The word "tumor-like" means that this process is voluminous, which makes it look like a tumor. But unlike a tumor, the retention cyst contains fluid, the cyst wall is thin and transparent, and, most importantly, the cyst does not metastasize to other organs.
Causes of the retention cyst of the left and right ovary
There are many reasons for this disease. One of the reasons is endocrine disorders in a woman's body, in particular hormonal imbalance. This is because the female sex hormones, estrogens, thicken secretions (mucus) that are secreted in the lining of the uterus, tubes and ovaries. Such thickened mucus can clog the excretory duct of the gland and disrupt its outflow from it. As a result of this, the gland increases in volume due to the accumulated liquid (secretion) in it.
On the other hand, a cyst can form at the site of the follicle, corpus luteum and other formations of the ovary. An ovum matures in the follicle, which must come out of it and enter the fallopian tube. For this, fluid accumulates in the follicle, ruptures and the egg is released. If this did not happen or happened unsuccessfully, then a cyst appears in the place of the follicle.
A retention cyst can be formed by endometrial cells trapped in the ovary in some way. Endometrial cells are modified endometrial cells. They can come off the lining of the uterus (endometrium) and travel to other organs. The peculiarity of these cells is that during menstruation they bleed profusely, wherever they are. So, if they are in the submucous layer of the ovary, then the blood released from them will gradually accumulate and form a cyst, which in this case will be called "chocolate", since the blood turned off from the circulation and clotted becomes brown Colour.
Also, the reasons for the development of ovarian cysts can be numerous abortions, hypothyroidism, early puberty, and other endocrine diseases.
Classification of retention cysts
- The corpus luteum cyst is formed from the corpus luteum, which is located in the ovary and at a certain point in the menstrual cycle releases female sex hormones - gestagens. These hormones are needed to prepare the uterus to receive a fertilized egg.
- Follicular cyst - formed from a follicle. The follicles contain the egg and when it ripens, they burst and release it from the ovary. Thus, the egg for a short time enters the abdominal cavity, from which it is captured by the elements of the fallopian tubes and moves along the latter. If this process fails (for example, if the follicle does not rupture at the right time), a cyst forms at the site of the follicle.
- Paraovarial cyst - arises from the ovarian epididymis, located in the mesentery of the fallopian tube. This cyst grows very slowly and therefore does not manifest itself clinically for a long time. But such a cyst can grow to a huge size (up to several tens of kilograms!).
Ovarian retention cyst life cycle
The cyst arises from a failed follicle and gradually increases in volume due to the fluid accumulating in it. With its small size, this pathology has an asymptomatic course. When the size of the cyst becomes significant, then certain symptoms appear. In the future, the cyst can be subjected to involution (reverse development and disappearance) or burst. When the cyst wall is destroyed, its contents enter the abdominal cavity, causing aseptic inflammation (peritonitis) in it. This phenomenon is accompanied by pain, fever and tension of the abdominal muscles (the blade of a sharp abdomen).
Differential diagnosis of retention cysts with other diseases of the abdominal organs.
Retention cyst of the right ovary
The clinic of the retention colon of the right ovary in case of its rupture may be similar to the symptoms of acute appendicitis.. Therefore, for differential diagnosis, it is necessary to do ultrasound of the abdominal organs and diagnostic laparoscopy.
Also, differential diagnosis of the right ovary must be performed with intestinal tumor, ovarian tumor, ectopic pregnancy.
Retention cyst of the left ovary
A retention cyst of the left ovary is clinically similar to a tumor of the sigmoid colon. For differential diagnosis, ultrasound of the abdominal organs, diagnostic laparoscopy and irigoscopy (X-ray examination of the sigmoid colon filled with barium suspension) are used.
Retention cysts of the left and right ovary must also be differentiated from ovarian apoplexy, ovarian cancer, tubal (ectopic) pregnancy.
The decisive method for diagnosing ovarian cysts is an ultrasound examination of the abdominal organs.When conducting this study, a round or oval formation with a thin wall and liquid contents is clearly visible on the ultrasound monitor of the device. When the intestine is ruptured, ultrasound diagnostics can reveal the presence of fluid in the abdominal cavity.
Symptoms common to retention cysts of the left and right ovary
- Hormonal Disorders
- Reproductive dysfunction
- Menstrual irregularities
- In case of cyst rupture - clinic of acute abdomen
- Increase in the volume of the abdomen
- Lower abdominal pain
Symptoms of the retention cyst of the left ovary.
With a retention cyst of the left ovary in the left iliac region, a volumetric elastic formation is palpated. When it breaks, there is a clinic of an acute abdomen (tension of the muscles of the anterior abdominal wall). The patient may be bothered by pulling pains in the left abdomen.
Symptoms of the retention cyst of the right ovary.
With a retention cyst of the right ovary in the right iliac region, a volumetric formation can also be detected by palpation. With large cysts, indigestion may be observed. The patient may be disturbed by pulling pains in the lower abdomen on the right.
Complications of retention cysts
Torsion of the cyst pedicle is an acute condition that resembles an acute abdomen clinic. This is due to the infringement of the vessels that supply blood to the cyst wall and the development of its necrosis. Clinically, this is manifested by severe abdominal pain, positive symptoms of peritoneal irritation, and tension in the muscles of the anterior abdominal wall. When listening to the abdomen, the murmur of the intestines is not audible. Bloating and constipation may occur. This complication requires urgent medical intervention and emergency surgery in a hospital setting.
Suppuration of the cyst - that is, filling the contents of the cyst with pus. This occurs when an infection is attached to the cyst. At the same time, the body temperature rises to febrile numbers, severe pains throughout the abdomen, fever, vomiting and nausea appear, the heart rate increases, and pressure may decrease. The tactics of treatment are the same as for twisting the legs of the cyst, only in addition to an emergency operation, the patient needs to perform additional antibacterial and detoxification treatment.
Rupture of the cyst capsule is a rather rare complication, which is clinically manifested by sharp abdominal pain, nausea, vomiting, and a decrease in blood pressure. The patient also needs to be urgently taken to the hospital and operated on. The operation will consist in opening, revision (examination) and sanitation (removal of excess contents) of the abdominal cavity.
If you do not provide emergency assistance with these complications, then the patient can be lost. Therefore, any ovarian cyst must be treated.
Treatment of the retention cyst of the left and right ovary
Treatment of the retention cyst of the left and right ovary has two directions: conservative and operative.
Conservative treatment consists in normalizing the hormonal background of a woman and monitoring her for a long time.Observation consists of systematic examinations of a woman, including with the help of ultrasound of the abdominal organs. If the cyst begins to decrease against the background of hormonal correction, then the treatment is continued until the cyst is completely involved. If conservative therapy does not have any effect on the growth of the cyst, then the question arises of conducting surgical treatment of this disease.
The operation to remove the cyst is as follows: the woman is put into anesthesia, several small 1 cm incisions are made in different parts of the abdomen. These incisions are needed in order to introduce manipulators through them into the abdominal cavity, with the help of which the cyst will be exfoliated and resected. During this operation, the ovaries are not affected. One of the manipulators is a video camera (endoscope). Everything that happens in the abdominal cavity, he projects onto the monitor and, thus, the operating doctor orients himself in the abdominal cavity. This technique belongs to endoscopic operations, which are very common in our time.
The advantages of such operations are numerous. This is an aesthetic effect (the absence of a large incision in the abdominal cavity and the subsequent formation of charm), and a small trauma to the body, and a low risk of complications. After such operations, only a few small scars of 1 cm in size remain on the anterior abdominal wall.
Prophylaxis
Prevention of the retention cyst of the left ovary and the right ovary is the same.
Firstly, if you suspect a gynecological disease, you must go to an appointment with a gynecologist.
Secondly, you need to monitor your hormonal levels. If the menstrual cycle changes, amenorrhea, dysmenorrhea and other similar troubles appear, then again it is necessary to inform your gynecologist about this.
Drug prevention of retention cysts is the use of hormonal contraceptives.These artificially administered hormonal preparations create an optimal concentration of estrogens and gestagens, which determines the properties of the liquid and affects the functional activity of ovarian follicles. Some hormonal contraceptives can create the effect of artificial medical pregnancy.
Any pregnancy has a beneficial effect on the woman's body, since during it the endometrium of the uterus rests (there is no menstruation).And if you do not allow the endometrium to rest, then its constant increased mitotic activity (constant growth and rejection of the endometrium - menstruation) creates a favorable background for development uterine cancer. Therefore, for the fact that a woman does not fulfill her sacred function - does not give birth, she pays with the risk of developing cancer.
Some hormonal contraceptives of the latest generation create a so-called artificial pregnancy, have a beneficial effect on metabolic processes of a woman, normalize their hormonal background, reduce the intensity and soreness of menstruation and have few side effects effects.
Hormonal contraceptives are selected individually for each woman by her gynecologist.
