An ovarian cyst is a lesion that forms inside the ovary, on its wall, or completely outside. Many ovarian cysts resolve on their own, but all need to be investigated. Which cysts are treated conservatively, and which are better to remove a cyst on the ovary?
Ovarian cystis the most common disorder of this organ. There are several types of cysts and the formof cyst treatmentdepends on them and their size. With small functional cysts - the doctor may recommend observation orhormonal treatment . Largeovarian cystsmeasuring more than 4 cm in diameter and inactive cysts should be removed. Cysts are also removed in women over 45.
Ovarian cyst - when to remove
Doctors advise to excise the cyst when:
- the cyst is over 4 cm in diameter and compresses the adjacent organs
- change grows fast
- the walls of the cyst are disturbingly thick
- there are irregularities in the structure of the cyst walls
- the cyst is solid, i.e. it is made of cohesive tissue or there are many solid elements in it
- there are many chambers in the cyst
- the cyst is heavily vascularized
All these changes can be seen on a transvaginal ultrasound scan. In the diagnosis of ovarian cysts, the doctor, after detecting a change, usually recommends hormonal tests (estrogens, progesterone, LH and FSH).
In women with a family history of ovarian cancer or if the cyst shows disturbing features, she may also order ovarian cancer markers (CA 125 and CA 19-9). Ovarian cyst operations are performed either laparoscopically or using the classical method. The doctor decides about the choice of method.
Ovarian cyst - types of cysts
Ovarian cysts, although common, are still mysterious. It is not known exactly why they arise. Gynecologists most often bet on hormonal disorders, less inflammation. More is known about the types of cysts.
- Functional cyststhat is related to the woman's menstrual cycle are the most common. These can be follicular cysts - when the Graaf follicle, in which the corpus luteum is formed, which is needed in case of pregnancy, does not rupture, but begins to grow. The second type of ovarian functional cysts are cyststhe corpus luteum. They form when the corpus luteum, although not fertilized, does not disappear. Doctors often only observe both types of cysts because they tend to disappear spontaneously within a few menstrual cycles. In such a case, a transvaginal ultrasound should be performed at the time recommended by the gynecologist, usually on the 5-7th day of the cycle. In some cases, they offer hormonal treatment.
- Inactive cysts- are less related to the menstrual cycle and are usually more suspicious. Usually, doctors recommend that they be removed. Chocolate or endometrial cysts are quite common among non-functional cysts. These are cysts filled with dark, bloody material - fragments of the endometrium - that are brown in color. Hence their name. They usually develop in women suffering from endometriosis. There are also skin cysts - dermatoid. They are walled structures containing fat cells, skin cells, hair and even teeth. It is presumed that stem cells (those from which various types of tissues can be formed) begin to differentiate into cells of various tissues under certain conditions. The doctor decides on the treatment of these cysts (also called teratomas), on a case-by-case basis. Sometimes it is better to delete them, other times it is enough to monitor.
Do an ultrasound once a year
Ovarian cysts do not give any symptoms for a long time Only when they are large they can cause abdominal pain, constipation, flatulence or increased urge to urinate. That is why systematic visits to the gynecologist and performing a transvaginal (transvaginal) ultrasound once a year are so important. Only in this examination, the doctor can assess the type and size of the cyst and decide on further treatment. It is a very important prophylaxis of ovarian cancer, which is usually diagnosed too late in Poland.