One of the cases of ovarian lesion is an endometrioid cyst. Fabrics of the body form an incorrect order, as a result of which pathology arises. Due to continuing functioning, they are also bleeding. After entering the uterus, cysts move to the ovarian tissues and create education there. Cysts can also appear in other organs.

Endometrioid cyst, even without complications, can not resolve completely without outside interference. Cysts are often different in volume. The growth is directly proportional to the duration of its existence, but the hormones can have an impact on it, slightly reducing. Pathology is dangerous because it causes severe pain, while possessing a high chance of recurrence.

The first sign of the formation of cysts is sharp pains with which it will be necessary to turn to the therapist. In some cases, some other feature may say about the occurrence of pathology, such as the displacement of the menstrual cycle. To accurately determine the presence of the disease helps an ultrasound study. With the help of ultrasound, it is possible to detect various cysts. According to statistics:

• In four cases, out of five cysts is one-sided, in the remaining 1/5 - bilateral.
• Cysts grow as bleeding, although most often found not big. The content is dense, opaque, since blood is coagulated. So, in the diagnosis of small formations, it may be mistaken to be established that this is a tumor and not correct treatment.
• In the affected body, more than one cyst is rarely formed. In rare cases, their two or three. Four or more - exclusively, although possible.

MRI or CT can help ultrasound in determining the severity of the disease and the treatment method, since it allows you to more carefully examine the affected organ. Both methods are quite expensive, but necessary for the correct diagnosis. The doctor, according to the received photo, accurately sets the magnitude of the problem.

Laparoscopy is called the inspection of the abdomen from the inside. Operation occurs when the use of painkillers with local anesthesia or under anesthesia. In the abdomen create holes through which the tools are missing. Using air, the organs are lifting, allowing you to look inside. There are no special requirements that need to be fulfilled to medical intervention. To prepare for laparoscopy for the presence of cysts at the bodies of the ovary, for example, not enough for a few hours before the operation.

Symptoms

The only and main symptom of any cyst is pain. It is characterized as exhausting - broaching spasms that are disturbing with a large periodicity. In some cases, such a cyst causes unpleasant sensations with sexual acts, and both from the side of the left and right ovary, which is due to the arrangement of education. It is possible to have sex with a cyst - a question to a partner with pathology, since it will feel pain.

During pregnancy, the influence on the body does not change, although the very presence of cyst contributes to infertility. In addition, it disrupts the menstrual cycle.

Cysts in various organs

In general, education appear in different sites Organism:

The answer is no. In practice, not a single case of complete resorption of endometriosis or any other cyst is recorded. It can not completely disappear in itself, but can decrease depending on hormone bursts. This is based on the method of hormonal treatment.

Medical intervention

The need depends on the manifestation of the disease. For example, with the disease of the cervix, there are two types of interventions. For already giving birth, one type of treatment is suitable, and the second for the rest. The causes of pathology in the neck of the uterus are not clear gynecologists.

Indications for surgery:

• During the diagnosis of "endometrium formations", constant pain in the field of small pelvis organs are observed.
• Permanent pains in the field of small pelvis organs caused by other reasons, but exacerbated during menstruation.
• The impossibility of pregnancy. With infertility, laparoscopy is shown, the features of which are directly dependent on pathology.
• Big cysts. The formation of the formation of eight and more centimeters provoke the operation, since they are squeezed and interfere with the health of the organs.

Types of operations

Laparoscopy.

This is the most common type of medical intervention when removing formations. Depending on the patient, anesthesiologist conducts common anesthesia or local anesthesia. Regardless of the disease, several punctures are made in the stomach, inserting tools for inspection and work. An endometrioid cyst and its appendages are ruined, if any. The hearth disease is migrated, and tools, together with education, are derived from the body. Preparation for laparoscopy The ovarian cysts is to perform data by a doctor of requirements, it is also not necessary to eat 5-6 hours before the operation, and immediately before it needs to make sure that the actions of the anesthetic method.

Laparotomy.

The principle is similar to the previous one, but the abdomen is made. It is shown in rare cases, such as the inability to make laparoscopy. Also applied in suspected relapse.

Other types of treatment

Pathology can be treated without surgical intervention. It is believed that it is possible to treat an endometrioid ovarian cyst folk remediesBut this statement is wrong. Symptoms and brain treatment is also similar to basic methods.

Hormonal treatment

It is performed using various preparations that contribute to the opposite development of the disease, that is, its degradation.

• First of all, these are combined oral contraceptives. They need to adhere to a clear reception schedule, and when buying it is necessary to pay attention to the presence of a dienethest. Clayra and Bonade preparations are recommended.
• Progestogens cause hormonal bursts, negatively affecting cysts. All drugs are divided into injections and means for receiving inside.

Tableted is much more convenient in use, and a sharp discontinuation of the reception does not affect the body. Most take 2-3 times a day for some period. Injections can be done only 2-3 times a week, sometimes less often, because they have been exposed for a long time. Injections make in / m.

Duphaston, Norcut, Vizann is distinguished among the tablets. Admission must be consulted with a specialist. Instructions for use are available in packs. Preparations have different testimony and side effects.

Among the injections, solutions containing the medroxyprogesterone acetate are isolated. Various injections have a similar effect, but different duration of action.

• Antigonadotropins

There are only several preparations, but their use in the treatment of a cyst is rare, since they have a mass of contraindications and side effects.

• Agonists

In accordance with its name, they cause heat and dryness, because they destroy their hormones, replacing them with their own. These drugs are contraindicated to persons under the age of 16, as well as all women who were not pregnant. In all other cases, this drug is considered one of the best to combat these cysts.

ethnoscience

Does not exist people's methods The treatment of endometrioid cyst, as well, and any other, which would allow to completely get rid of pathology. According to the reviews of many women, the treatment of glands does not lead to a positive result, since the time spent wasted is very expensive to the patient.

In the treatment of a cyst of any type in any part of the body, it is necessary to advise himself in a timely manner with a doctor, to fulfill its demands, not be afraid to "go under the knife."

Endometrioid ovarian cyst is often developing as one of possible consequences Endometriosis.

Finding on various internal organs (abdominal cavity, small pelvis), soft tissues of the mucous membrane and blood clot of blood can lead to the occurrence of this extensive education. Endometri-like foci is considered the usual phenomenon in the presence of such a cyst.

According to medical statistics, almost 80% of women faced a similar problem, but clinical symptoms were observed only from a quarter of them.

Endometrioid cyst: basic concepts

The main difference of endometroid from the functional cyst is the mechanisms of occurrence of the disease (pathogenesis), which is why such a type of formation is almost always bilateral.

Since the endometroid cyst is most often affecting both ovaries, then the differences between the treatment of both organs is insignificant. But it should be borne in mind that the endometrioid cyst of the right ovary at the same time as the same formation on the second is a typical sign of the third stage of the development of the disease.

The cyst on the left ovary is not less common than the right, although in relation to most pathological processes on the left (less involved and active) side of the body, this is true.

The only difference is the causes of occurrence, since appendectomy or other surgical intervention in the peritonean cavity most often leads to the development of cysts on the right ovary. Endometrioid cyst left ovary may be caused by inflammations of the thick bowel and operations on it.

In case of endometriosis in the genital form, the foci occurring in the small pelvis organs is dependent on the current hormonal background and is functionally active. The cyclic nature of the menstrual-like reaction is therefore becoming the usual result of such pathological processes. As the soft tissues of the endometrium grow up, continuing to bleed in the cortical substance of the ovaries, a special type of cyst is formed. They are characterized by the contents (blood clots) and specific symptoms.

Experts argue that endometrium cysts most often arise as a concomitant disease in the uterine fibromome, endometrial hyperplasia and internal endometriosis. The most dangerous age in this plane from 25 to 45 years, i.e. core; In the future, the risk is significantly reduced. The sizes of the cyst on average about 5 cm, but they can reach 12-15 cm.

The lack of glands on the wall of education is considered to be the first histological sign of cysts.

At first, the symptoms of cysts are sometimes not manifested at all, but it can only be discovered on the plan medical examination, during the ultrasound.

The absolute asymptomaticity of some diseases of the genitourinary system has recently been considered fairly common, as applies to even venereal diseases. Without conducting laboratory studies of the secretions at an endometrioid cyst, it is often unable to establish their pathological character, since the appearance and consistency can comply with normal indicators.

In addition, the hidden flow is not accompanied by external manifestations (pain, bleeding, cycle disorders), which are most often a reason for a visit to the doctor. The only measure capable of protecting a woman from the development of a cyst is a planned medical examination, which is advisable to spend every six months.

Stages of development of cysts

• 1 Stage It is characterized by the minimum area of \u200b\u200baffected tissues of the pelvis and abdominal organs, there are few endometri-like foci;
• 2 Stage means the presence of cysts on one of the ovaries, the dimensions of which are not more than 6 cm; There are separate spikes in the peritoneum and appendages;
• 3 Stage It implies the development of a cyst and on the right, and on the left ovaries (more than 6 cm), endometrium processes are distributed almost to the entire abdominal cavity, capturing the uterus and phallopy tubes, in the appendages the adhesion is striking new areas;
• 4 Stage means not only the presence of a cyst of a significant size on both ovaries, but also a strong defeat internal organs spikes;

Causes of Development and Symptoms of Endometriode Cysts

Numerous theories about the possible causes of education so far do not give an unambiguous answer, but there are several factors that specialists still refer to a number of probable.

The theory of implantation of the disease (implantation theory) is considered to be generally accepted. According to this statement, the endometrium is directed upward, falling into the peritoneum through the tubes of the uterus, which leads to the development of cysts.

Most often, endometriosis and its consequences are observed with constant changes in the hormonal background and the development of inflammatory processes.

• chronic and acute forms of venereal diseases, endometritis, salpintingitis and other diseases;
• changes in the level of hormones and various complications after abortion;
• violation of metabolism, ovarian dysfunction, impaired pituitary operation;
• recurrences in surgical removal of cyst;

The reason for contacting a person skilled in most cases is pain syndrome. With an endometrium cyst, the character of pain can be described as stupid, and the location of the localization is the bottom of the abdomen and the loin. Before and during periods, pain can increase, as the liquid is accumulated in the cavity itself. Top-like gains of pain in rare cases can be observed together with nausea, vomit, dizziness and fainting.

Among possible symptoms There is a violation of digestive processes (constipation, meteorism, bloating, problems with bladder). Weakness, lethargy and increased irritability can also be observed during menstruation, closer to its end. Sometimes it causes problems with the setting of the correct diagnosis, since the manifestations of the endometrioid cyst during periods and irritation of the peritoness ("acute belly") are quite similar.

Violations in the menstrual cycle may not occur as optional are both allocations before. The only symptom that observed in almost all women is odors.

Endometrioid cyst when planning pregnancy

The unequivocal recommendation of most doctors when the problem is detected at the stage of preparation for conception and tooling is the removal of cysts. The feasibility of continuing or interrupting pregnancy, as well as the removal of education must necessarily determine the specialist.

Possessing the necessary information and watching the dynamics of the development of cysts, only the attending physician may insist on one or another solution in each case. Endometrioid ovarian cyst and pregnancy most often do not interfere with each other, but soft ovarian tissues with laparoscopy will be injured in any case.

Surgical intervention in the body of a woman who is carrying a child very often leads to a pregnancy interruption, but in some situations is the only possible alternative.

The obstruction of the ovidifiers due to the adhesive process, as the result of the operation stops some women from a similar solution. In addition, such pathological processes can spread to the subsequent pregnancy, without extending the fruit to develop normally. The presence of a cyst, however, does not interfere with Eco, and institutions offering such a service do not make laparoscopy to preserve the full reserve of both ovaries.

Methods of diagnosis and treatment

Endometrioid cyst, the treatment of which must be started only after the formulation of an accurate diagnosis is most often detected during a planned gynecological inspection.

With certain symptoms, the specialist appoints a comprehensive study, consisting of both laboratory tests and from instrumental examinations.

The pain characterizes the cyst, as well as an increase in ovaries due to swelling of extensive education before menstruation.

If there are doubts or to clarify dimensions, MRI, ultrasound and doplometer organs of the small pelvis can be appointed. The objective of research is to identify the condition of blood circulation in a wrapper of cysts, which can be disturbed for a number of reasons. Laparoscopy Most specialists are recognized as the most reliable method of diagnosis.

Features of treatment

Depending on the stage of development of the disease, the severity of symptoms and manifestations, as well as individual features The physician chooses the appropriate therapeutic reception or their combination.

• conservative therapy implies the use of hormonal drugs, immunomodulators, vitamin complexes and enzymes, as well as taking painkillers and anti-inflammatory funds;
• surgery It consists of removing foci of endometriosis by laparoscopy or lapatorium, while surgical intervention is organ-grumbling;
• combined technique applies and conservative, and surgical intervention;

An integrated treatment approach allows to eliminate the main symptoms and manifestations, stop the spread of endometride foci and adhesions, as well as prevent the development of infertility.

In some cases, concomitant diseases (extragenital and genital pathological processes) may significantly make treatment, forcing the doctor to give preference to the operation.

If the formation of a small size is most often used conservative treatment (hormone reception for a long time). Antispasmodics and sedatives are used to remove pain sensations.

Delete or not?

Removal of the endometrioid cyst of the ovary, oddly enough, is not carried out so often. In most cases, the testimony to the operation is the lack of effect from elected conservative treatment in combination with large sizes of cysts.

Additional factors under which the best output is surgical intervention, infertility are considered against endometriosis complicated by the possible development of malignant neoplasms.

Affects the choice of the method and age of a woman. In the case when the operation is necessary for a patient of a childbearing age, planning to have a child in the future, radical interventions are not applied. Among the methods used everywhere, allocate the resection of the ovaries and enucleation of cysts.

Hormonal therapy is carried out before and after surgery. The reception of hormonal drugs before surgical removal allows partially to remove inflammation around the foci of endometriosis, reduce the functional activity and slow down the blood supply to the affected areas. After the operation carried out, the reception of hormones makes it possible to prevent the relapse of the pathological process and leads to the regression of small foci, not subjected to removal.

Physiotherapeutic methods in the postoperative period are designed to adjust the metabolic processes and prevent the distribution of adhesions. Depending on the age and condition of the patient, the following techniques are applied:

• electrophoresis;
• phonophoresis;
• SMT therapy;
• laser therapy;
• igloreflexotherapy;

When the endometrioid cyst is removed, the pain syndrome is gradually coming to no, and the menstrual cycle is restored. Specialists recommend women who suffered a similar operation, observed in the gynecologist regularly, necessarily passing an ultrasound with each inspection.

- This is a pathological extensive formation on the surface of the ovary consisting of a accumulated menstrual blood surrounded by a shell of endometrial cells. The endometrium ovarian cyst in some cases can not manifest themselves for a long time, in others - accompanied by abnormal menstruation, infertility, pain, up to the clinic of the "acute abdomen." The diagnosis of the endometrioid ovarian cyst is based on ultrasound and laparoscopy data. The treatment of the endometrioid ovarian cyst includes the surgical removal of pathological education and long-term hormonal therapy.

General

The endometrioid ovarian cyst may be accompanied by pain at the bottom of the abdomen and in the area of \u200b\u200bthe belt, amplifying during menstruation, during sexual intercourse. Sometimes pains can be very strong, and with a large scale and breaking the cyst capsule develops a "acute abdomen" clinic.

For the endometrium ovarian cyst, abundant monthly, lengthening of the menstrual cycle with allocating secretions before and after menstruation is characterized. The symptoms of intoxication are possible: weaknesses, nausea, elevated temperature.

Complications

The growth of the endometrioid ovarian cyst can lead to local changes in ovarian tissue: the degeneration of eggs, follicular cysts, the appearance of scars that violate the normal function of the ovary. With a long existence of an endometrioid ovarian cyst can be detected by the adhesion process in a small pelvis with impaired intestinal function and bladder (constipation, meteorism, urination disorder). Endometrioid ovarian cyst is a serious gynecological pathology that can be complicated by the suppuration, the breakdown of the walls of cysts with the influence of its contents into the abdominal cavity and the development of peritonitis.

Diagnostics

Gynecological examination does not always allow to identify signs of endometriosis. With an endometrial ovarian cyst, it is possible to detect the presence of a low-fat painful formation in the ovary and its increase before menstruation. The diagnosis of an endometrium ovarian cyst is established according to the results of ultrasound of the small pelvic organs with doplertometry of the uterine-placental blood flow, MRI and laparoscopy:

• Ultrasound with dopplerometry. Determines the absence of blood flow in the walls of the endometrioid ovarian cyst.
• Research oncomarkers. When determining the level of the monomarker Case-125 in the blood, its concentration may be normal or more increased.
• Diagnostic operations. With infertility, hysterosalpingography and hysteroscopy are carried out. Diagnostic laparoscopy is the most accurate diagnostic method of an endometrioid ovarian cyst. Conducting biopsy and follow-up histological examination of the focus of endometriosis in ovarian tissue is necessary to identify the likelihood of its discharge.

Treatment of endometrial ovarian cysts

The treatment of an endometrium ovarian cyst can be conservative (hormonal, non-specific anti-inflammatory and pain relief therapy, intake of immunomodulators, vitamins, enzymes), surgical (organ-bearing removal of endometrium foci by laparoscopic or laparotomic access) or combined. Complex treatment of endometriosis is aimed at eliminating symptoms, prevention of disease progression and infertility treatment. The treatment tactics of the endometrioid ovarian cyst depends on the stage, symptoms and the duration of endometriosis, the age of the patient and the availability of problems with the conception, concomitant genital and extragationalital pathology.

Conservative treatment

With a minor size of the endometrioid ovarian cyst, long-term hormone therapy is possible using low-volume monophase COCs, nucleon derivatives (levonorgestrel), prolonged MPa, androgen derivatives, synthetic agonists of GNVG. The pain syndrome associated with the growth of the endometrioid cyst of the ovary is stopped by the reception of NSPIDs, antispasmodic and sedatives.

Surgery

With the ineffectiveness of conservative therapy during endometrial ovary cysts, more than 5 cm, combined endometriosis and infertility, the risk of complications and oncological alerts are shown only operational treatment.

Among women reproductive ageWishing to have children try to avoid radical operations (ooforectomy, admexectomy). Preferred methods of endometropoid cyst surgery are enucleation of heterotopic formations or ovarian resection. The removal of foci of endometriosis and endometrium ovary cysts is advisable to spend with preliminary and postoperative hormone therapy.

Postoperative period

Preoperative hormone therapy allows to reduce the foci of endometriosis, their blood supply and functional activity, an inflammatory response of surrounding tissues. After surgical removal of the endometrioid ovarian cyst, the corresponding hormonal treatment contributes to the regression of the remaining endometride foci and warns the relapse of pathology.

2010-06-25 15:32:11

Asks Elena:

Good day! I am 27 years old. A month ago, he fell into a hospital with bleeding, conducted surgical scraping. I made an ultrasound, the conclusion of endometrial and myoma of the uterine of small sizes. Histology results: endometrial endometrial hyperplasia, focal endometritis. Also passed the tank analysis from the vagina and the uteride cavity, but there are no results yet. This hospital recommends treatment with a hormonal drug Yarik or Nova-Ring. At the same time, the analysis of hormones did not take me.
A year ago were childbirth. Pregnancy and childbirth passed without complications. The child was born weighing 4 kg. The first monthly went in a year and 1 month and immediately bleeding.
At the age of 14, I also had 2 juvenile bleeding. At the age of 17, I had an operation to remove the pairing cyst of the ovary, was also polycystosis of the left ovary. After that, for some time, the collaps is progesterone intramuscularly before menstruation. Then the menstrual cycle more or less adjusted. There were no special problems. Got pregnant without problems.
Please tell me how can I be treated and which of these drugs is preferable?

Replies Lischik Vladimir Danilovich:

Dear Elena! Advised only what you need to take some kind of contraceptive drugs with therapeutic goal. What specifically? It can only solve the doctor who watches you. Many options.

2010-06-23 17:53:27

Asks you can not:

Mom's cyst ovarian burst and bleeding was not. Just it was somehow I don't even know that it was brown. She went on an ultrasound, gynecologist. Is it dangerous if she burst, cyst and momar will not be a cancer ??? please tell me???

Replies Lischik Vladimir Danilovich:

Your mother is most likely to have a similar functional cyst. These formations refer to pseudo-pumping formations. There is no danger of cancer development, but it is necessary to be under the supervision of the gynecologist because it is a sign of violation of the ovarian function.

2010-06-21 11:20:11

Olga asks:

4th day after laparacopy of two-minute egg cysts (5 cm and 8 cm) diagnosis of endometriosis, I did not give birth to 39 years old and did not premine, the harmonies of the injection were offered for 3 months (menopausa) - care of the consequences - the situation, hair loss and the collapse of the bones, very I'm afraid I can not make a decision if I am generally chances to get pregnant

Replies Kushniruk Natalia Sergeevna:

Dear Olga,
it all depends on your plans: do the treatment of infertility or not? Try instead of dosage 11.25 mg of GNVG agonist to prick 3.75 mg with a revision of ultrasound after 27 days from the injection. Assess the chances of pregnancy without seeing your uterus, ovaries, hormone levels, spermogram indicators are very difficult.
Everything needs to be resolved directly at the reception.
The only thing that can be said is probably - you can not waste time. As soon as you are discharged - sign up for reception in the clinic of reproductive medicine.
Sincerely, Natalia Sergeevna Kushniruk.

2010-06-19 20:05:54

Asks Alexa:

Hello! Please tell you methods of treatment. You know more than our city doctors and I have previously been convinced of it. A mom is 51 years old, for 3 years as it was a bourgeing cyst of the ovarian 200ml .Der wanted to cut, but she could not endure the heart . Orakoy cells (CA-125) were higher than the norm. The physicist. Picked natural drops, tincture of herbs and so on. Now the cyst was caught up to 100ml for 1.5 years. But there was a liquid in the brush cavity (where the ovaries). It was seen with the help of an ultrasound, 7-10 ml in the Obée We hand over the analysis on CA-125. Tell me, what can be fluid ??? Thanks for any help.

Replies Kaliman Viktor Pavlovich:

Good day!
SA-125 is one of the monarchors. It is necessary to take it according to the testimony and by appointing a doctor.
The liquid that is in the douglas space may be different etiology. Therefore, you need to consult a doctor.

2010-06-15 15:35:10

Asks Klopot Christina:

I have been to me there was a follicular ovarian cyst, I cured him, but I can't do it for Bereminichi, I dewy cocia medicine for me

Replies Medical consultant portal "Site":

Good afternoon, Christina. First you need to find out for what reason the pregnancy does not come. To do this, you need a consultation doctor-reproductologist. The survey must pass you and your husband. Only after that you can discuss any treatment.

2010-06-13 08:07:31

Asks Natalie:

Tell me, please, how can I cure an endometrial ovarian cyst (size 19N24mm)? Is it suitable for treatment with hormonal contraceptive zhinin?

2010-06-12 22:00:57

Inna asks:

Good day. On April 9, I had laparoscopy (removed ovarian cysts). After that, the monthly was April 15th. In May, there was no month, I thought prevented, went to the hospital, but the doctor said that there was no. There are still no menstruation. What's the matter. I'm already worried.

2010-06-01 08:06:05

Asks Elena:

Month and 10 days ago there was an operation to remove the uterus and the left ovary, because of the Moma of the uterus and the cysts of the ovary. There is a normal. Big fear of sex. Please explain what I need to be afraid, but what about not? When can I start a sex life after the operation without harm to health?

2010-05-31 16:41:32

Olga asks:

Hello! I have a cyst left ovary, which is not resolved for 5 months after it is treatment. In that month, the cyst was 5 cm in size, this is already 62 * 60mm changed due to liquid education. I am 24 years old, I still did not give birth, I wanted a child with my husband, please tell me if you can pregnant from the ovary and what could be the consequences, thank you in advance.

Replies Victoria Anatolevna Victoria:

Olga, of course, you must first remove or cure the cyst, and then plan a pregnancy, otherwise it may be twisted or a cyst break (the apoplexy of the ovary)

Popular articles on the topic: cyst ovarian 2 cm

The ovarian cyst ... many women who have heard such a diagnosis covers panic. What to do? Well, if an experienced doctor calms and explain everything. And if not? Read about whether the ovarian cyst is terrible, which is due to the diagnosis and what treatment will be effective.

IN last years The information has been accumulated to expand the scope of the use of drugs that increase the sensitivity to insulin, or insulinonsitizers.

Multiple cystic education, which can be seen on the ovaries during the ultrasound, is not yet diagnosed. To confidently talk about the syndrome of polycystic ovaries, the doctor should note at least two symptoms and on the basis of this to decide on treatment.

The polycystic ovarian syndrome determines the pathology of the structure and function of the ovaries against the background of neuro-exchange disorders such as anointulation, hyperitrihosis, obesity. In the ovaries is activated by the synthesis of androgen, the process of follicularogenesis.

The presence in the body of a woman of a certain number of men's sex hormones - androgens (testosterone, androstendion) is a biological necessity, since they serve as an indispensable substrate for synthesis in the ovaries.

Ectopic pregnancy is the development of the embryo outside the uterus. Find out why in case of ectopic pregnancy is important under the supervision of gynecologists, how to diagnose in time and how to prevent the severe effects of ectopic pregnancy.

News on the topic: ovarian cyst 2 cm

Ovarian cysts are stripped liquid bags. Cysts in the ovaries may be single or multiple. Very often, this disease proceeds without clinical manifestations and symptoms. Sometimes women appear clear clinical symptoms that are very important in time to recognize to refer to the necessary specialist without delay

Strong pain in the abdomen, bloating and other symptoms forced the 66-year-old resident of Hong Kong, who considered himself a man, consult a doctor. He very quickly discovered in a patient ... ovarian cyst. But ahead of the patient was waiting for the chief "surprise".

Update: December 2018

Endometrioid ovarian cyst is one of the manifestations of endometriosis. Imagine that blood, parts of the inner mucous membrane of the uterus (endometrial) and bunches, which normally go on menstruation, begin to be embedded in the wall of the uterus, and then apply to the fallopian tubes and ovaries.

In addition to the wrong location, this fabric (it is called endometrioid) continues to partially function. During the menstrual cycle, it occurs the same changes as in the uterus. The fabric also swells, and bleeds.

When endometrium tissue gets to ovaries, it is embedded in its shell and forms a capsule. As already mentioned, this cloth continues to function and blood accumulates in the capsule. The wrapper of the cyst is dense, and the contents are thick and reminds dark chocolate (color of curved blood). Sometimes such cysts are called "chocolate".

The sizes of the cyst can differ significantly.

What does it depend on? It is not yet established, as in general, the nature of endometriosis. Of course, the longer the cyst exists without treatment, the more its dimensions will increase. But for some women, the progression will be slow, and other cyst growth is very fast and combined with other symptoms of endometriosis (pain during sexual intercourse and during menstruation, infertility and abundant menstrual bleeding).

Than dangerous endometrium ovarian cysts

Among all the formations of a small pelvis (cysts, tumors) 10-14% are precisely endometrium ovarian cysts. The danger of these cyst in the development of infertility, frequent recurrences of the cyst after treatment, the development of a massive adhesion process in a small pelvis and the formation of a pelvic pain. There is also a danger of cyst breaks in their large sizes or sharp physical exertion and injuries.

Why endometrium ovarian cysts are formed

The cause of endometriosis has not yet been revealed. Over it employs obstetricians-gynecologists and endocrinologists, histologists, cytologists and pathologists. There is even a special association where the slogan is the phrase "when endometriosis is a sick question."

What managed to find out is the hormonal predisposition of some women to endometriosis and some other factors:

• violation with excess estrogen and lack of progestins. Behind these terms lies that the first phase of menstruation (up to 15 days cycle) passes with an excess of hormones, and the second phase (from 15 days and to menstruation) with a disadvantage.
• interrupting pregnancy surgically, that is, a medical abortion. During the abortion, an acute metallic curette is used, which is made to scraping the inner wall of the uterus. During scraping, the layers of the walls of the uterus are damaged, and cell migration can occur.
• heredity. If mom or other close relatives suffered from manifestations of endometriosis, it can transmit genetically.
• chronic inflammatory diseases of small pelvis organs (walking). If chronic inflammation is present in pipes and / or ovaries, then the tissues become more vulnerable and loose. Such fabric always worse opposed damage, including the introduction of foreign cells.
• other dormricons and metabolic diseases. As a rule, all hormonal systems We are interrelated. Therefore, patients with thyroid diseases (especially with hypothyroidism, when the function of the thyroid gland is reduced), disorders of the cycle and diabetes mellitus of any type are in the risk group.

Types of endometrioid cyst

In some sources, endometrioid cysts are divided into disease stages:

• Stage I Stage - the defeat of one ovarian, the size of the cyst of minor (up to 3 cm);
• Stage II - the defeat of one ovarian, the size of the cyst to 5 - 6 cm;
• III stage - the defeat of one or more of both ovaries, the size of a cyst up to 5 - 6 cm, the active formation of adhesions in a small pelvis and initial signs of lesion of other organs (intestines, bladder, etc.);
• IV Stage is the defeat of both ovaries, the size of the cyst is large, more than 6 cm. Such cysts are already called cystoms. Kistoma is a cyst of large sizes that initial stage Diagnostics are always suspicious on oncology.

But more often, everything is also used by a purely clinical classification of endometrial cyst, which indicates which ovary, is amazed, the size of cysts and complications. It helps not be distracted from the main thing and formulate only the most important in the diagnosis.

An example of a diagnosis formulation:

1. Common endometriosis. Endometrioid cyst left ovary. Breaking cysts. Internal bleeding. Hemorrhagic shock I degree.
2. Common endometriosis. Endometrioid cyst of the right ovary of large sizes (5 cm). Secondary infertility.

As we see, the presence of cyst entails various consequences. Below we will tell about it more.

Diagnostics

Clinical picture, that is, the symptoms

Complaints of the patient, lack of pregnancies and analysis of the menstruation calendar make it possible to suspect endometriosis and cysts as its manifestation.

Ultrasound Research (Ultrasound)

Ultrasound is an affordable, safe and painless method of diagnosing a variety of diseases. In addition, this method allows you to get the result immediately. Ultrasounds are detected by cysts even very small sizes, the accuracy of detection depends on the level of resolution of the Uz-apparatus, as well as from the experience of the doctor. Often we see the description of formations from 5-8 mm.

Ultrasound statistics testifies:

• one-sided cysts are detected at about 80% of patients;
• bilateral cysts about 20%
• one cyst in the affected ovarian is found at the majority, it is about 80%
• two cysts in one ovarian - in 16%;
• three cysts in 2.5%;
• four cysts are very rare, about 0.5%.

Uz-features of endometrioid cyst:

• thick capsule (outer sheath or wall of cysts)

The wall of the endometrioid cyst not only limits its contents, but also functions. The inner layer of the wrapper of the cyst continues to "menstruate", the contents accumulate, so the cyst is growing.

• the relatively small diameter of the cyst, mainly there are cysts with dimensions up to 7-8 cm
• thick, "opaque" for ultrasound content. Doctors ultrasound call it "increased echogenicity."

Due to the fact that the internal contents of the cyst is very thick and dense, small cysts are sometimes taken for tumors.

• on the ultrasound, the wall of the cyst sometimes has a double circuit
• cysts are most often located on the side of the uterus or behind the uterus.
• endometrioid cysts most often detect in a childbearing age when the menstrual cycle has already been established.
• cysts grow the duck from the ovary

This means that the cyst does not "inflate" the ovary, but grows away from him. Therefore, at large cysts, the ovarian fabric seems to be "molded" and stretches over the surface of the cyst.

• frequently formed by the adhesion process around the cyst

Magnetic resonance tomography (MRI) and computed tomography (CT)

These are additional research methods that can clarify the structure of cysts, its sparesiness with neighboring authorities and other subtleties that may be needed to solve the issue of further treatment tactics.

These methods are very expensive, and computed tomography also carries a significant radiation load. CT is a method from a group of radiographic, so it cannot be used during pregnancy.

Laparoscopy

Laparoscopy is an inspection of the abdominal cavity from the inside with the help of devices (laparoscope and manipulators).

This is an operation that is carried out under anesthesia. Spinal anesthesia or general anesthesia are used, depending on the clinical situation. In the front of the abdomen, holes are performed through which the devices are introduced. The air is injected into the stomach, the organs are slightly moved away and you can inspect the area of \u200b\u200bthe abdominal cavity.

Ideally, diagnostic laparoscopy goes into therapeutic, which we will tell a little lower.

Depending on the symptoms and stage of the process, the diagnostics can be carried out and completed at the ultrasound level or continue further.

If there are manifestations (pain, abundant irregular menstruation and other), on ultrasound we see endometrial cysts of small sizes and endometriosis of the uterus, then it is logical to conduct drug treatment, to evaluate the effect and conduct control ultrasound.

If the patient does not come pregnancy. Pronounced abdominal pain in front of menstruation, then it will be possible to need more high-tech methods from paragraphs 3 and 4.

Symptoms

Pain syndrome

Pains are concerned about and during menstruation, reaching the intensity that the dies are described as "unbearable" and "exhausting".

Pains most often have the character of pulling and buty, more often worried pain in the bottom of the abdomen and in the lower back.

Less frequently, women note the same pain in the middle of the cycle, about 14-16 days of the menstrual cycle, that is, during the period of ovulation (the exit of the egg from the ovary).

There may also be pain in the sexual act, they are localized, as a rule, from the side where the cyst was formed.

Disruption of menstrual cycles

If the cyst deform the ovary, has a large size and displaces the normal ovarian fabric, then the ovulation in this ovary may not happen. Then the cycle is broken.

Menstruation can linger and then come very abundantly.

Infertility

By themselves, cysts violate the ripening of eggs. At the same time, it is necessary to take into account the causes of endometriosis. One of the reasons is an excess of estrogen, female sex hormones that prevail in the first phase of the cycle. If there are many estrogens, and gestagens (hormones of the second phase cycle) are not enough, then the entire process of conception and attachment of the embryo in the uterus is disturbed.

In infertility in case of a cyst can be primary and secondary. Primary infertility is the state when pregnancies never happened. Secondary - if there were pregnancy with any outcome (normal childbirth, premature birth, miscarriage or frozen pregnancy), and then more than 1 year without contraception, the desired pregnancy does not occur.

Nonspecific treatment

Non-specific treatment is that the treatment does not remove endometriosis and cysts from the body, but will help alleviate the symptoms (pain, abundant bleeding). NSAIDs (nonsteroidal anti-inflammatory means):

• diclofenac
• indomethacin,
• celecoxib,
• ropecoxib.

These drugs are used situationally, usually in the period before and on time of menstruation, if necessary in the middle of the cycle. It should be known that the uncontrolled use of these drugs is not harmless and can lead to serious liver lesions.

Hormonal treatment

Kok (combined oral contraceptives)

COC is used in women with endometriosis to reduce symptoms (pain, abundant bleeding) and recovery after surgery.

But the problems of the presence of a cyst contraceptives do not solve. "To be treated" exclusively Kok cannot, but they can be used in a complex with other methods.

To date, the optimal mode of receiving KOC is a continuous mode after surgical treatment. Thus, the possibility of relapse of endometrioid cyst is maximally suppressed.

Of the variety of combined estrogen-gestagenic contraceptives for patients with endometriosis, those that contain a component of the dienogest are preferred: zanin (or its analogues of the silica and bonade) or Clayra (at the moment there is no analogues).

Progestainenes

These are the preparations that are analogues of female hormones that prevail in the second phase of the menstrual cycle.

As a rule, women with endometrioid cysts have an excess of estrogen. Progestogens "balance" this imbalance, and thus help to suppress the growth of foci and cyst.

There are preparations of progestogennes in tablets and in injections, each view has its drawbacks and advantages.

Preparations in tablets are easier to dose and cancel in the event of allergies, but they have to drink every day, do not forget about it and control the reception at the same time.

Injection is easier to use, they are made 1 time in a few days or even once a month. But at the same time, if the drug did not fit, then its action can not be taken and "cancel", because he has already been introduced and his formula is such that it will be absorbed slowly and gradually. In favor of intramuscular drugs, it is possible to say that allergic reactions to them are still rarity.

From tableted drugs are used: Didrogesterone (Duphaston), Norethisterone Acetate (Nigolut), Dienethrose (Visann), much less often Megester (Megayis).

From intramuscular drugs are used: acetate medroxyprogesterone (depot-wire or medroxyprogesterone-lance).

Duphaston is used from 1 to 3 tablets per day, the reception modes and duration differ depending on the severity of the symptoms of the disease and other concomitant diseases.

Nigolut is used for 1 tablet (5 mg) from 5 to 25 days of cycle up to 6 months, further reciprocolate at the gynecologist to determine the tactics of reference. The drug is categorically not recommended to assign themselves independently, as you can not take into account the many side effects and risk of thrombosis.

MEGES is extremely rare, but so far appears in clinical guidelines. Dosage and reception duration regulates exclusively doctor obstetrician-gynecologist.

Byzanna is at the moment the preparation of choice or the preparation of the first line of therapy. This is the hormonal drug of the Gestagenne group, which regulates the hormonal background of the woman in such a way that eliminates and balances excess estrogen. Namely an excess (absolute or relative) serves as a weighty cause of the development and further spread of endometriosis. And, as a result, the development of endometrium cysts of ovaries and adhesions in a small pelvis.

Dienogest 2 mg (Byzanne) is used in continuous mode from any day cycle, 1 tablet per day. The duration of reception determines the attending physician. As a rule, the primary reception cycle is 3 or 6 months. After the treatment period expires, the control of ultrasound with an assessment of the achieved effect is shown. We want to see a decrease in either the disappearance of the ovarian cysts, a decrease in the size of the uterus. It is also necessary to purely clinical control. Complaints of the patient should be estimated in dynamics. You always need to know whether pain disappeared (if they were), abundant menstrual bleeding and how much the blood loss decreased.

Against the background of taking a drug of menstruation, they change their character, they can disappear at all in the second-third month of reception, or to manifest themselves with scanty oscillations without explicit cyclicity. This is not entirely convenient, but when the patient got used to the monthly five-seven-day (sometimes more) abundant bleeding, when the gasket change occurs once an hour and more often, labor activity was broken and the work is impaired, this is usually tolerated.

Also on the background of taking the drug must be ready for some unpleasant sensations. Symptoms of estrogen deficiency may appear, such as heat feeding to face and body, the episodes of sweating and rapid heartbeat, dry mucous membranes. All these manifestations are temporary and disappeared after the cessation of admission.

The depot-provision (Medroxyprogesterone-Lance) is introduced intramuscularly, as and how many times a month you will enter your attending physician. These drugs have a significant side effect - bleeding breakthrough, which do not coincide with the cycle, it is almost impossible to predict and it is not always possible to stop quickly.

There is also an intrauterine therapeutic system with a hormone levonorgestrel. In ordinary life, the patient is often called her "spiral".

But between the usual copper spiral, which is intended only for contraception, and the intrauterine system has a principal difference.

Intrauterine therapeutic system (Peace) every day allocates a small dose of the hormone, which acts on the inner wall of the uterus and suppresses the growth of endometride foci and cyst.

As a rule, Miren is installed after the operational treatment of the cyst if the patient does not plan to pregnancy. Peace has a significant drawback - it is its price, in different pharmacies it ranges from 10 to 15 thousand rubles. Not everyone can pay at a time, but when calculating the benefit is obvious, as Mirena is set at least 5 years.

Antigonadotropins

Danazol and Gestrinon, which belong to this group of drugs, are rarely used rarely due to the mass of side effects.

Gonadotropin Rilizing Gormon Agonists

These are drugs that suppress the synthesis of their own hormones. They are carried out quite hard, dryness of the mucous membranes, heat tides and other symptoms. which are similar to menopause. Preparations of this group (DIFERELINE, BUSERELIN) are not prescribed to adolescents and barking women.

But in Eco Schemes in women with endometriosis and after removing endometrioid cyst, these drugs, a short rate and combined with others drugs, just indispensable.

Delete or not? Operational treatment

The question of the operational treatment of endometrioid cyst is solved with the clinical manifestation and reproductive plans for women. Some and the same cysts in those who have given birth and those who are planning pregnancy are treated in different ways. Indications for surgical treatment of endometrioid cyst:

Endometrioid cysts and chronic pelvic pain

Chronic pelvic pain is constantly present. And in the middle of the cycle, in front of menstruation and in time it is enhanced. Sometimes painful sensations are so pronounced. That the woman is disabled. Accept a large number of Anesthetics, which in turn can increase bleeding and adversely affect the liver.

Infertility

In the case when cysts interfere with pregnant, the operational treatment is shown. If there is technical capabilities, a laparoscopic operation is recommended.

The volume of operation is selected individually depending on the size of the cyst and the preservation of the ovarian tissue.

In order for the woman to be pregnant in the subsequent, we must preserve the maximum amount of ovarian fabric.

It is recommended to use all sorts modern technologies (Laser knives, ultrasound), washing the abdominal cavity. If possible, the ears of the ovary of the ovaries should be avoided, it violates blood flow and can disrupt the function of the remaining part of the ovary.

Combination of neighboring organs

Cysts can reach impressive sizes (8-12 cm or more). Of course, such "add-ons" in the abdominal cavity cannot not affect the functioning of other organs. Next to the uterine and ovaries are the bladder, a straight intestine, loops of the small intestine.

Depending on which the direction is growing (back and forth), the work of a particular organ suffers. If a cyst / cysts grow back, they can squeeze the rectum.

In this case, the defecation process is violated, that is, difficulties when going to the toilet "in large". It is necessary to fit, make more effort, the toilet becomes less often, and fever is due to stagnation. Due to permanent population, the crack of the rear pass or inflammation of hemorrhoidal nodes (hemorrhoids) may be formed.

The problems with the toilet rarely associate with gynecology, if there are no other complaints (disruption of the cycle or abdominal pain during menstruation). Therefore, often the patient takes the laxatives for years, and then come to the gynecologist with the cysts of impressive sizes.

If a cyst / cyst is located in front, then they can squeeze the bladder. If the cyst is large, then the bladder compression is significant, its possible volume decreases. That is, for example, at a medium-term woman, the maximum volume of the bladder reaches 750 ml. And if the bubble presses the cyst, then the volume decreases it, "tolerate" it turns out much less and run to the toilet has much more often.

Less often, patients are concerned about such a problem as stressful urinary incontinence. Due to the small volume of the bladder, the voltage in it becomes greater and with a sharp movement (rings, tilt), cough, sneezing, the misses of small portions of urine.

It greatly violates the quality of life, the patient has to constantly carry gaskets with a large absorbent ability, to count on time to move around the city, drink less fluid than you want.

Also (less often) cysts can squeeze the loops of the small intestine, which are lowered in a small pelvis and cause pain and stool violation.

As we see, the problems of adjacent organs sometimes go to the fore and significantly violate ordinary activity. Therefore, the operational treatment is shown here.

Methods of surgical treatment

Laparoscopy

It is a "gold standard" in the operational treatment of many gynecological and surgical diseases. Endometrium ovarian cysts among them.

The operation is carried out under anesthesia. The general will be anesthesia or spinal anesthesia (injection in the spine with the anesthesia of the lower body with preservation of consciousness) - it solves an anesthesiologist before surgery.

With any form of anesthesia, further technique of operation is carried out according to a specific algorithm. On the skin belly, cuts are performed (punctures) about 1 cm, as a rule, their three. Through these punctures in the cavity of the belly, the tools are introduced, with which the operating doctor can inspect the abdominal cavity and perform various actions.

A small amount of air is injected into the abdomen of the belly, it is necessary that all organs dealt with, and it is better to see the site that we operate. Also, after disgracing the intestinal loops, it is better to explore the abdominal cavity and reveal other foci of endometriosis.

Rarely, when endometride cysts exist in themselves. More often with the cysts there are other manifestations, in this case we are talking about the foci of endometriosis on the peritoneum.

If we find them during surgery, it is necessarily ablation (cavity) of these foci. This allows you to prevent the re-development of the cyst.

Larotomic access

Laparotomy is an operation with a cut of the abdominal wall. In case of endometrium cysts, it is done much less frequently. An open laparotomic operation can be chosen in women, taking into account individual characteristics. For example, if there were already operations on the stomach (optionally gynecological) and there is a risk of sucks, then all the departments will not work technically technically. Or had an unsuccessful laparoscopic operation, or if the doctor had a suspicion of the malignant rebirth of the cyst.

Related manipulations

During any of these operations, the following operational actions may be further carried out:

• ablation (cavity) endometrial foci on the peritoneum and intestines (about it above)
• ablation of the sacratling nerve (to reduce or completely disappear of pelvic pains)
• pressexy neurectomy (removal of some nerves to reduce pelvic pains).

How to recover after surgery

The period of recovery after the operation depends on the volume of surgical intervention. After a laparoscopic operation, the seams are removed by 7-9 days, abdominal pain and seam healing pass quite quickly. By the time of the statement (the same 7-9 days), the patient usually feels quite good. After an open operation, pain can be maintained longer, up to two to three weeks descending.

In order to recover after surgery and prepare for pregnancy recommended Kok with dienethomate or wisin (see the section of conservative treatment).

People's methods for the treatment of endometrioid cyst

Unfortunately, neither herbs nor any "natural" funds will not help get rid of cysts and pain / abundant irregular menstruation. Therefore, you should not waste time for doubtful treatment. Sometimes the patient comes to the doctor with such a running process that the pregnancy or regulation of the cycle speaks with a very low hope.

What can not be done if you have an endometrioid ovarian cyst

There are no specific restrictions for patients with endometrioid cysts. Only intensive physical exertion and frequent thermal procedures (sauna, sauna, hot tubs) are not recommended, which can provoke a cyst break and / or bleeding.

Conclusion

In our current article we tried the most fully and accessible to tell you about what endometrial ovarian cysts represent what they are threatened and how to be treated. We encourage you in a timely manner to the gynecologist, which you trust and follow its recommendations. Watch yourself and be healthy!