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An ovarian cyst (cystis ovarii) is a pathological space within the ovary that is separated from the normal tissue by a wall. It can be benign, e.g. persistent Graaf’s follicle, or malignant – ovarian cancer. That is why early detection is so important for the prognosis.
An accidental find
An ovarian cyst can be felt by a gynecologist during a routine examination. In order to verify the initial diagnosis, a transvaginal ultrasound should be performed (assessment of the size, shape, exact location of the cyst and its content – liquid / solid). Some gynecologists also perform a pregnancy test to exclude a possible pregnancy. It is also recommended to measure the level of hormones (estrogens, progesterone, LH, FSH) and the determination of tumor markers (CA-125 is usually elevated in ovarian cancer). The last of these tests should be carried out especially in women: over 35 years of age, with a family history of ovarian cancer, and in those with a solid cyst in the USG examination.
Cysts usually occur in women who are fertile (menstruating). They can grow inside the ovary, in its wall or be an exophytic, i.e. growing outside. Cysts can be single or multiple. If they are numerous and, in addition, are found on both ovaries, they may prevent normal eggs from maturing, and thus become a cause of infertility.
Regular gynecological check-ups play an important role in the diagnosis of ovarian cysts and should be kept in mind. Make an appointment today for an initial consultation with a gynecologist online via the halodoctor.pl portal.
Ovarian cysts – symptoms
Cysts are usually asymptomatic and are often found by chance during a follow-up ultrasound. Only when they become large or compress the surrounding tissues, abdominal pain, a feeling of pressure on the bladder, cycle disorders and / or intermenstrual bleeding, or in the case of a cyst rupture and its contents entering the peritoneal cavity, symptoms of “acute abdomen” may appear (peritonitis).
Features of the cysts found in ultrasound examination, which indicate a worse prognosis, are: excessive thickness of the cyst wall, irregular wall structure, the presence of solid lesions, the presence of multiple ventricles in the cyst (multicentricularity), and increased vascularization of the cyst.
So far, no clear causes of cyst formation have been identified. Some gynecologists point to untreated inflammation of the genital tract or genetic factors as the reason. Most, however, lean towards the hypothesis of hormonal imbalance.
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There are two main types of ovarian cysts:
1) Functional ovarian cysts:
– follicular cyst
During the normal menstrual cycle, the egg matures forming the so-called Graaf’s bubble. The follicle ruptures and the cell flows freely into the fallopian tube. In the case of hormonal disorders, it may happen that the signal initiating the rupture of the follicle does not appear, which over time fills with fluid and grows to form a cyst.
– corpus luteum cyst
A ruptured Graaf follicle physiologically transforms into a corpus luteum, which, if the egg is not fertilized, disappears. It happens, however, that this body does not disappear and a cyst forms inside it.
2) Inactive ovarian cysts:
– endometrial cysts (sometimes called chocolate cysts).
A chocolate cyst is a cyst that forms in the course of endometriosis, a disease where the endometrium (the tissue that lines the inside of the uterus) ‘grafts in’ to other tissues. The resulting cysts are filled with dark brown blood – hence their name.
– dermoid cysts (otherwise leathery)
They contain min. epidermal cells, fat cells and even bone tissue or teeth. These tissues probably come from the undeveloped organism of the fetus.
– Polycystic ovary syndrome.
Do you need to remove the ovary?
In the case of functional cysts, their periodic inspection (most often on the 5-7th day of the cycle) is performed by ultrasound. They usually do not require treatment as they disappear on their own after a few cycles. In some cases, doctors decide to use hormone therapy – birth control pills.
If the cysts within one ovary are numerous, it may be necessary to remove the entire organ. If the second ovary is healthy, a woman can still become pregnant and give birth to a child.
A cyst that compresses the surrounding tissues or organs or which, due to its large size, is associated with a risk of rupture, must be removed surgically (laparoscopy – if a malignant lesion is not suspected, especially in young women planning offspring or using the classic method).
Do you know that…:
According to the recommendations of the Polish Gynecological Society, every woman over 35 should have a transvaginal ultrasound (tv) every year.