Ovarian cysts

Although ovarian cysts can be seen at any age, they mostly occur during reproductive years. Cysts are mostly functional and harmless. It can produce cysts in terms of ovarian function. Every woman of reproductive age develops a small cyst, called a follicle, containing the egg cell, every month, and this structure, which reaches an average of 2 cm in diameter, cracks in the days corresponding to the middle of the menstrual period. This is what we call ovulation every month. However, in some menstrual periods, follicles, that is, cysts containing eggs, can grow excessively.

The diagnosis of ovarian cysts is usually made during a routine gynecological examination. To confirm the diagnosis of the cyst, ultrasonography is performed vaginally or in the abdomen. In this way, it is possible to get information about the type of cyst and whether it is malignant. Rarely, additional imaging techniques such as computed tomography and MRI may be required. Blood tests called tumor markers may be required to determine the type of cyst. Most ovarian cysts are benign. One of these tumor markers is CA-125. In those with a family history of ovarian cancer, in cysts developing after menopause, or in cases of suspected cancer, the level of the tumor marker CA-125 in the blood can be checked. Laparoscopy can also be performed if necessary to diagnose or determine whether the mass is malignant. Masses belonging to other organs that may occur in close proximity to the ovaries should be considered in the differential diagnosis of ovarian cysts.

Ovarian cysts often do not cause symptoms. Any or more of the following symptoms may occur together:

– Menstrual irregularity, spotting or inability to menstruate
-Painful menstruation and increased pain intensity over time
– Pain in the groin
-Feeling of fullness and pressure in the abdomen
-Pain during intercourse
A palpable mass or swelling in the abdomen in large cysts
– Fullness in the breasts
-Urinary and bowel complaints
-Getting fat
-Nausea, vomiting
-Increase in hair growth
-Infertility
– Cyst torsion (suffocation) symptoms
– Sudden severe sharp pain may be a sign of cyst rupture.

TYPES OF OVARIAN CYST

-Functional (Functional) Cysts
-Follicle Cysts
-Endometrioma (Chocolate Cyst)
-Dermoid Cyst (Teratoma)
-Cystadenoma

Do Ovarian Cysts Become Cancerous?

Most ovarian cysts are benign (80-85 percent). It occurs in advanced ages, is bilateral, solid, adherent, irregular surface and tends to grow rapidly, has more than one, solid parts inside, causes fluid accumulation (ascites) in the abdomen, spontaneously after a certain period of time. It is recommended that cystic formations that do not disappear or grow, and that are accompanied by elevations in some blood parameters called tumor markers, should be operated because of the possibility of malignancy. Findings obtained in examination and ultrasound help our suspicion.

If the ovarian cyst is suspected to be cancerous, surgery should be performed without delay by an experienced gynecologist and obstetrician in a center that has the possibility of rapid tissue diagnosis (Frozen section) during surgery.

What does Torsion of Ovarian Cyst mean?

It occurs when the cyst turns around and disrupts its own blood circulation. Blood circulation is disturbed and tissues lose their vitality. This is quite a painful condition. The risk of torsion is especially higher in cysts with large diameters and dermoid cysts. In this case, the operation should be treated early. But most of the time, since the tissues completely lose their vitality, it is not possible to protect the torsioned ovary and surgical removal of the ovary is required.

When should ovarian cysts be operated?

1. If the mass is solid (solid) or semisolid (semi-solid)
2. Postmenopausal (postmenopausal) or premenarche (before first menstruation) cysts
3. A cyst larger than 5 cm and persistent (if it continues despite suppression by observation or birth control pills)
4. The cyst that gives the impression of malignancy (malignant or cancer risk)
5. If it is growing fast
6. If there are signs of ascites and metastases in the pelvis
7. In case of torsion

What are the Main Surgical Treatments for Ovarian Cysts?

The surgical method is chosen according to the size of the cyst, its sonographic appearance, and the suspicion of being benign or malignant.

Laparoscopy

If the cyst is small and appears benign, only a diagnostic laparoscopy or an additional minor operation may be needed. It is based on imaging the inside of the abdomen with small incisions (incisions) just below the navel and one or two more in the abdomen, using thin special surgical instruments, and telescopic systems from these incisions. Cysts can be removed with this method. This method is less painful, and the hospital stay and return to work are shorter. Aesthetically, the results are better than open surgery (Laparotomy).

laparotomy

It is the method used for large cysts and for the removal of cysts that may be malignant. During surgery, it may be necessary to remove the ovary along with the cyst when necessary.

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