Cyst on the ovary

Cyst on the ovary: description

A cyst on the ovary is a type of bladder that can be filled with tissue or fluid. Mostly it is only a few millimeters to centimeters in size and causes no complaints. It is often discovered by chance during an ultrasound check-up. Most commonly, such cysts develop during puberty or menopause, as they can cause severe hormonal fluctuations that favor the growth of a cyst.

Non-congenital ovarian cysts

Most ovarian cysts develop only at the sexually mature age. They are also called “functional” cysts. Since they are mainly formed under the influence of hormones, they usually occur in the context of the female cycle. However, women are particularly likely to be affected during puberty and menopause, as the hormone balance undergoes changes at this time. In some cases, the cysts may also occur as a side effect of hormone therapy or disease-related hormonal imbalances. One differentiates between different functional ovarian cysts: follicular, Yellow-body cysts, chocolate cysts and polycystic ovaries.

Congenital cysts

The gamete cells of the ovaries produce sex and sex hormones (estrogens and progesterone). If a gland duct is blocked or misplaced and the gland fluid backlogs, a cyst is formed. This process takes place during embryonic development. The cyst is then called “innate”. The inborn cysts include, among others, the dermoid cysts and the parvo (creep cysts). They are much rarer than the functional cysts.

Cyst on the ovary: symptoms

Read everything important to the signs of the disease in the post ovarian cyst – symptoms.

Cyst on the ovary: causes and risk factors

While the congenital ovarian cysts are due to misplaced gonadal outlets, the acquired cysts develop under hormonal influence. There are different types of cysts.

Luteal cyst

After ovulation, the tissue of the ovary, in which the egg has grown – the follicle – transforms into the so-called corpus luteum. This produces the sex hormones estrogen and progesterone. If the egg is fertilized, the corpus luteum initially persists during pregnancy. If fertilization of the egg does not occur, the corpus luteum is broken down and with the decrease in hormone concentrations in the blood enters the menstrual bleeding.

However, if the corpus luteum has not degraded properly or even continues to grow, one or more cysts will form. But they can also be caused by bleeding into the corpus luteum. Yellow-body cysts can grow up to eight centimeters in size. In most cases they re-form themselves after some time.

Follicular cyst on the ovary

During the first half of the menstrual cycle, an ovum matures in a follicle of the ovary. The follicle contains fluid to protect the egg. During ovulation the follicle bursts, the egg gets into the fallopian tube, where it can be fertilized. If there is no ovulation, the follicle continues to produce fluid. It forms a follicular cyst. Especially women of childbearing age are affected by these cysts. The follicular cyst persists for about four to eight weeks, continuing to produce hormones. In most cases, it will eventually self-educate.

Chocolate cysts

In the disease “Endometriosis” uterine lining (endometrium) occurs outside the uterus. The Endometriosegewebe reacts like the normal uterine lining to the cyclic hormone fluctuations. It builds up, bleeds and builds up again. However, if the blood is unable to drain properly due to localization on the ovary, blood-filled cysts may form. These cysts are then called “chocolate cysts” because of their thickened, dark-blooded content.

Polycystic ovaries

In polycystic ovaries, many small cysts are found in the ovaries. The numerous cysts arise due to a hormonal imbalance. The cause is an excess of male sex hormones and insulin suspected, which prevents the normal maturation of the follicles. Too much insulin is produced by the body, for example, in case of obesity or a (latent) diabetes type 2 disease, to compensate for the lower sensitivity of the cells to the metabolic hormone. This favors the formation of numerous cysts in the ovaries. The so-called polycystic ovarian syndrome can not only lead to infertility and miscarriage, but also to cardiovascular diseases, diabetes mellitus and mental illness.

dermoid cysts

The so-called dermoid cysts are among the innate cysts. They have formed from the embryonic gonadal tissue and may contain hair, sebum, teeth, cartilage and / or bone tissue. The dermoid cysts grow very slowly and can reach a size of up to 25 centimeters. A malignant degeneration of the cyst in the form of a tumor, however, is found only in about one to two percent of cases.

Parovarialzysten

The Nebeneierstockzysten (parovarial cysts) arise from embryonic tissue and are located next to the actual ovaries. They represent residual tissue from the embryonic developmental period. The parovarial cysts can be variable in size and possibly grow on a stalk.

Cyst on the ovary: examinations and diagnosis

The doctor will first ask for suspected ovarian cysts to the complaints and pre-existing conditions. The following questions can be asked, among others:

• How old are you and at what age did you have your first menstrual period?
• When was the last menstrual period?
• Do you have a regular cycle?
• How many days does the bleeding take?
• Did you take or take hormone supplements?
• How many pregnancies and births have you had so far?
• Do you suffer from endometriosis?
• Are there any diseases of the ovaries in your family?
• Do you have a child wish?

Subsequently, the doctor will examine the patient to palpate any (painful) enlargements of the ovaries. Depending on the cause of the cyst, it can be assessed by laparoscopy and removed at the same time.

Especially in women over the age of 40 years should always be a precise clarification of a cyst on the ovary done to rule out a malignant event.

ultrasound

The ultrasound examination (sonography) allows the visualization of the ovaries. The doctor can assess the ovaries and surrounding structures with a transducer through the abdominal wall or vagina. By means of an ultrasound examination it is already possible in many cases to determine the type of cyst.

laparoscopy

For many cyst forms, it is sufficient if the doctor controls the course by means of ultrasound examinations. However, if suspicion of a dermoid cyst or an endometriosis cyst must be considered by sonography, a laparoscopy is usually performed under general anesthesia. Three small cuts in the abdominal wall guide the camera and surgical instruments into the abdomen. The surgeon can examine the ovaries up close, remove tissue samples from the cyst or remove them completely.

Cyst on the ovary: treatment

The treatment of the ovarian cyst depends on its type and size. Unless it causes discomfort and is not too big, its growth can be observed first. In more than 90 percent of cases, the cyst will return on its own. For this purpose, cysts should be monitored at regular intervals by ultrasound and palpation by the doctor. Sometimes drug therapy with hormones can lead to a regression of the cysts. In rare cases, however, an operative removal is necessary.

drugs

The ovarian function is suppressed by hormone preparations such as birth control pills. In part, the hormones can also inhibit cyst growth or even cause their regression. Endometrial cysts use a substance similar to the male sex hormone for treatment.

Surgical removal of ovarian cysts

Most ovarian cysts are acquired cysts that spontaneously regress and require no surgery. Surgery to assess or remove the cyst is usually not performed until symptoms or complications occur. New cysts after menopause or cysts that last for months must also be surgically evaluated.

For the surgical procedure there are different methods available. The choice of procedure depends on the size of the cyst and its cause. In most cases, a laparoscopy is performed, with which the cyst can be examined and possibly removed. Only with large cysts the belly must be opened by a cut.

Therapy of polycystic ovaries

The treatment of polycystic ovarian syndrome depends on an existing or non-existent desire for children. First and foremost is the reduction of body weight through increased physical activity and a balanced diet. If necessary, the insulin level must be lowered by medication. In addition, hormones can be given that regulate ovarian function and counteract the increased production of male sex hormones.

Cyst on the ovary: disease course and prognosis

In more than 90 percent of cases, an ovarian cyst heals by itself and causes no discomfort or complications. In very rare cases, however, it can rip or twist (stem rotation). This can cause complications.

Tearing an ovarian cyst

Only in rare cases an ovarian cyst ruptures. Sometimes this can happen as part of a palpation, but usually the cyst tears without a special trigger. The process is often painful, for example, in the form of a sudden, stabbing pain, but usually harmless. However, if adjacent vessels also tear, it can lead to bleeding in the abdomen, which usually has to be treated surgically.

Stament rotation of a cyst on the ovary

Large ovarian cysts, such as the endometriosis cysts, in some cases are connected to the ovary via a mobile vascular pedicle. Sudden movement of the body may cause the stem to rotate and stop the blood supply to the cyst or surrounding tissue. Depending on where the cyst is located, a lack of blood supply leads to severe pain, nausea, vomiting and sweating. The tissue surrounding the cyst may die and cause further complications such as peritonitis or septicemia.

In most cases, cysts on the ovary pose no health risk. However, they can very rarely lead to malignant diseases such as ovarian cancer and should therefore be monitored regularly. However, a goal twist is a dangerous and painful complication. It is possible that after the removal of one Cyst on the ovary form new cysts.