for a woman. Behind this diagnosis, she most often expects to hear an equally terrible conclusion - surgery.

Is it always possible to put an equal sign between the diagnosis of “ovarian cyst” and surgery?

Let's find out!

What types of ovarian cysts are there?

Below I will not give a generally accepted classification, but simply divide the formations of the ovaries to make it clear.

• functional
• endometrioid
• benign tumors
• malignant tumors
• dermoids

Functional ovarian cysts

Video version:

These include two types of cysts - follicular cysts and corpus luteum cysts.

The mechanism of formation of these cysts is as follows:

Normally, at the beginning of every woman's menstrual cycle, follicles (small vesicles containing an egg) begin to grow in the ovaries. Usually, in one menstrual cycle, several follicles grow and only one of them grows to 20 mm and bursts in the middle of the cycle. This process is called ovulation. An egg is released from the ruptured follicle and in its place another formation is formed - the corpus luteum. The corpus luteum is a burst, collapsed follicle, inside of which there is a little blood, which gradually resolves. The corpus luteum exists for 10-12 days and if pregnancy does not occur, it regresses.

During the maturation of the follicle and the formation of the corpus luteum, disturbances may occur, leading to the formation of cysts.

If the follicle grows to 20 mm and does not burst, but continues to grow further, then such a follicle turns into a cyst, which is called a follicular cyst. The size of a follicular cyst can reach 8-10 cm, but usually it is about 4-6 cm. Such cysts resolve on their own within 2-3 months and do not require surgery! To speed up their resorption, monophasic hormonal contraceptives are usually prescribed.

There are cases when a follicular cyst bursts and its contents spill into the abdominal cavity. In this case, bleeding may occur, which will require hospitalization. Therefore, if you have been diagnosed with a follicular ovarian cyst, you should refrain from physical activity and violent sexual intercourse.

A corpus luteum cyst is formed in almost the same way as a follicular ovarian cyst. Often this is due to more pronounced hemorrhage into it, or it simply increases in size under the influence of various factors. Corpus luteum cysts also should not be operated on; they, as a rule, resolve on their own within 2-3 months.

Functional ovarian cysts (follicular and corpus luteum cysts) are operated on only if complications arise against their background (bleeding, suppuration, etc.) or if they do not disappear or decrease in size for more than 4-6 months. This does not happen very often, so in most cases functional ovarian cysts are not operated on!

Endometrioid ovarian cysts

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This is a benign ovarian tumor. Such cysts are also called “chocolate” cysts, since their contents are a dark liquid that resembles melted chocolate. Such contents of cysts are due to the fact that their inner wall consists of the same cells that make up the mucous membrane of the uterine cavity. These cells are also sensitive to hormone fluctuations and are able to be shed into the cyst cavity, similar to menstruation. That is, small menstruation occurs inside the cyst. As the contents of the cyst accumulate, it increases in size.

Most often, endometrioid ovarian cysts are asymptomatic and are accidentally found during ultrasound. They are double-sided and can reach large sizes. The growth rate of such cysts is different and difficult to predict. Some cysts may not grow for a long time and maintain their size throughout life, decreasing slightly after menopause. Endometrioid cysts have a small risk of degenerating into a malignant ovarian cyst, most often occurring in late reproductive age and after menopause.

Since endometrioid ovarian cysts are sensitive to sex hormones, in some cases, for their treatment, drugs are used that temporarily introduce a woman into artificial menopause (GnRH agonists: zoladex, buserelin, diferelin, lucrine depot, etc.), as well as drugs synthesized from male sex hormones. Drug treatment can reduce the size of the cysts, but, as a rule, after stopping treatment, the cysts begin to grow again. To prevent relapses after the main course of treatment, modern hormonal contraceptives are prescribed.

All endometrioid cysts respond to treatment differently - they can significantly decrease in size, or they can, despite treatment, remain the same size.

Most often, endometrioid ovarian cysts are operated on. This is a relatively simple operation that is performed laparoscopically (with special instruments inserted into the abdomen through small holes under the control of a video camera). The cyst along with its capsule is removed from the ovary, while the ovary most often retains a sufficient amount of the tissue it needs. If the size of the cysts is very large, then it happens that the ovarian tissue can hardly be found. In this case, the entire ovary is removed.

Relatively often, endometriotic cysts recur after surgery. To prevent their reappearance in the postoperative period, a course of drugs is prescribed that are used for the medical treatment of these cysts (GnRH agonites and derivatives of male sex hormones). The duration of this anti-relapse course of treatment is from 3 to 6 months.

Endometriotic cysts and pregnancy

Sometimes the question arises of what to do in a situation when a woman is diagnosed with a small endometrioid ovarian cyst and she is planning a pregnancy. Surgical treatment not only entails getting rid of the disease, but also often gives rise to quite serious problems that affect the ability to get pregnant. Adhesions, which occur to varying degrees after surgery, can make the fallopian tubes obstructed, which is why pregnancy may not occur or an ectopic pregnancy may develop. In addition, excessive coagulation of the cyst bed after its removal from the ovary can damage the remaining tissue, which will affect the function of the ovary.

Therefore, if you have small ovarian cysts, it is possible to become pregnant and, after giving birth, evaluate her condition and decide whether she should be operated on or whether she can be further monitored.

True ovarian tumors

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Benign tumors, like malignant ovarian tumors, are always operated on, and the earlier they are detected, the better. As a rule, ovarian tumors do not manifest themselves in any way and only sometimes can lead to nagging abdominal pain or menstrual irregularities. This “secretive” behavior of tumors once again indicates the need for annual ultrasound, regardless of age. I repeat once again, surgical removal of tumors in their early stages allows us to achieve a very good prognosis in treatment.

There is such a “funny” ovarian tumor - dermoid or “dermoid cyst”, or “teratoma”. It is a rounded formation in the ovary, inside of which there is a liquid in which fat, hair, teeth, nails float - in general, a set of “spare parts” differentiated in composition. This cyst is formed from the remaining rudiment of one of the embryonic tissues. The size of such cysts varies from a few centimeters to gigantic sizes. Such cysts are usually removed surgically. A separate type of such cysts, “immature teratomas,” is a malignant formation.

Thus, functional ovarian cysts are not operated on (extremely rare). You can get pregnant with small endometrioid cysts. All other ovarian “cysts” should be operated on without delay.

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2018 Blog about women's health.