What is Ovarian Cyst?
When it comes to women’s health, ovarian cysts are among the first to come to mind. After women start to have menstrual bleeding, they also start to risk developing ovarian cysts. Since the function of the ovaries begins in adolescence and ends during menopause, ovarian cysts are rarely seen during adolescence and after menopause. They are seen in two forms as benign ovarian cyst and malignant ovarian cyst. Types of ovarian cysts, which are generally benign, are among the gynecological diseases also known as ovarian cysts. In some cases, symptoms of ovarian cysts are observed, in some cases, cysts that do not show any symptoms can be detected incidentally during gynecological examinations. All the details about ovarian cyst are in the rest of the article.
What is an ovarian cyst?
In the uterus, cysts are sacs filled with water. It is surrounded by a membrane-shaped cyst wall. Cysts in the ovaries are mostly harmless.
What causes ovarian cyst?
Ovaries develop structural egg cysts in women with normal menstrual cycle. With the end of menstruation, one of the egg cells in the ovary begins to grow and becomes a cyst. This cyst is called “follicle”. In the middle of menstruation, this cyst bursts and the egg cell inside is thrown into the tubes. During this burst, there is often a small bleeding into the abdomen and the body limits this bleeding itself.
In the meantime, some women notice that they have vaginal bleeding in the form of groin pain and sometimes light spotting due to bleeding in the middle of their menstrual period. This situation; it is a sign that indicates natural, must-have, ovulation. There is no need to be afraid. Often, bleeding and pain disappear within hours. If there is a coexistence on the days when these complaints are seen, the chance of pregnancy will be high. For those wondering what cyst means, the details are listed below:
- Ovarian cyst rupture
Rarely, the body cannot stop the bleeding that occurs when the egg cell is thrown into the tube and the bleeding continues. In this case of internal bleeding, the patient’s blood pressure decreases, his heart rate accelerates, cold sweat, his eyes darken, severe groin pain and he feels bad. This condition is called “ovarian cyst rupture”.
If there are such complaints, the patient should be brought to a health institution as soon as possible. The patient is evaluated by the obstetrician. The amount of bleeding inside is determined by ultrasound. The amount of internal bleeding is determined by making a blood count. If there is no danger to life, it can be followed in the hospital. During this follow-up, it is monitored whether their complaints increase or not. The blood count is repeated and it is examined that the bleeding does not continue.
If the bleeding continues, there will be a decrease in the blood values called hemoglobin and hematocrit. Despite the possibility of an emergency surgery, the patient should not eat or drink anything by mouth. The need for fluid is met with serum therapy. Anesthesia is administered to control bleeding in patients who have worsening hemoglobin and hematocrit values during follow-up. A procedure called laparoscopy is performed by entering a camera through the belly button. Open surgery is not preferred.
- Corpus luteum
Sometimes cysts called egg-containing follicles do not burst and turn into overgrowing ovarian cysts. Normally, when the follicle cyst reaches 2 cm in diameter, it bursts and the egg inside is thrown into the tube. The remaining empty follicle turns into a structure called “corpus luteum”. This structure does not need to be surgically removed. It is a normal structure.
How is the diagnosis of ovarian cyst made?
Generally, a diagnosis of ovarian cyst is made incidentally during gynecological examination. Evaluation by vaginal or abdominal ultrasonography often gives information about the type of cyst and whether it is malignant. Rarely, advanced examinations such as computed tomography and MRI are required.
How to understand benign cyst and malignant cyst?
Tumor tests can be performed in the blood to distinguish whether the cyst is benign or malignant. Most ovarian cysts are benign. Among these tumor tests, Ca-125 can be increased especially in ovarian cancers and benign chocolate cysts called endometrioma. If the diagnosis cannot be made with all these evaluations, the cyst can be evaluated with a camera by anesthesia with a procedure called laparoscopy.
What are the symptoms of ovarian cysts?
Ovarian cysts are often asymptomatic. In some cases, a condition called “ovarian pain” that occurs in the lower abdomen may be among the symptoms of cysts. However, “ovarian pain” is not a scientifically correct term because eggs are organs that do not feel anything. Since cyst symptoms cannot be found physically, it is useful to have a regular gynecology examination.
Among the symptoms of ovarian cysts;
- Menstrual irregularity, spotting or inability to menstruate
- Painful menstruation
- Pain in the groin
- Pain during intercourse
- Swelling in the abdomen
- Breast fullness
- Urinary and bowel complaints
- Getting fat
- Nausea, vomiting
- Increased hair growth
- Inability to conceive
- Sudden severe sharp abdominal-groin pain
What are the types of ovarian cysts?
It is the most common type of cyst seen in women between the ages of 20-50. It occurs when the developing egg cell does not crack and continues to grow. They are well-circumscribed, stretched cysts containing clear fluid. They are detected as black on ultrasound. They are generally less than 5 cm in diameter and usually do not show symptoms.
These cysts disappear spontaneously or by using 2-3 boxes of birth control pills. Cyst surgery may be necessary for cysts that do not shrink or grow larger despite treatment. These cysts can be treated with a few surgical interventions.
Hemorrhagic – Corpus Luteum cyst
After ovulation, the follicle undergoes a change and takes the name “Corpus Luteum” and produces hormones. “Corpus Luteum Cysts or Hemorrhagic Cysts” occur with excessive growth of this structure or bleeding into this structure. These cysts are generally more painful and larger than follicle cysts. They usually shrink on their own or with birth control medications. Since they continue to release hormones, they can cause menstrual delays. Rarely, they may cause bleeding into the abdomen and severe pain due to rupture (rupture, rupture of the cyst) or torsion (the cyst turns around itself and the blood circulation stops), which can sometimes lead to surgery.
Hemorrhagic Cyst rupture: The rupture or rupture of the overgrowing cyst is called “Hemorrhagic Cyst Rupture”. Although the bleeding due to tearing in the abdominal cavity stops spontaneously, it can sometimes reach life-threatening dimensions.
Signs that the bleeding is severe;
- Cold sweats
- General condition disorder
- Severe groin abdominal pain
- Nausea, vomiting
- Does hemorrhagic cyst prevent pregnancy?
- Since it can lead to hormone production, pregnancy may be difficult in the presence of hemorrhagic cysts.
Endometrioma (chocolate cyst)
Frequently, painful menstruation, pain during coexistence, inability to conceive, and groin pain are among the symptoms of chocolate cyst.
What causes chocolate cyst?
It is the proliferation of the tissue called endometrium, which covers the inner part of the uterus, on the ovaries. Endometrial tissue migrating to the ovaries is called “endometriosis”. Small point endometriosis foci bleed into themselves over time and turn into dark brown cysts. This cystic formation is called endometrioma. Inside of the cyst is filled with dark brown fluid. For this reason, it is also called “chocolate cyst”.
Does chocolate cyst prevent pregnancy?
Endometriosis can bind the abdominal organs, ovaries and tubes to each other. These adhesions can cause groin pain and not conceiving. Click for more detailed information on the subject.
Dermoid cyst (Teratoma)
It is the most common type of cyst in the uterus in those younger than 20 years old. These cysts may contain tissues such as hair, bone, teeth, and fat. Therefore, it is easy to diagnose dermoid cyst with ultrasonography. These cysts are not caused by a problem related to the ovulation period, but due to problems that occur while the patient is still in the womb.
When the cyst is detected, it should be removed carefully by laparoscopic closed method without damaging the ovary and without dispersing the formations such as hair, hair, fat and teeth inside the abdomen. Dermoid cysts can be seen in 12% of both ovaries. Therefore, it should be evaluated very carefully in the other ovary.
They are benign tumoral structures that develop from the surface layer surrounding the ovarian tissue.
How is ovarian cyst burst?
As mentioned earlier, cysts are fluid-filled sacs. It is surrounded by a membrane. Cysts may rarely open as a result of increasing fluid content or thinning of the thin membrane over time. In this case, the contents of the cyst, the fluid is poured into the abdomen. This is manifested by sudden very severe abdominal pain.
Ovarian cyst and cancer relationship
Ovarian cysts are benign with a probability of 80-85%. Although benign cysts do not tend to cause cancer, they can cause different complaints in people.
Malignant ovarian cyst can occur in the following situations:
- Cysts that occur in advanced ages,
• Presence of cysts in both ovaries,
• Detection of a solid (solid, filled like potato) structure next to fluid-filled
• Cysts with irregular borders and edges attached to the environment,
• Cysts with rapid growth, • Suddenly Cysts with large numbers of solid parts in them,
• Cysts that cause fluid accumulation (acid) in the abdomen , • Cysts that do
not disappear or grow on their own during follow-up,
• Cysts with increases in blood tests called tumor markers.
If the ovarian cyst is suspected to be cancer, the operation should be performed by an experienced obstetrician and in a center (Frozen Pathology) that can immediately diagnose the part taken during the operation and give information whether it is benign or malignant.
If it is found to be malignant by examining immediately during the operation, the content of the operation is expanded. Biopsy of lymph nodes may be required.
What does torsion of ovarian cyst mean?
It occurs when the cyst turns around and disrupts its own blood circulation. Blood circulation is impaired and tissues lose their vitality. This is a very painful condition. The risk of torsion is higher in cysts with large diameters and dermoid cysts. In this case, the operation should be treated early. Laparoscopy should be preferred for ovarian cyst surgery. If it is delayed for ovarian cyst treatment, ovaries may be lost.
How to treat ovarian cyst: ovarian cyst treatment
Treatment of ovarian cyst; The size of the cyst is decided according to the ultrasound image, benign or malignant suspicion. Generally, this problem is solved with ovarian cyst surgeries.
Laparoscopy, which means closed surgery, should be the first choice in ovarian cysts. For cysts other than very large cysts and cysts with a high risk of cancer, the closed endoscopic method called laparoscopy is always preferred. Surgery is performed with 1-2 cm incisions in the belly button and 1-2 abdominal skin. The cyst is removed with a closed method with the help of a camera by giving carbon dioxide gas into the abdomen. The patient gets up and drinks after 4 hours and stays in the hospital for 1 night on average. This method is less painful and the duration of hospitalization and return to work is shorter. Very small scars remain on the skin, the patient can continue sports. These postoperative patients may have shoulder pain. Aesthetically, the results are better than open surgery (laparotomy).
It is no longer preferred nowadays. However, it is the method used in large cysts and cysts with a high probability of being malignant. During the operation, it may be necessary to remove the ovary when necessary together with the cyst.