Ovarian cysts are benign formations that develop in the ovaries, they look like round bags of varying sizes, at least three inches, with thin walls, filled with clear liquid. These cysts are seen on the surface of the ovary like small bumps. In most cases ovarian cysts are usually asymptomatic, being discovered during routine gynecological controls or a after a pelvic ultrasound exam. Ovarian cysts most frequently occur in women of childbearing age.
Normally, every month, the ovarian follicle is formed. The ovarian follicle contains inside the female sex cell, called oocyte. The oocyte is released into the fallopian tube and then empty follicle becomes obsolete. In pathological cases, it happens that the follicle does not release the oocyte, continuing to grow and filling with liquid – turns into an ovarian cyst.
Another case that may lead to the appearance of ovarian cyst is when follicle debris do not dissolve, but continue to fill with fluid. This form is called a corpus luteum cyst and is the most common type of ovarian cyst diagnosed in practice.
There are two types of ovarian cysts:
- Functional – up 90% of ovarian tumors. Stand the origin of their appearance excessive ovarian stimulation during the menstrual cycle, makes a follicle or yellow body to turn into cysts. Can occur throughout life, with a high prevalence between puberty and menopause. This type of cysts are benign, a link between their presence and development of ovarian cancer was not proven. Generally these types of ovarian cysts regress spontaneously or under drug treatment. If the ovarian cyst is present at the onset of pregnancy it is not recommended to interfere with them until after the first quarter.
- Organic. Characterized by the presence of vegetation and internal diameter greater than six millimeters, which presents a solid part (like the skin tissue), caused by the proliferation of the uterine lining. These kind of ovarian cysts do not resolve spontaneously, and require treatment. These criteria allow proper evolution evaluation (benign or malignant). Early detection is very important as a correct and early diagnosis grows the chances fo a complete healing. To determine the correct nature of these cysts it is often necessary that, besides pelvic abdominal or endovaginal ultrasound exam , a Doppler study of tumor blood flow is recommended.
Most ovarian cysts are benign, asymptomatic and resolve without treatment. However, there are situations when they are at the origin of various symptoms such as irregular periods, pelvic pain, feeling of pressure in the small intestine, difficulty urinating, pain during intercourse, increased breast sensitivity similar to that of pregnancy . In such cases symptom medication should be taken in case of intene pain and contraceptives to prevent other cysts (as a result of the cessation of ovulation).
Surgical removal of the ovarian cyst through a small incision (laparoscopy) is recommended if a functional painful ovarian cyst does not disappear after medical treatment. If the ovarian cyst looks abnormal at ultrasound or if there are other risk factors for ovarian cancer, surgery is recommended through a larger incision (laparotomy) instead of laparoscopy.
Complications can be severe. The most common and most dangerous complication is torsion (twisting) of the ovarian cyst, in which case it is a medical emergency because it may lead also to fallopian tube rotating, situation that can cause necrosis. Ovarian cyst torision is manifested by atrocious stomach pain, unilateral, that usually radiates down on foot. In these circumstances, the patient must be rushed to a hospital. If surgery is done in the first 6 hours after onset of crisis the intervention of untwisting of the cyst. If the torsion has exceeded 6 hours, and the fallopian tube is necrotizing unfortunately the patient loses her fallopian tube.
Another complication is bleeding or rupture of a cyst with signs of ascites that may be confused easily with an ectopic pregnancy. This situation also requires emergency surgery. The dominant symptom of this complication is strong pain located on one side of the abdomen (in the ovary that has the cyst). Another unpleasant result following the rupture of an ovarian cyst is anemia.
Ruptured ovarian cyst is difficult to recognize, because in many cases it has no symptoms. The first sign that can occur is pain felt in the lower abdomen, nausea, vomiting and fever.
Infection can follow any complications of the ovarian cyst. Undetected or poorly diagnosed, can lead to death due to septicemia. The first infection symptoms usually are fever, malaise, chills, pelvic pain.
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