Ovarian Masses (Cysts)

1-What do we understand when we say ovarian cysts?
They are formations consisting of cystic (liquid-filled vesicles) and solid (hard tissue particles) structures in places, which develop from the ovary, which is one of the main reproductive organs in women and is about 3 cm in diameter.
2-How often does it occur and at what ages?
Although it is most commonly seen at the age of 20-44, different types can be encountered at almost every age, and perhaps every woman may encounter this problem at least once in her life due to the types with different characteristics.
3-Which complaints can be made, what should women suspect and consult a doctor?
Although a doctor is consulted with complaints such as pain in the groin, abdominal tension, irregular menstruation, frequent urination and constipation, it is most often encountered in routine gynecological examination in women who have no complaints, which increases the importance of routine gynecological examination, which should be done every 6-12 months in ovarian cysts.
4-What is the most important issue in the follow-up and treatment of ovarian masses?
In fact, this is the most crucial point of the subject. Whether an ovarian mass is encountered during routine gynecological controls or detected while investigating complaints, the primary target is whether these masses are malignant cancer or benign masses. To make this distinction, we first search for a detailed ultrasonographic examination and tumor markers in the blood, and if necessary, we apply advanced diagnostic methods such as PET-CT MRI, computerized tomography. If there is a suspicion of cancer, we first plan a surgical operation and try to make a definitive diagnosis after the pathological examination without wasting time.
However, pleasingly, only 7% of the formed masses have a malignant potential in premenopausal 7% and postmenopausal 30%.
After distinguishing between benign and malignant masses, it is necessary to distinguish between a functional cyst formation (which is usually the result of ovulation every month in the menstrual cycle) or a benign tumor in benign patients with a large mass.
Here, it is necessary to be patient and experienced to make this distinction. First of all, after a detailed technical evaluation, drug treatment or observing the patients for 1-3 months is essential. Most of the non-cancerous benign masses are functional cysts and regress only by observing for 1-3 months or by using birth control pills and saves patients from unnecessary surgical operations.
However, if the cysts do not regress or continue to grow after 3 months of treatment and observation, then a surgical operation should be planned.
5-Why is surgical treatment planned for non-functional benign tumors and how is it performed?
There are 2 important problems in benign tumors. First; Depending on their type, 1 -25% of them may have the potential to become cancerous in time and they should eliminate this risk. On the second important issue, since these cysts mostly appear before menopause, as the cysts grow, they begin to steal from the ovary, reduce and destroy the ovarian capacity, and after a while they may cause reproductive problems.
6-Is there a risk of infertility from ovarian cysts?
Yes, in fact, all ovarian cysts, even functional ones, are closely related to infertility. Tumor cysts destroy the ovary and reduce its volume, and as it gets late, ovarian reserves decrease, especially endometriomas, which are popularly called chocolate cysts, increase the risk of infertility by both reducing the volume of the ovary and sticking to the tubes. Ovarian reserves should also be investigated in women with frequent functional cysts, and attention should be paid to the risk of early menopause. Because we see functional cysts more frequently in the premenopausal period when the quality of the ovaries decreases.
7-Functional cysts need to be followed up because they regress in a great winter?
Of course, close monitoring of functional cysts can cause internal bleeding by tearing, or ovarian torsion by turning around, if it is delayed, it can prepare the ground for serious conditions that will completely destroy the ovary, and it is necessary to make sure that all functional cysts are destroyed, but then it can be ensured that this cyst is not a tumoral cyst.
8-What is the importance of chocolate cysts?
Chocolate cysts are the layer forming the menstrual cycle in the uterus, which we call endometriosis, forming a cystic structure in the ovaries and can cause infertility, severe pain, adhesions and sexual problems. It is vital for the treatment and follow-up to be done perfectly, to protect both sexual and reproductive health of the person and to increase the quality of life. One of the most important treatment mistakes is to perform late surgery as well as early surgery. Another important issue is that the cyst will recur to a great extent after the surgery and even if a successful surgical treatment has been applied, it should be meticulous to continue the medical treatment until menopause. It should not be forgotten that each recurrent chocolate cyst causes more complex problems.
9-Is there any significance of cysts in childhood and adolescence?
It is absolutely important because some types of ovarian cancers are observed at that age, and benign cysts formed at these ages may cause a significant loss of ovarian tissue. In this age group, patients usually come late, as there is not much habit of going to the doctor. Young girls with complaints of meaningless inguinal pain, menstrual irregularity and abdominal swelling in these age groups should definitely be evaluated with ultrasound.
10-What kind of method do you apply in the treatment of these masses?
Since these diseases are usually in pre-menopausal ages, there are many cosmetic concerns, and since the majority are working women or young girls who continue their education, surgical treatment is a method that will cause the least cosmetic damage, and the hospital stay as short as possible and the social or work environment as soon as possible. aiming to return. In recent years, we prefer laparoscopic surgery (classical or robotic) in almost all of our patients, except for advanced cancer patients. Thus, patients can go to their homes and return to their social environments on the same day or the next day, by performing all the surgical goals we aim perfectly.
11-What should women pay attention to in order to avoid the problems that ovarian masses can cause?
Women of reproductive age should not delay their routine gynecological check-ups, but young girls under the age of 20 should be referred to a doctor when complaints of menstrual irregularity, swelling in the abdomen or meaningless abdominal pain occur.
After menopause, controls should not be delayed until at least 70 years of age. It should not be forgotten that while premenopausal ovarian masses have only 7% cancer potential, this rate increases to 30% after menopause and they have the potential to encounter more serious conditions.

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