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Ovarian cysts

Cysts are bulky lumps formed in ovaries. They are most often benign, but some types tend to regenerate or may be malignant.

Therefore, during operations aimed to remove cysts, with the slightest surgeon’s suspicion of a malignancy, it is necessary to conduct an urgent intraoperative histological examination.

There are many types of cysts, and not all of them need to be operated on. For example, functional cysts that in most cases go away on their own within a couple of months. Some cysts also disappear with anti-inflammatory therapy, namely cysts of the corpus luteum and follicular cysts.

The ovaries are paired glands that not only provide hormons of youth and beauty to a woman, but are also responsible for her fertility, so operations on them should be performed very carefully and only by the best specialists.

A follicular cyst is simply a fluid-filled follicle with a diameter of 3-5 cm, which, for one reason or another, did not ovulate. As a rule, such cysts are discovered by chance during a planned ultrasound scan and do not bother the woman in any way. A follicular cyst does not normally require treatment, since in most cases it resolves itself within 2-3 months.

A corpus luteum cyst is a benign formation that forms when fluid accumulates in the corpus luteum (a temporary structure that forms at the site of the follicle after its ovulation), as a rule, disappears under the influence of anti-inflammatory therapy within a few days.

The remaining cysts cannot be observed for longer than 3-4 months, surgical treatment is necessary due to the risk of malignant degeneration of the cyst.

Endometriomas are one of the typical manifestations of endometriosis. Such cysts have a capsule and are filled with thick brown-colored contents, which is why they are called “chocolate cysts”. Previously, it was believed that endometrioid cysts occurring during menopause may remain unoperated, but for the last 10-15 years, given the risk of malignant degeneration of cysts during menopause, it is still recommended to remove them. In addition, endometrioid cysts can be one of the causes of infertility, therefore, if the patient has infertility and such a cyst is detected, it must be removed.

With an endometrioid cyst whose diameters reaches 3 cm and with the preservation of fertility, it is enough to undergo ultrasound regularly so as not to miss the possible growth of the cyst.

Dermoid cysts (mature teratomas) are benign tumors that form from human embryonic cells. Since initially a teratoma is formed from cells that can differentiate into any cells of the body, inside these cysts there can be areas of any human tissue – fat, bones, skin, hair, cartilage, etc.

Teratomas also belong to tumors that are subject to surgical removal, since, firstly, there are immature teratomas, which are malignant tumors in their structure, and secondly, the contents of these cysts are very toxic in case they enter the abdominal cavity. Therefore, in order to prevent possible rupture of the cyst or its torsion, it is better to perform a preventive operation to remove it.

Serous and mucinous ovarian cystadenomas are benign ovarian tumors. They can be divided into smooth-walled and papillary cystadenomas.

Smooth-walled tumors are safer, as they have a lower risk of degeneration than papillary ones. However, histologically, cystadenomas are quite often found to be a borderline tumor with a high proliferation index and a risk of malignant transformation. According to many international treatment standards, serous and mucinous ovarian cysts must be removed, regardless of their type and size.

Even the ultrasound report and tumor markers within the normal range do not allow to be 100% sure that the formation is non-malignant. The final answer can be received only during the operation, after an urgent intraoperative study of the removed tissues.

That is why we always use urgent examination when removing ovarian cysts and follow all the rules of ablation – during the operation, the contents of the cyst do not enter the abdominal cavity, and an urgent examination allows us to find out the type of tumor right during the operation and carry out the necessary amount of treatment.

When removing ovarian cysts in women of reproductive age (18-49 years), it must be remembered that it is the ovaries that provide hormonal support for a woman’s youth, and their safety very much depends on the volume and technique of the operation.

During laparoscopic surgery, we remove only the thin capsule of the cyst with its contents, without affecting healthy tissues of the ovaries. This allows our patients to keep the same amount of ovarian tissue as before the operation and to maximize fertility and health of our patients.

 

 

Операции на яичниках и маточных трубах

  • Что такое кисты яичников?
    Кисты яичников – это объемные образования в яичниках, которые чаще всего являются доброкачественными, но некоторые виды могут быть злокачественными или иметь тенденцию к перерождению.
  • Какие кисты требуют оперативного вмешательства?
    Оперативное вмешательство требуется для всех кист яичников, кроме функциональных кист, которые обычно рассасываются самостоятельно в течение нескольких месяцев. Другие кисты необходимо оперировать из-за риска их злокачественного перерождения.
  • Как лечатся фолликулярные кисты яичников?
    Фолликулярные кисты яичников не требуют лечения, так как они обычно сами рассасываются в течение 2-3 месяцев. Рекомендуется регулярное УЗИ для контроля возможного роста кисты.
  • Почему эндометриоидные кисты яичников требуют оперативного лечения?
    Эндометриоидные кисты яичников должны быть удалены, так как они могут переродиться в злокачественные опухоли. Кроме того, они могут быть одной из причин бесплодия.
  • Почему дермоидные кисты яичников требуют хирургического удаления?
    Дермоидные кисты яичников являются доброкачественными опухолями, но их содержимое является токсичным. Для предотвращения возможного разрыва или перекрута кисты, рекомендуется профилактическое удаление таких кист. Также, возможно злокачественное перерождение таких кист.
  • Какие симптомы сопровождают кисту яичника?
    Симптомы кисты яичника могут включать боль или дискомфорт внизу живота, нерегулярные менструации, учащенное мочеиспускание, ощущение переполненности или давления в животе, а также изменения в половой активности.
  • Как диагностируется киста яичника?
    Для диагностики кисты яичника врач может провести физическое обследование, ультразвуковое исследование или магнитно-резонансную томографию (МРТ).

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