What is the difference between an ovarian cyst and a serous cyst? Serous cyst: symptoms, causes and treatment. Therapeutic tactics in the detection of a serous neoplasm

2015-12-12 21:59:52

Lily asks:

3.4 years ago, 1 birth, caesarean section, at 33 weeks, the decision was made at the consultation, because the fetus did not develop, maybe due to airborne herpes. As a result, the girl is 1.1 kg 39 cm, healthy. In February, a cyst was found on the right ovary 3 cm, they said follicular. Then pregnancy, April 26, 2015 miscarriage for a period of 5-6 weeks without cleaning, the cyst is also follicular by ultrasound, the tests are good, then the tests for infections are also good. after another 2 ultrasound, the size of the cyst is also 3 cm. Langidaza treatment 10 injections, suppositories, herbs. January 34 bullet. I can’t have the operation, there is no one to leave the child with. Is it possible to get pregnant and remove the cyst along with childbirth, because the first one was a caesarean? The answer is very important.

Responsible Palyga Igor Evgenievich:

Hello Lily! Cysts are monitored for 3 months and then removed. In your case, the cyst is clearly not follicular, if after the next menstruation it did not disappear. Tactics should be as follows - laparoscopy with removal of the cyst, hormone therapy for several months to correct the hormonal background, and then pregnancy planning.

2015-02-17 10:04:41

Ludmila asks:

Good afternoon!
October 2014 On ultrasound, they found a 40mm ovarian cyst, on the first ultrasound showed that the cyst was on a leg. I went to the local gynecologist, removed the IUD, drank anti-inflammatory drugs and after 2 months did a second ultrasound in another place, here it showed that the cyst was 40 mm serous. About myself, 36 years old, giving birth, a child of 13 years old, there are no complaints about the violation of the MC.
Advise a good specialist for further treatment.
Thank you in advance.

Responsible Sitenok Alena Ivanovna:

Good afternoon, Lyudmila. It is forbidden by the rules of our portal to offer the services of a specific doctor or your own. Your cyst definitely needs treatment, not anti-inflammatory.

2014-05-05 20:13:43

Julia K. asks:

Hello! !My name is Yulia. I am 27 years old. right ovary.
Diagnosis: Bilateral endometriotic ovarian cysts. Endometriosis of the pelvic peritoneum.
During the operation, up to 50 ml of serous-hemorrhagic fluid was found in the abdominal cavity. The uterus is of normal size. The right ovary with an endometrioid cyst 1*1*0.8 cm. The left ovary with an endometrioid cyst 1.5*1*1 cm. Left, right fallopian tubes are convoluted, fimbriae are visualized, funnels are open. Intraoperative chromopertubation was performed, the dye exit was bilateral. On the peritoneum of the anterior and posterior Douglas, in the area of ​​the sacro-uterine ligaments, the peritoneum of the bladder, multiple endometrioid foci were determined.
After the operation, a gonadotropic hormone agonist (Decapeptyl Depot) was used for 3 months.
A week ago I did a vaginal ultrasound M-ECHO homogeneous. The thickness is 8.0 mm. The right ovary is usually located. Dominant formations Rd1-16mm ECHO (=) (dominant follicle) Number of antral follicles 12-6mm. Type Proliferative 1 (early/late) The left ovary is usually located. The number of antral follicles is 12-6 mm.
Today is already the 64th day after the last injection of Decapeptyl Depo. The doctor said that in a couple of days ovulation will begin and about 2 weeks later menstruation should go. On the first day of menstruation, he prescribed Mercilon hormonal tablets. But my state of health has not been very good for the last two weeks. I have already left the IC. I haven't had hot flashes for a week now. There was a runny nose (not strong), the sense of smell disappeared, I don’t feel the taste (it appears then disappears again), there are days that during the day I feel sick so that I don’t eat or drink, weakness, sleep is gone, pulls the lower back, the stomach sometimes tingles in the side too. I’m already thinking if it could be pregnancy?) Until April 1, there was very often unprotected intercourse. Now my husband has been on a business trip for a month already. I hope I haven’t missed anything)))
I look forward to an answer.
Thank you in advance)

Responsible Korchinskaya Ivanna Ivanovna:

To exclude the fact of pregnancy, test at home in the morning urine. There may be similar delays after decapeptyl injections. Mercilon You were appointed for how long? I would advise planning a pregnancy after the restoration of your own hormonal levels and the passage of menstruation. If pregnancy does not occur within 6 months. open sexual life, then I would advise planning IVF so as not to waste time.

2011-05-26 11:46:42

Gennady asks:

Zhenya 43 years old. Diagnosis of Cr right breast pT2pN1pN0, after RME + OE + 1k APCT class. gr. Stage 2 hormone positive ER +++ H=220 positive (H=50 to 300) PgR++ H=150 positive (H=50 to 300) HER-2/Neu - 0 negative 0
She completed 1 course according to the AS scheme, there will be 3 more. Further, LT is recommended for the l / outflow zones and Fareston Hormone Therapy. Histology results:
Lobular-ductal carcinoma of the breast with infiltrative growth, tubular-solid structure. In the studied l / s MTS in
1 out of 17 l/knots. Small serous cysts in the ovaries. Decipher the histology please. Is Radiation Therapy Needed After PCT? Its necessity is questionable. Fareston alone may suffice for further treatment.

Responsible Bondaruk Olga Sergeevna:

2011-03-19 20:16:06

Tatyana asks:

Hello! I have such a situation. The gestation period is 22 weeks. At 14 weeks, ultrasound showed signs of a corpus luteum cyst in the right ovary measuring 50 mm. On the next.Uzi at 18 weeks - the same doctor made a conclusion - Signs of hydrosalpinx on the right. My gynecologist said there was nothing to worry about. From February 23 to March 1, she had a cold with a temperature of 38-39. There was a cough. On March 2, in the evening, when coughing, there was an acute pain in the lower right (she took a noshpu). ​​On March 3, the pain did not go away, she went to the hospital. On ultrasound (19.6 weeks), a conclusion was made: Behind the uterus, somewhat to the right, a two-chamber anechoic formation 81 * 51 * 54, homogeneous, with clear, even contours, the wall thickness of the formation is 0.9 mm. On the periphery of education point hyperechoic inclusions. Free fluid in the retrouterine space is determined in small quantities. Left ovary 25*13*18. The tissue of the right one is not visualized separately. The size of the fetus corresponds to 20 weeks of pregnancy. Given the lack of visualization of the right ovary, more evidence for an ovarian cyst on the right (serous cystadenoma cannot be ruled out). Tumor malnutrition? adhesive process of the small pelvis.) After the ultrasound, they immediately put me in the hospital for preservation, because risk of miscarriage. Treatment was prescribed and the pain was relieved. at 21 weeks, they did an ultrasound again, showed that the cyst had grown to 83mm. After that, she took an analysis to determine the ovarian cancer antigen, everything is in order. She lay from March 3-18, was discharged. The cough did not completely go away. When I cough, I feel a cyst. At discharge, the doctors suggested thinking about an operation - removal of the tumor, because. the cyst grows and it is possible that it will develop into a malignant one. Either torsion of the cyst is possible, or oxygen is blocked for the child. and the cyst and uterus will grow. At the same time, doctors cannot say with certainty that a miscarriage will not occur during the operation. I myself was given a choice - either a planned operation to remove the tumor and the possibility of maintaining a pregnancy of 50%, or to wait for acute pain and an urgent operation. The fact is that I have a high degree of myopia (laser restoration in 2004) and in any case, a caesarean section. I ask for your help, tell me please, I'm afraid to risk a child and have an operation. It remains to be hoped that while the baby is growing up, there will be no acute pain. The doctor who treated me and the deputy head physician are of the same opinion. But the head doctor insists on the danger and advises to do the operation as soon as possible. Please advise how to proceed? I can't risk a child, maybe. I am 29 years old, and a long-awaited pregnancy after a miscarriage (24 years old) and a frozen pregnancy at 27 years old. Thank you, I hope for an answer.

Responsible Chubaty Andrey Ivanovich:

Good afternoon. In order to answer you, you need to see and examine you. And you demand from me to judge the chief physician and the chief medical officer ...

2010-05-06 22:23:15

Olga asks:

Good afternoon! I am in despair. I am 37.9 years old. I have been trying to get pregnant for 2 years, but there are constant complications. In June 2009, I was operated on for an ovarian cyst and serous myomatous nodes (medical treatment did not give any results). Were protected for 4 months. Pregnancy was established on February 1, 2010. At the end of February, there was a threat of miscarriage. She was treated in a hospital (actovegin, duphaston, normal immunoglobulin, vitamin complex) for 12 weeks, a thickening of the collar space, cervical hygroma of the fetus, non-immune dropsy was found, although gynecological blood tests, and heredity were normal. They appointed a puncture of the chorion, but did not have time to do it - the child froze at 14 weeks. On April 1, they did a curettage. The cause of the fading was not established, they say it is most likely genetic. On April 9, the ultrasound showed: Visualization is satisfactory, The position of the uterus is central, the size of the uterus is 57-31-46 mm, the contours are even, the echostructure of the myometrium is homogeneous, the endometrium is not located, The uterine cavity is expanded to 4.5 mm for account of liquid contents and clots. The doctor-"uzist" advised to do another ultrasound after menstruation. did an ultrasound: the uterus in retroversio. The uterus is spherical, dimensions 49-32-34 mm, the contours are even, the echostructure is homogeneous, a moderate decrease in echogenicity, unevenly expressed in different parts of the uterine body, the endometrium is not located, the mucosa of increased echogenicity with small hyperechoic inclusions in the parietal sections, the uterine cavity is expanded to 4 mm due to liquid content and hyperechoic formation along the posterior wall 7-2.5 mm conclusion: post-traumatic endometritis, endometrial polyposis. take Lindenet-20 (prescribed by the operating doctor, although the local doctor strongly recommended condom protection and taking Duphaston, the third doctor agrees with the surgeon) The doctors' opinions differed. , but after the last ultrasound, I have not yet consulted a gyna cologists. I don’t understand why the uterus has changed-retroversio. There was no potology before. What are the threats of polyps? Will it be necessary to do scraping again? , experienced, qualified), then whom to trust? Maybe motherhood is not my destiny? Or still start somewhere again.

Responsible Gordeychik Andrey Evgenyevich:

Good afternoon, Olga!
If the uterus is in retroflexion, this is not a pathology, but a physiological feature of your body. Endometrial polyps can lead to infertility, therefore, require removal with a hysteroscope. Concerning protection, my opinion coincides with the recommendation of your surgeon, since the use of Lindenet-20 does not require the use of condoms. I think you should not despair about your motherhood. Start from the beginning. Consult an experienced gynecologist.

2009-09-08 18:00:43

Ludmila asks:

I am 41 years old. I live in Kiev. Since 2005. problems began in gynecology. According to ultrasound, the diagnosis was nodular fibromyoma 5-6 weeks, two-sided adnexitis until 2009. 09/04/09 Ultrasound diagnosis - endometrial hyperplasia fibromyoma nodule 9-10 weeks, endometrium 12mm, serous cyst of the left ovary, ultrasound in another clinic: fibromyoma nodule 6-7 weeks, follicle on the left ovary, endometrium 7-8mm. do the third ultrasound? I still have mastopathy. I'm not mistaken?) what is better to do. Treatment in Kiev clinics (Kyiv Regional Hospital.) Thank you very much!

A serous ovarian cyst is a bubble with liquid contents, which is formed as a result of pathological growth of the tissues of the organ. Education refers to true tumors () and is characterized by a tendency to malignancy.

Causes of the disease

In their structure, serous cysts are benign epithelial tumors (cystadenomas), enclosed in smooth or papillary (papillary) capsules and filled with a clear yellowish liquid, resembling blood lymph in composition and appearance.

Formations that have smooth outer and inner surfaces of the shell are called simple or smooth-walled. They have a benign course, almost never become malignant and have mostly unilateral localization (cysts of the right ovary or left).

The surfaces of papillary cysts are covered with growths resembling warts or papillae. Such formations can degenerate into cancerous tumors and are divided into the following types:

• inverting (with papillae inside);
• everting (with papillae outside);
• mixed.

Everlasting forms of serous cystadenomas are considered the most dangerous.

The defeat of the ovaries in papillary cystadenomas is mainly bilateral (cysts of the left ovary and right). In this case, papillary growths can spread to the adjacent abdominal wall, which is accompanied by early clinical manifestations and ascites.

The reasons for the development of pathology are still poorly understood. Among the factors provoking the development of pathology include:

• inflammatory processes affecting the genitourinary system;
• hormonal disorders;
• infertility;
• habitual miscarriage;
• numerous abortions;
• untimely onset of menstruation and menopause;
• adverse environmental impact;
• stress, psycho-emotional overload.

In addition, it is believed that the development of cystadenomas is preceded by the prolonged existence of untreated functional cysts, for example, follicular ones.

The disease affects women of all age groups, but most often the pathology is diagnosed in those people whose age has reached 40-45 years.

Characteristic features

In the initial stages, the disease is asymptomatic. In this case, cysts can be detected during a gynecological examination, ultrasound, and operations on the abdominal organs.

As the pathology progresses and the formations increase in size, women may experience:

Menstrual irregularities and obvious signs of inflammatory processes in serous cystic formations are rare.

Diagnostics

For the primary detection of serous cysts, a gynecological examination is used to determine the size of the formation, its localization, consistency and mobility. Then additional diagnostics are carried out, allowing:

• clarify the data obtained during the inspection;
• exclude malignancy of the tumor;
• study the structure of the capsule and its contents.

For this purpose, women are prescribed:

1. ultrasound. It is done both through the abdominal wall and transvaginally. Allows you to accurately determine the parameters of the neoplasm, to identify ascites.
2. Blood test for tumor markers. The presence of deviations in the results indicates the degeneration of the tumor.
3. CT and MRI. They are used as an addition to ultrasound and provide an opportunity to clarify and confirm the diagnosis.

In the early stages, serous cystadenomas give an ultrasound picture similar to functional ovarian cysts. In such cases, the size of the neoplasms is monitored and an attempt is made to conservative therapy. With the ineffectiveness of treatment and the constancy of the size of the tumor in different phases of the menstrual cycle, a diagnosis of a serous cyst is made.

Therapy

Due to the fact that serous cysts have the ability to malignant degeneration, their treatment is performed exclusively by surgery. The volume of surgical intervention, as well as access to neoplasms are selected depending on:

• on the size and degree of malignancy of the tumor;
• from the age of the sick;
• the presence or absence of comorbidities.

Women can be carried out the following:

• cystectomy - removal of a cyst within healthy ovarian tissue;
• ovariectomy - removal of the neoplasm together with the ovary;
• adnexectomy - removal of uterine appendages;
• removal of the uterus with appendages.

Removal of benign formations with a small size is carried out mainly by laparoscopy.

Drug therapy is used as an auxiliary. In the presence of inflammatory processes, appropriate drugs are prescribed, with signs of infection - antibiotics and disinfectants, with pain - painkillers and antispasmodics, with blood loss and shock - plasma-substituting and anti-shock agents.

The use of traditional medicine in the treatment of serous cysts does not give a positive result. At best, the formation will stop growing, at worst, complications develop.

Food should be low in calories. You should eat food with a high content of vegetable fiber, vitamins A, group B. Single-component diets are contraindicated in the treatment.

Complications

Untimely or inadequate treatment of serous cysts can lead to the development of complications. For example, women may experience:

• , hemorrhage, necrosis;
• rupture of education, bleeding;
• compression of surrounding organs;
• tumor infection (rare)
• malignancy (rare).

Cyst pedicle torsion, necrosis or hemorrhage develops due to excessive physical exertion or prolonged exposure to the sun. Complications are accompanied by sudden pain that is not relieved by analgesic drugs, intestinal upset and other signs of an acute abdomen.

And bleeding can lead to a state of shock. Squeezing of surrounding organs can result in infertility, acute intestinal obstruction, acute urinary retention.

Infection of the tumor is carried out by lymphogenous or hematogenous route. The complication is accompanied by a general deterioration in well-being, an increase in body temperature, and symptoms of intoxication.

Degeneration into a malignant tumor requires immediate treatment.

Prevention measures

Measures to prevent the development of cystic serous formations include:

• regular preventive examinations at the gynecologist;
• periodic ultrasound of the pelvic organs;
• timely detection and treatment of diseases of the genitourinary system, which are inflammatory and infectious;
• regular blood tests for the presence of tumor markers (especially if close relatives had a history of cancer).

If you suspect a serous cyst, you should immediately consult a doctor.

Women of all ages are susceptible to its appearance, especially during periods of hormonal surges - pregnancy, lactation and menopause.

Despite the fact that the cyst is a benign tumor, it has the ability to degenerate into a malignant form. Therefore, the neoplasm requires close attention from physicians.

In this article, you will learn about a serous ovarian cyst - what it is, why it appears, how to treat it, and so on.

Essence of pathology

A serous cyst (cystadenoma) is the most common benign tumor of the ovary. In appearance, it resembles a sac that is filled with fluid (serosa).

The shell of the cyst is quite dense and inelastic. That is why the neoplasm is considered an epithelial tumor.

Cystadenoma rarely leads to cancer, but such cases have occurred.

The bubble inside the ovary can be completely - from a couple of millimeters to several centimeters in diameter. It all depends on the histological structure of the cyst, the number of its chambers and internal contents.

A serous cyst may have a stalk on which it is suspended and connected to the fallopian tube. In this case, it grows in the side of the abdominal cavity. It can be single-chamber, or.

Cystadenoma can be located both inside and inside, and in some cases - simultaneously in two.

More than half of the patients go to the doctor only after the tumor reaches 5 cm, and all because in the early stages the serous cyst does not bother its owner.

A serous cyst initially forms in one of the ovaries. The second ovary retains its function of producing eggs, so it is quite possible.

As a rule, the tumor is a single-chamber or multi-chamber neoplasm. When the inflammatory process is attached, the smooth shiny surface of the cystoma becomes dull and covered with adhesions.

Cystadenoma can eventually appear in another, healthy ovary, this phenomenon is called polycystic.

Due to its rather large size, ovarian cystadenoma is dangerous only in terms of its associated complications. It is highly likely that after a few weeks the serous cyst will decrease or. But in any case, a woman with such a diagnosis must be under the supervision of a gynecologist, take hormonal pills and undergo an ultrasound scan once a quarter. If there is a tendency for the growth of the neoplasm, surgical intervention is indicated.

Associated symptoms

At the initial stage, the pathology does not manifest itself in any way. The tumor is small and can only be identified by ultrasound.

But over time, the cyst begins to grow, and it can be recognized by :

• observed (critical days are painful, and the amount of blood increases significantly, or vice versa, decreases);
• disturb over the pubis, in the groin (the nature of the pain is aching cramping);
• there is irritability, nervousness;
• sleep is disturbed, loss of strength, apathy worries;
• increased urination;
• body temperature may rise;
• in advanced cases, an asymmetric increase in the abdomen is clearly observed.

If a woman is concerned about any of the above symptoms, she should immediately consult a gynecologist for advice.

Causes

The source of the cyst is the outer serous membranes, which begin the process of penetration into the ovarian tissue. But there is no unambiguous opinion on the account of why this happens.

There are several reasons that cause the formation of cystadenoma:

• hormonal disbalance;
• hereditary factor;
• diseases of the endocrine system (enlargement of the thyroid gland);
• inflammatory diseases of the fallopian tubes;
• sexually transmitted diseases;
• constant overheating of the inguinal region and lower abdomen (hot baths, solarium, prolonged exposure to the sun);
• improper use of hormonal contraceptives;
• abortion and pelvic surgery.

Types of formations

There are three types of cystadenoma:

• paratubal (localized on the fallopian tubes);
• simple;
• papillary (located inside the ovaries).

A paratubal cyst is a capsule up to 2 cm in diameter with a serous fluid inside. Not capable of being malignant. For a long time it does not cause any discomfort, and only with a large diameter does a woman begin to feel cramping pain.

The papillary cyst consists of several sections, its inner shell consists of a cylindrical or cubic epithelium. With rapid growth, this type of neoplasm is recommended for removal. It is formed due to disturbances in the work of the endocrine system. It is found in women under 40 years of age. Symptoms are frequent urination, pain in the lower back and lower abdomen.

A simple cyst in most cases affects the right ovary. It is single-chamber, inside a yellowish liquid. The size varies from 4 to 15 cm. It occurs in women during menopause, i.e. after 50 years.

Diagnostic measures

To confirm the diagnosis of "serous cyst", you must pass.

It includes:

• examination by an obstetrician-gynecologist(in the area of ​​the uterine appendages, a mobile and elastic neoplasm with a smooth surface is detected);
• Ultrasound of the pelvic organs(helps to detect a tumor from 3 cm with a dense smooth capsule, a transvaginal probe should be used to find a smaller cyst);
• Magnetic resonance imaging(a three-dimensional model of cystoadenoma is created);
• color dopplerography(helps to distinguish a malignant tumor from a benign one);
• blood test(allows to exclude the development of oncology).

The photo below shows what a cyst looks like on an ultrasound.

Surgical removal

A serous ovarian cyst is removed with :

• wedge-shaped resection (excised triangular area of ​​damaged tissue);
• adnexectomy (removal of appendages - fallopian tubes and ovaries);
• cystectomy (preserve healthy tissue by excising only the capsule);
• (removal of the cyst through a small incision; reduces the risk of complications in the postoperative period, eliminates the adhesive process).

Conservative treatment

Individually selected allow you to normalize the hormonal background and stop the growth of the tumor.

At an early stage of the disease, when the cystadenoma has not reached an impressive size, treatment is carried out with medications.

They include:

• vitamins;
• hormonal pills;
• anti-inflammatory drugs;
• absorbable substances.

Medicines are prescribed to women of childbearing age. This is necessary to maintain the ability to become pregnant and give birth to a child.

The most common hormonal pills are:

• Diana-35;
• Logest;
• Three-regol.

Dufaston or Utrozhestan is also used - these drugs are analogues of progesterone, which facilitates the work of the corpus luteum. Exactly is the most effective medicine in the treatment of serous ovarian cysts, because it has virtually no side effects.

CAREFULLY!

The optimal dosage of the drug is selected exclusively by the doctor, based on the results of examinations and tests. Self-medication is unacceptable!

A complex of physiotherapeutic procedures is also prescribed, for example, mud therapy or magnetotherapy.

There are also relief of pain and inflammation in the presence of cystadenoma.

Here are some of them:

• saline solution. It is necessary to stir 1 tbsp. salt in a glass of hot water, let the solution cool. Soak a towel in it and apply to the lower abdomen for 15 minutes. The action of the compress is based on the property of salt to draw out liquid;
• infusion of plants and herbs. You should mix equal amounts of sweet clover, coltsfoot and chamomile, pour them with cold water, bring to a boil and leave for 12 hours, then strain and drink 0.5 cups before each meal.

Impact on pregnancy

During pregnancy, the hormone prolactin is actively produced, which can prevent the growth of a serous cyst.

Pregnant women are prescribed hormone therapy to avoid ovarian torsion.

A cystadenoma up to three centimeters in size will not interfere with carrying a child. If the tumor is larger than this diameter, then for up to 12 weeks there is a risk of spontaneous abortion.

This is due to the raising of the uterus into the abdominal cavity - the leg of the cyst is twisted and a miscarriage occurs. In such cases, urgent surgical intervention is required.(the cavity of the cyst is filled with a mucus-like liquid - mucin, the surface of the tumor is rough);

Symptoms of a ruptured cyst are:

• increase in body temperature;
• sharp pain in the lower abdomen;
• nausea, vomiting;
• headache, malaise, weakness;
• pale skin;
• loss of consciousness;
• bleeding from the vagina.

If the above symptoms are observed, you need to urgently call an ambulance. An urgent operation is required.

Conclusion

Timely detection of a serous cyst is the first step to recovery.

If surgical intervention is necessary, the prognosis of the disease is quite favorable. The tumor rarely recurs and becomes malignant.

Even during pregnancy, cystadenoma is not a sentence. Modern hormonal preparations are able to restrain the growth of the cyst so that the expectant mother can successfully carry and give birth to her baby.

Useful video

The video explains what an ovarian cyst is:

In contact with

A serous ovarian cyst (cilioepithelial or simple cystadenoma, serous cystoma) is a true benign neoplasm originating from the epithelium of the ovary.

The disease most often occurs in women aged 30 to 50 years. The tumor usually reaches a size of 5–15 cm, but in some cases its diameter can be much larger (up to 35 cm).

In the structure of all ovarian tumors, simple cystadenomas account for 11%. The pathological process is one-sided, that is, the formation is localized either on the right or on the left ovary.

In 28% of patients, cystadenoma is a multi-chamber formation, and in the rest it is single-chamber.

Serous ovarian cyst - what is it?

A serous cystoma usually forms in one ovary. It is a smooth-walled (single-chamber or multi-chamber) formation, the inner walls of which are lined with ciliated cylindrical or cubic single-layer epithelium. Epithelial cells secrete a serous fluid (clear, light yellow). The gradual accumulation of this fluid leads to stretching of the capsule of the tumor-like formation and its growth. At the same time, it begins to compress the nerve fibers, which becomes the cause of the pain syndrome.

When a cystadenoma becomes infected, its surface becomes dull, and the contents become cloudy. If the inflammatory process continues to spread, then adhesions will begin to form over time.

Causes

Currently, the exact causes of cystadenomas are unknown. It is assumed that long-term functional ovarian cysts (yellow body, follicular) lead to their occurrence. Over time, their cavity is filled with serous fluid and increases in size.

Predisposing factors for the occurrence of a serous cyst are:

• hormonal disorders;
• severe somatic diseases;
• severe stress;
• severe physical overload;
• long-term adherence to extreme low-calorie diets;
• prolonged sexual abstinence;
• earlier (up to 12-14 years) puberty;
• specific and non-specific infectious and inflammatory diseases of the female genital organs;
• surgical interventions on the pelvic organs (uterus, ovaries, bladder, large intestine);
• hereditary predisposition.

Kinds

Depending on the structural features of the internal walls of the cystic formation, two types of cystadenomas are distinguished:

1. Smooth-walled serous cyst. Almost never degenerates into a malignant tumor.
2. Rough papillary (papillary) serous cyst. On the inner walls there are dense growths of a whitish color on a wide stalk. Malignancy, i.e., malignancy is observed in 50% of cases.

Symptoms

With smooth-walled small serous cystomas, the diameter of which does not exceed 3-4 cm, there are no clinical symptoms. Usually, such tumors are discovered incidentally during an ultrasound of the pelvic organs or a gynecological examination.

As the formation grows, the patient shows signs of the disease:

Complications

The most common complications of a serous ovarian cyst are:

• malignancy (with the papillary form of the disease);
• torsion of the cyst leg;
• capsule rupture.

With torsion of the leg or rupture of the capsule, the patient develops a symptom complex of an acute abdomen, which is characterized by the following symptoms:

• severe pain in the abdomen;
• nausea, repeated vomiting;
• increase in body temperature;
• severe weakness;
• pallor of the skin;
• delay in passing gases and stools.

Diagnostics

To make a correct diagnosis, all patients with suspected cystadenoma are prescribed an examination, which includes:

• bimanual gynecological examination;
• Ultrasound of the pelvic organs;
• computer or magnetic resonance imaging;
• blood test for tumor markers (CA 72-4, CA 19-9, CA-125);
• color dopplerography.

Differential diagnosis is carried out with the following diseases:

• functional ovarian formations;
• tubovarial abscess;
• ectopic pregnancy;
• appendicitis;
• diverticulosis of the sigmoid colon;
• malformations of the genitourinary system;
• tumors of the pelvic organs.

Treatment

The main treatment for cystadenoma is surgical removal. There are no reliable data on the effectiveness of conservative therapy (medication, physiotherapy) and alternative methods.

The choice of the method of surgery in each case is carried out by the attending physician, taking into account the size of the tumor, the presence or planning of pregnancy in the future, the age of the woman, the presence or absence of concomitant diseases. Patients of reproductive age usually undergo cystectomy (exfoliation of the cyst walls with subsequent closure of its bed) or resection of the ovary with the maximum possible preservation of unchanged tissue. For perimenopausal women, doctors usually recommend radical surgery that involves the complete removal of the affected ovary (oophorectomy). If a malignant degeneration of a cystic formation is suspected, bilateral removal of the ovaries and uterine body (hysterectomy with bilateral oophorectomy) is performed.

Attention! Photo of shocking content.
Click to view.

The indications for elective surgery are:

• serous ovarian cystoma with a diameter of more than 6 cm;
• preservation of education of any size over 4-6 menstrual cycles.

Emergency surgery is indicated for all patients with suspected torsion of the leg or rupture of the capsule of the serous cystoma.

Elective surgeries are currently most often performed by the laparoscopic method, and emergency surgeries are performed by laparotomy (with a traditional dissection of the anterior abdominal wall).

Timely surgical treatment of cystadenoma helps prevent the occurrence of ovarian cancer and ensures a high quality of life for patients.

Forecast and prevention

With timely diagnosis and treatment, the prognosis is generally favorable. After undergoing organ-preserving surgery, women of childbearing age are recommended to protect themselves from pregnancy for at least 2-3 months.

Prevention of the formation of serous adenomas includes:

• early detection and treatment of inflammatory diseases of the female genital area;
• refusal of promiscuous sexual life;
• observance of the regime of alternation of work and rest, avoidance of physical and psycho-emotional overload;
• proper rational nutrition;
• maintaining an active lifestyle.

According to American gynecologists, in the prevention of the occurrence of benign serous cysts, the use of monophasic oral combined contraceptives by women of reproductive age is of no small importance.

Video

We offer you to watch a video on the topic of the article.

Postmenopause begins after the end of menstruation. At what age it occurs depends on the characteristics of the woman's body. For some, it sometimes occurs at the age of 40, and sometimes even after 60. The average age fluctuates around 50. During this period, a variety of diseases can develop in the body of a woman, including cysts of various types. All points must be considered in detail.

What is menopause

Postmenopause is a natural process that is caused by the decline and then cessation of ovarian production of estrogen with progesterone. As a result, the maturation of eggs stops, the uterus atrophies.

In the first years after the onset of postmenopause, women may experience sleep disturbances, emotional outbursts, and many complications.

In this period, the release of estradiol, the main female hormone, also stops. The uterus is reduced in size due to myometric atrophy. This happens especially rapidly during the first five years.

What diseases can develop

There is no single answer to this question. But most often there is increased pressure associated with hormonal changes. In the absence of hormonal type protection, the development of atherosclerosis is accelerated. And this entails coronary heart disease, the development of a stroke, leads to a heart attack, and other cardiac pathologies. After the onset of postmenopause, the frequency of the disease increases.

Nearly half of women who go through menopause are at risk of developing osteoporosis due to calcium loss. Therefore, the risk of fractures during a fall increases.

Often, the risk of malignant tumors of the cervix, itself and the ovaries, as well as intrauterine bleeding, increases. Among the diseases that develop during postmenopause, ovarian cysts are common.

Serous cyst

This pathology occurs in more than 70% of women suffering from similar diseases.

Such a cyst is a cavity filled with a clear fluid, which is called serous. It is distinguished from other formations by the presence of a dense capsule.

Its features are:

• clarity of contours;
• low-elastic dense shell, formed from epithelial tissues;
• the cyst capsule often forms 1 chamber and is formed on one side;
• the size can increase up to 150 mm;
• the likelihood of degeneration into a cancerous tumor is very high.

The risk group, as a rule, includes the fairer sex, who have a protracted menopause. Normally, this period lasts two to three years. After that, menstruation stops.

Types of ovarian cysts

Gynecologists distinguish several types of serous cysts:

1. Simple, the walls of which are lined with epithelium, similar in appearance to the mucous cells of the uterine tubes. Appears usually on one side. It consists of one chamber, but there are also cavities consisting of several chambers. The cyst is smooth. This means that there are no growths inside it. It increases very slowly, but can grow up to 25 cm or more. But it never degenerates into a cancerous growth.
2. Papillary refers to coarse papillary cystadenomas. It represents the next stage of development simple. The papillae begin to develop after several years of cyst formation. Inside on the walls there are dense papillae on wide legs. In half of the cases, such a cyst degenerates into a malignant one, giving metastases.
3. Borderline papillary has signs of a benign or malignant formation. The walls are lined with many dense papillae. It does not grow, but becomes malignant in half the cases.
4. A mucinous cyst is a cavity lined with glandular epithelium. Always multicamera. Often grows rapidly (up to about 35 cm). The content of the cyst is mucus. It is very rich in peptides.

Symptoms of pathology

To treat a cyst in a timely manner, you should know how it manifests itself. Among the main symptoms:

1. Pain in the lower abdomen. But it's not the cyst itself that hurts. Pulling soreness occurs when its capsule is stretched and an increase in it to sizes exceeding 5 cm in length is observed.
2. Increased pain signals the emergence of complications. Such complications include: suppuration of the cyst, rupture of the capsule, twisting of the leg of the leg.
3. Increased urination, and sometimes incontinence. This is due to compression of the bladder by a cystic tumor.
4. Constipation that occurs in cases of intestinal clamping.
5. The abdomen increases, but this is observed with the development of a giant cyst.

If the size of the cyst is small, for example, their diameter is not more than 3 cm, there are practically no symptoms of its presence. It is only detected by ultrasound.

Serous ovarian cysts are benign pathologies of the appendages. In another way, the pathology is called cystadenoma. This cyst must be very carefully examined, because under its guise, ovarian cancer develops.

This cystadenoma can proceed for a long time without any symptoms and can grow to a large size. A progressive cyst is not amenable to conservative therapy.

In the fairer sex, who have not reached the age of forty, cystadenoma often disguises itself as a follicular cyst, and sometimes as a luteal cyst.

During ultrasound, it is not always possible to accurately determine the type of tumor. A serous cyst is accidentally discovered by a histologist, and is accurately diagnosed only after surgery.

A cystic cavity that has degenerated into a cancerous tumor gives the following symptoms:

• an increase in the abdomen due to the accumulation of fluid;
• a sharp decrease in body weight;
• constant feeling of weakness;
• periodic depression;
• slight rise in temperature.

Reasons for development

The causes of serous ovarian cavities have not been established. But this is often influenced by the following factors:

• imbalance of sex hormones;
• pathology of the endocrine system;
• inflammation in the pelvic organs;
• abortions in the past;
• operations on the abdominal organs;
• heavy load on the body;
• frequent severe stress;
• improper use of hormonal drugs.

The likelihood of developing a cyst increases when more than two factors are present.

What factors are associated with the appearance of simple cysts

Several medical studies have evaluated factors that may be associated with ovarian cysts in postmenopausal women.

These lesions were more common in patients receiving hormone replacement therapy (either estrogens alone or estrogens plus progestins) and in women with recent menopause.

The scientists conducted a more exhaustive analysis in a large population. They found that ovarian cysts were associated with age (the younger the woman, the higher the risk of cysts), smoking, previous history of surgery for benign gynecological conditions, previous history of benign ovarian cyst, higher education, premature menopause. and first pregnancy before age 20. No association was found with the use of hormone replacement therapy, the use of hormonal contraception, infertility, or a history of infertility.

The researchers also found that previous hysterectomy, age, and weight of the patients were significantly associated with simple cysts.

Signs of complications

Signs of pathology include:

• sudden pain in the lower peritoneum from the side of development;
• causeless nausea, vomiting, which do not bring relief;
• stool and urine disorders;
• increased heart rate;
• lowering the pressure level;
• the appearance of sticky sweat;
• discharge from the genitals in the form of blood clots;
• pallor and possible loss of consciousness.

With the disease, there is a small risk of developing a malignant tumor. In total, in medical practice, according to statistics, 16 malignant neoplasms out of 8,600 simple cysts were registered. According to various sources, the level of malignancy is 0.19%. 0.41% of women diagnosed with a cyst developed ovarian cancer. 0.44% of women without a cyst developed ovarian cancer.

What features are associated with a malignant neoplasm? This is probably the most interesting question. However, the information provided in the available studies on this issue is unfortunately scarce. Based on data from studies that included eight cases of ovarian cancer, the researchers found that most of them (6/8) were stage I.

What to do when signs of a break appear

If the first symptoms appear, you should:

• ensure patient rest in the supine position;
• apply ice on the stomach;
• call an ambulance.

Treatment of capsule rupture or pedicle torsion is surgical only. Immediate hospitalization to the hospital and preparation for emergency surgery is required.

Serous cyst of the right ovary

The main reason for the development of a serous cavity on the ovary on the right is hormonal pathologies. At risk are women with:

• irregular periods;
• early onset of menstruation or too late;
• the onset of menopause;
• pathology of the genital organs;
• development of infertility;
• repeated pregnancy.

Symptoms of the development of right-sided serosa of the ovary:

• soreness and discomfort in the right side in the lower part of the peritoneum;
• violations of the functions of reproduction;
• frequent urination, stool disorders;
• hardening of the mammary glands.

Treatment Methods

A newly appeared cyst can be treated medically. It often dissolves without leaving a trace. The course of treatment also includes vitamins, anti-inflammatory hormonal drugs. You can also use traditional medicine. But this is extremely rare.

Cystadenoma usually does not resolve and is not treated with medication. In 90% of cases, it has to be removed promptly, especially if it has grown to a size of more than 3 cm in diameter.

If studies have shown that the ovarian cyst is benign, doctors tend to preserve as much ovarian tissue as possible, only removing the tumor. The ovary is removed if the formation is already malignant.

The problem of cysts in postmenopausal women remains a controversial issue in gynecological practice. Ovarian cysts are common in asymptomatic postmenopausal women. The risk of malignancy is very low. Histologically, most cysts are serous cystadenomas.

Treatment of adnexal cysts in asymptomatic postmenopausal women is still a controversial issue in gynecological practice among physicians around the world. Although the treatment of these lesions has certainly moved from systematic surgical removal to a more conservative approach, many gynecologists are still reluctant to advise such conservative treatment to their patients, preferring surgery instead.

Types of surgery and methods of surgical intervention

With the surgical removal of cystadenoma, doctors use the following types of operations:

1. The most current type of surgery is laparoscopy. This is the least traumatic, bloodless type of surgery. Recovery after it is fast. The patient leaves the hospital after 3-4 days.
2. Laparotomy, abdominal surgery, like removal of the appendix. It is carried out less frequently, and only if it is necessary to remove a large amount of tissue. Recovery occurs within 10 days. It leaves a scar behind.

The main methods of surgical intervention include:

• cystectomy, removal of a cyst and an ovarian capsule, no matter which one (right or left);
• wedge resection, which is the removal of a wedge of affected tissues;
• oophorectomy, meaning the removal of the cavity along with the gland;
• adnexectomy (removal of a cyst, ovary and appendages.

The method and method of surgical intervention is chosen by the doctor, depending on the results of the examination.

Some problems related to the object of treatment still remain unresolved, such as the size of the lesion, above which surgery should be recommended, the risk of twisting. Research is ongoing in which experts are trying to find out what factors are associated with the appearance of pathology, how long follow-up should be carried out in the case of conservative treatment, what frequency of follow-up should be recommended and, most importantly, if the lesion remains in place, what is the real risk of developing malignant tumor.

conclusions

According to the findings of a number of modern authors, it can be assumed that ovarian cysts are often found in asymptomatic postmenopausal women. The risk of malignancy is very low, and having a simple ovarian cyst does not appear to increase the risk of developing ovarian cancer.

The conclusion is consistent with autopsy findings. Another finding consistent with the autopsy findings is that most of the cysts found were small and that the most common histology is a simple cyst or serous cystadenoma.