Types of cysts: the main difference
- Follicular cyst - the follicle did not rupture during ovulation and continued to grow; disappears on its own in 1–3 cycles
- Corpus luteum cyst - formed after ovulation; also usually goes away on its own
- Endometrioid (“chocolate”) cyst is a manifestation of endometriosis; doesn't go away on its own
- Dermoid cyst (mature teratoma) - contains different types of tissue: fat, hair, tooth buds; innate by nature, does not disappear on its own
- Cystadenoma is a true tumor of ovarian tissue, serous or mucinous; can reach large sizes
- Paraovarian cyst - located next to the ovary, not in it
- Thecal lutein cysts - associated with ovarian stimulation
Практический вывод: при обнаружении простой тонкостенной кисты у женщины репродуктивного возраста первым шагом почти всегда является не операция, а контрольное УЗИ через 2–3 менструальных цикла. Значительная часть таких кист исчезает без всякого лечения.
Symptoms
- Often there are no symptoms - the cyst is found by chance on an ultrasound
- Nagging pain in the lower abdomen, usually on one side
- Increased pain with physical activity and sexual intercourse
- Menstrual irregularities
- Feeling of heaviness and fullness
- Abdominal enlargement with large cysts
- Frequent urination due to pressure on the bladder
- Constipation
- Sudden sharp pain from a torsion or rupture is an emergency
Complications requiring urgent care
- Torsion of the cyst leg - blood supply stops, sharp pain, nausea, vomiting occurs; emergency surgery required
- Rupture of a cyst with bleeding into the abdominal cavity - sharp pain, weakness, dizziness, drop in pressure
- Suppuration of the cyst - pain with high fever
- Compression of neighboring organs with large cysts
- Malignization is rare, but possible with true ovarian tumors
If you experience sudden, sharp pain in the lower abdomen, especially with nausea and dizziness, you should immediately seek medical help rather than take painkillers and wait. Torsion and rupture of the cyst are conditions where delay is dangerous.
Diagnostics
- Examination by a gynecologist
- Transvaginal ultrasound with Dopplerography - the main method: size, structure, presence of septa, dense inclusions, blood flow
- Control ultrasound after 2–3 cycles for a simple cyst is a key step
- Tumor marker CA-125 and ROMA index - assessing the risk of malignancy, especially in postmenopause
- MRI of the pelvis with a complex structure of the formation
- Pregnancy test - required for lower abdominal pain
- General blood test
- Assessment of ovarian reserve when planning surgery in women wishing to become pregnant
Treatment
- Observation with control ultrasound - with a simple cyst up to a certain size in a woman of reproductive age
- Combined hormonal contraceptives - do not “resolve” an existing cyst, but prevent the formation of new functional cysts
- Laparoscopic cystectomy - enucleation of the cyst with maximum preservation of healthy ovarian tissue; the main method for true cysts
- Laparoscopic ovarian resection
- Removal of paraovarian cyst
- Laparotomy - for very large formations and suspicion of a malignant process
- Ovariectomy - removal of the ovary; discussed with extensive lesions and postmenopause
- Emergency surgery for torsion and rupture
При операции важен принцип максимального сохранения ткани яичника: каждая кистэктомия уменьшает овариальный резерв. Поэтому у женщин, планирующих беременность, объём вмешательства обсуждается заранее, а показания к операции оцениваются особенно строго.
When is surgery necessary?
- The cyst did not disappear after 2–3 observation cycles
- The size exceeds the established threshold or the formation is growing
- Complex structure: partitions, dense component, increased blood flow
- Tumor markers and ROMA index increased
- Education detected in postmenopause
- Dermoid or endometrioid cyst
- Severe pain syndrome
- Complications: torsion, rupture, suppuration
- The cyst interferes with pregnancy or IVF
Where are ovarian cysts treated in Tashkent
We need high-quality ultrasound with Doppler ultrasound, a laboratory for tumor markers and a surgical service with careful laparoscopic techniques.
In Tashkent, examination and laparoscopic treatment of ovarian cysts are carried out at the UROLOGIC COMPLEX medical center and at the Tashkent Medical Park clinic.
If you were offered surgery immediately after the first ultrasound for a simple thin-walled cyst, check whether follow-up observation is possible within 2-3 cycles: a significant part of such cysts disappear on their own. Clinic contacts are below.
