Endometrioid ovarian cyst: treatment, symptoms, causes

What is it? - endometriosis is a systemic disease with local manifestations. The essence of this pathological process consists in the appearance of tissue, which resembles the endometrium in structure and function, but is not localized in the uterine cavity.

One of the frequent localizations is the ovary. So the endometrioid cyst is formed.

Causes of

The causes of the development of the disease have not been completely studied yet.

Therefore, various theories explain the mechanism of development. So, the main predisposing factors for the endometrial ovarian cyst are:

• weighed down;
  
• increased estrogen content in the body( either relative or absolute);
  
• immune disorders;
  
• retrograde contraction of the fallopian tubes, which creates conditions for the transfer of endometrial cells into the abdominal cavity;
  
• a large number of abortions in the anamnesis;
  
• no history of delivery;
  
• anovulatory menstrual cycles;
  
• prolonged use of intrauterine contraceptives.

This disease is characterized by the following features:

• high incidence of malignant degeneration of endometrial cells;
  
• regression of endometrioid cysts during pregnancy;
  
• hormonal dependence.

See also what is the ovarian follicular cyst.

Symptoms of the endometrioid ovarian cyst

The main clinical syndromes that develop against the background of the endometrioid ovarian cyst are the following:

• of the pain syndrome;
  
• infertility;
  
• violations of ovarian-menstrual function;
  
• in the case of large cysts there is compression of a number of located organs( bladder and rectum).

Pain is one of the most common manifestations of this disease. They are characterized by symptoms such as:

• pains that occur during menstruation;
  
• pain that appears during sexual intercourse;
  
• periodic pain in the lower abdomen, which are associated with neither sexual intimacy nor menstruation.

It is characteristic that with the progression of the disease, the intensity and duration of pain increase. Thus, in the initial stage of the endometrioid ovarian cyst pain only occurs in the first days of menstruation, but then they become longer, remaining until the end of menstruation.

In parallel pains that appear during intimacy are attached. In the last stage of the disease, pain is always present. Against this background, the nervous system of the sick woman is depleted, and disability( up to its complete loss) is disrupted.

Pain sensations in the endometrioid cyst of the ovary are localized either on one side( from the side of the affected ovary) or from both sides, especially with the development of a pronounced adhesion process. These pains can have a typical irradiation - in the lumbar region, sacrum, rectum.

On the background of pain may be meteorism, a violation of urination in the form of pain and rapidity( with inflammatory changes in laboratory tests are absent).In addition, against the background of the endometrioid cyst, infertility often develops( in 30-40% of cases).The reasons for its development are complex:

• anovulation;
  
• activation of luteinization processes of the follicle, which did not ovulate;
  
• decreased motility of spermatozoa in the female genital tract against a background of immune disorders;
  
• wrong direction of the wave of contraction of the fallopian tubes;
  
• pathological changes in the endometrium, which do not lead to a decidual reaction, therefore exclude the possibility of normal implantation of the oocyte;
  
• development of adhesive process;
  
• elevated blood levels of prolactin.

Violations of menstrual function are manifested in the following clinical options:

• pain during menstruation( as mentioned above);
  
• presence of bleeding before and after menstruation;
  
• irregular menstrual cycle( the duration of delays is very variable).

Complications of

Complications of the endometrioid ovarian cyst appear with late diagnosis and inadequate untimely treatment. These complications include:

• cyst rupture;
  
• peritonitis;
  
• intraperitoneal bleeding;
  
• torsion cyst;
  
• complications;
  
• patient's asthenia and some others.

Diagnosis of the endometrioid ovarian cyst

Diagnosis of the ovarian cyst of the endometrioid nature is based on the result of the following additional investigation methods:

• vaginal examination;
  
• ultrasound examination of pelvic organs, which is especially informative on the eve of menstruation, when there is an increase in the size of the cyst;
  
• determination of the level of oncologic markers in the blood;
  
• laparoscopy;
  
• Irrigoscopy and Irrigography;
  
• computed tomography.

Treatment of endometrioid ovarian cyst

Treatment of the disease necessarily implies surgical removal of the cyst, since conservative therapy is unsuccessful.

The operation to remove the endometrioid ovarian cyst can be performed in two main ways: the

• is laparoscopic, which has several advantages;
  
• laparotomic - a cut is made on the anterior abdominal wall.

Laparoscopy performed for a therapeutic purpose, favorably differs from laparotomy, namely:

• good cosmetic result;
  
• minimal risk of bleeding during and after surgery;
  
• almost complete absence of infectious complications;
  
• short rehabilitation period;
  
• is a quick return to the usual way of life.

In some cases, when the endometrioid cyst is large, the first etap shows hormonal therapy. With its help, it is possible to reduce the size of the cyst, which facilitates the technical operation and reduces the likelihood of relapse.

The main groups of drugs for hormonal treatment are the following:

• combined oral contraceptives;
  
• pure gestagens;
  
• antiestrogens;
  
• analogues of gonadotropins;
  
• antigonadotropins.

The duration of administration of drugs of these groups on the eve of the operation is three months. In addition, treatment can be continued in the postoperative period, which reduces the risk of relapse, especially if an endometrioid cyst has ruptured during the operation.

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