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Treatment of ovarian cysts

 
, medical expert
Last reviewed: 19.11.2021
 
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Treatment of the ovarian cyst depends on its type and diagnostic measures.

Ovarian cyst is a fairly common disease that occurs in almost 50% of all the fair sex, suffering from amenorrhea, dysmenorrhea and other menstrual irregularities.

Before the therapy is prescribed, a full range of studies is mandatory, which include: 

  • Visual inspection on a gynecological chair. 
  • Colposcopy. 
  • Abdominal and transvaginal ultrasound examination. 
  • An extensive study of blood and urine.

Ovarian cyst, the treatment of which varies from medication to surgical, is directly related to the normal functioning of the hormonal system. From the type of cyst, its size and stage of development depends on the way it can be eliminated.

Cysts can be functional and organic. Treatment of functional ovarian cyst is to conduct conservative measures, in addition, if certain simple rules are followed, such cysts can pass independently, especially if they do not exceed 3 centimeters. Also they are successfully neutralized correctly by a similar hormonal therapy, which allows you to get rid of tumors in a few months.

Types of operations for ovarian cysts

  • Kystectomy is the removal of the neoplasm by the use of capsule excision, while healthy ovarian tissue is preserved. The incision is regenerated with time, and the ovary regains its ability to function normally. 
  • Resection wedge-shaped - the cyst is excised by a wedge-shaped incision, the ovarian tissue remains intact, the functions are restored after several months.
  • Ovarioectomy - complete removal of the ovary. Often during such an operation, adnexectomy is also carried out - complete ectomy of the appendages. This type of operation is radical and will be performed in case of risk of oncology. 
  • Women in menopause are shown ovariectomy or hysterectomy - removal of the uterus and appendages.

In order to avoid surgical intervention, even such a sparing as laparoscopy, it is necessary to regularly undergo preventive gynecological examinations, including a complete examination (ultrasound and intravaginal, colposcopy).

Types of functional neoplasms and methods of their treatment

Follicular growth, which develops from the largest follicle, which has not passed the stage of rupture (without the release of the egg). The cavities of the cysts are smooth, rather thin, such cysts are always single-celled. If a small ovarian cyst is diagnosed, treatment can be conservative, as a rule, oral medication is prescribed. If the cystic formation exceeds in the sizes of 7-8 centimeters, it is picked out, or carry out a resection, both partial and full. If the cyst is detected in a timely manner, the operation is performed by a laparoscopic method, that is, with minimal trauma to the abdominal cavity. If the cystic ovarian formation is accompanied by a twisting of the leg, a full-blown abdominal operation is indicated. 

A corpus luteum cyst or a yellow body cyst can form when ovulation passes, and the follicle is overflowed with fluid, rather than what it is supposed to do-by the cells of the yellow body. This type of cyst is rarely diagnosed, moreover, cystic formation often resolves (involutionally) independently. Treatment consists in dynamic observation with ultrasound monitoring for 2-3 months. In the case of development, increase in size and risk of torsion of the leg, ovarian cyst treatment is prompt. 

Hemorrhagic neoplasm - this cystic formation, which is formed due to the penetration of blood during menstruation into the cavity of the follicular cyst. Most often, this type of neoplasms involution (dissolves) to the end of menstruation, in the case of a strong increase and filling with blood, a laparoscopic operation is indicated.

There are other types of cysts that are diagnosed as organic.

Types of organic cysts and possible ways to treat them

The dermoid cyst develops slowly, often asymptomatic. This fibroepithelial neoplasm or in other words a cluster of undeveloped embryonic tissues - the follicle of hair, cartilage tissue, fat or skin. Such an ovarian cyst is treated only by an operative method. The dermoid can be festered, then during surgery the cystic formation is opened, the purulent contents are removed and cavity drainage is put. Compulsory removal of the capsule is mandatory, otherwise the dermoid can recur and provoke complications in the form of malignant formations (oncoprocess). 

The endometrioid cyst develops due to the germination of the tissues of the mucosal epithelium of the uterus into the ovaries. Such a cystic formation is often filled with bloody fluid and rapidly grows to large sizes. This kind of neoplasm is also called "chocolate", because the content of the cavity in the form of a coagulated blood resembles a chocolate color in color. The standard method of treatment is a gentle laparoscopic operation, during which the excision is completely excised 

Epithelial neoplasm is a mucinous cystic formation, in the cavity of which there is mucin - a secretory fluid of a mucus-like consistence. These multicameral cysts often grow to large sizes and are removed only operatively, as they are able to malignise (grow into a tumor). 

Serous neoplasm - cyst with liquid, light contents, capable of transforming into malignant formation. Therefore, the method of its treatment is only operational. The amount of surgery is determined by the age of the woman and the results of the survey. As a rule, women before the age of forty are removed one ovary, during the operation a histological analysis of the education is carried out. If the histology shows a norm, resection is carried out within the boundaries of a healthy tissue. Older women undergo a thoroughgoing radical surgery to remove both ovaries in order to eliminate the risk of malignancy.

Schemes of treatment of ovarian cysts

The treatment scheme is directly related to such factors: 

  • Clinically manifested symptoms. 
  • Age of the woman. 
  • Risk of malignancy (overgrowth in malignant process). 
  • Necessity of preservation of reproductive function. 
  • Possible concomitant diseases.

Functional cystic formations of small size, without complications in the form of suppuration, rupture of the capsule, are treated more often by conservative methods. The appointment of single-phase or two-phase contraceptives, normalizing the functions of the hormonal system - Zhanin, Yarina, Novinet and others. Oral preparations are prescribed in combination with vitamins of group B, vitamins A, E, C and K. As additional therapy, homeopathy, physiotherapeutic procedures, and a strict diet are prescribed. The dynamics of changes in the state of the cyst is supervised by ultrasound scanning. In complex cases with suppuration, an increase in size, the functional ovarian cyst is treated only by operative methods.

All organic cystic lesions are to be surgically removed, mainly laparoscopic. Laparoscopy is indicated in those cases when there is no risk of malignancy, that is, an oncological process is excluded. If cysts develop into malignant, oncological formations, complete laparotomy with histology during surgery is indicated.

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