Serous cyst of the left. Simple serous ovarian cyst. Ovarian cystoma and its main symptoms

Serous ovarian cyst refers to benign tumor-like formations of the appendages. Another name for the pathology is cystadenoma. Education comes to light mainly at late reproductive age and in a menopause. Cystadenoma requires careful diagnosis, since ovarian cancer can be hidden under the guise of a simple cyst. Often, the final diagnosis can only be made after a morphological study of the formation.

Serous cystadenoma is characterized by a long asymptomatic course and can reach gigantic proportions. Conservative therapy is not amenable. Hormones are not effective, alternative medicine methods are not used - from useful herbs to leeches. Treatment of a serous ovarian cyst is always surgical. Only by getting rid of the neoplasm, you can eliminate the unpleasant symptoms of this pathology and prevent its malignant degeneration.

It is important to know how a serous cyst is formed and what signs it manifests in order to notice the disease in time and begin treatment. Let's take a closer look at how cystadenoma behaves, and find out if the chances of a favorable prognosis for this disease are high.

Classification: types of cystadenomas and their distinguishing features

In gynecology, there are several types of serous ovarian cysts:

• Simple cystadenoma. The wall of this formation is lined with epithelium, similar in structure to the mucous cells of the fallopian tube. Appears predominantly on one side. It usually has only one chamber, but there are also multi-chamber cavities. Smooth-walled - there are no outgrowths inside. The contents are yellowish serous fluid. It grows slowly, can reach a size of 20 cm or more. It is not malignant (that is, it does not degenerate into cancer);
• Papillary (rough papillary) cystadenoma is the next stage in the existence of a simple serous cyst. Papillae appear several years after the formation of the formation. Papillary cystadenoma consists of one or more chambers. Inside on the wall there are single or multiple dense growths - papillae on a wide stalk. In 50% of cases, such a formation becomes malignant and metastasizes. With growth, it leads to the appearance of ascites - the accumulation of fluid in the abdominal cavity (due to the spread of papillae along the peritoneum and a decrease in its absorbent capacity);

It looks like a papillary cystadenoma in the context.

• Borderline papillary cystadenoma has features of both benign and malignant tumors. The wall of the formation is lined with a large number of dense papillae. Not capable of invasive growth. The probability of malignancy is about 50%;
• Mucinous cystadenoma is a cavity lined with glandular epithelium. Almost always multicamera. It is prone to rapid growth and reaches large sizes - up to 35 cm. The contents of the cyst are mucus rich in peptides. The risk of malignancy is 15%.

It's important to know

Parietal cells of cystadenoma are capable of proliferation. Education grows not only due to an increase in the volume of fluid and stretching of the walls, but also as a result of cell division. This factor brings serous formation closer to true ovarian tumors (cystomas) and increases the risk of malignant degeneration.

The serous paratubal cyst deserves special attention. Such a formation is not localized in the ovary, but next to it. Differs in slow growth, has all signs of a simple cystadenoma.

Reasons for the development of pathology

The exact causes of serous ovarian cysts are not known. The influence of the following factors is expected:

• Imbalance of sex hormones. Emphasis is placed on excess estrogen and relative deficiency of progesterone;
• Diseases of the endocrine system (hypothyroidism, obesity, metabolic syndrome, pathology of the adrenal glands);
• Inflammatory diseases of the pelvic organs (acute and chronic salpingo-oophoritis, endometritis);
• Postponed abortions and spontaneous miscarriages;
• Surgical operations on the pelvic and abdominal organs;
• Excessive physical activity;
• Severe psycho-emotional experiences;
• Irrational intake of hormonal drugs.

The likelihood of developing pathology increases when two or more factors from the list are identified.

Sectional giant cystadenoma and its histological structure.

Symptoms of a serous ovarian cyst

Benign ovarian formations make themselves felt by the following symptoms:

• Lower abdominal pain. Depending on the localization of the formation, pain is determined in the projection of the right or left ovary. Unpleasant sensations occur in the lower abdomen and are not associated with the menstrual cycle. With the growth of the cyst, pain can be felt in the perineum, in the lumbar region, and radiate to the sacrum and lower limbs. Neoplasms of gigantic size lead to pain under the ribs on the left or right;
• Violation of urination (increased frequency, urination in small portions, urinary retention). It is noted with the growth of education up to 10 cm or more. Associated with compression of the bladder tumor;
• Chronic constipation occurs with large tumors and is caused by cyst pressure on the intestines. Accompanied by heaviness and bloating, flatulence, nausea;
• An increase in the size of the abdomen in benign tumors is not associated with ascites and is caused by stretching of the soft tissues.

Most of the symptoms of cystadenoma appear due to compression of neighboring organs. The photo shows an x-ray of a giant cystadenoma.

Simple serous cysts are characterized by a long asymptomatic course. A woman may be unaware of the existence of a pathology for many years until the formation begins to grow, pushing the surrounding tissues apart and causing pain. According to statistics, cystadenoma is detected mainly after 40 years, often in menopause. This may be due to both hormonal changes and the specifics of the examination at this age. Often, women go to the doctor only when they have complaints, including those associated with the onset of menopause, and a serous cyst becomes an accidental finding during an ultrasound scan.

In women under 40 years of age, cystadenoma successfully disguises itself as a functional formation of the ovary - a follicular or luteal cyst. With ultrasound, it is far from always possible to clearly determine the type of tumor. The serous cavity becomes an accidental finding of the histologist, and an accurate diagnosis is made only after the operation.

Cystadenoma, degenerated into a malignant tumor, makes itself felt with the following symptoms:

• An increase in the size of the abdomen due to ascites - accumulation of fluid in the abdominal cavity;
• Unreasonable weight loss;
• Unmotivated weakness, fatigue, depression;
• A slight increase in body temperature for a long time.

All these signs occur during malignancy of the tumor and require special attention from the doctor.

Main symptoms of ovarian cancer.

What threatens the presence of cystadenoma

A serous ovarian cyst is dangerous not only for the possibility of malignancy. With a long course, the risk of developing other complications increases:

• Capsule rupture. The cystadenoma is covered with a thick capsule, but even this can rupture during physical exertion or during intimacy. Damage to the cyst wall is accompanied by hemorrhage into the abdominal cavity and poses a threat to the life of a woman;
• Leg twist. A typical complication for tumors connected to the ovary with a thin tourniquet. Full and partial torsion of the cyst stem is possible, together with the appendages or in isolation from them. It threatens with necrosis of ovarian tissues and complete loss of its function.

Torsion of the peduncle of an ovarian cyst can lead to necrosis or suppuration of the formation.

Signs of complications:

• Sudden severe pain on the affected side. The pain begins in the lower abdomen, goes to the gluteal region and descends to the thigh;
• Nausea, vomiting is possible, which does not bring relief;
• Stool disorder - constipation or diarrhea;
• Violation of urination up to complete urinary retention;
• Increased breathing and heart rate;
• Decreased blood pressure;
• pale skin;
• Cold clammy sweat;
• Loss of consciousness;
• Bloody discharge from the genital tract.

When the first symptoms appear, you must:

1. Provide a woman with complete rest in a prone or half-sitting position;
2. Put ice on the lower abdomen;
3. 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.

It looks like a ruptured ovarian cyst with bleeding.

On a note

Complications of a serous cyst are often mistaken for an attack of appendicitis or other intestinal pathology. Diagnosis can sometimes only be made by laparoscopy. For this reason, all women entering the surgical hospital with complaints of abdominal pain must be examined by the gynecologist on duty.

Infection is another dangerous complication of cystadenoma. Purulent inflammation occurs against the background of sexually transmitted infections, or when one's own opportunistic flora is activated. The background for the development of the disease is usually chronic salpingo-oophoritis. Suppuration is accompanied by such symptoms:

• Severe cramping pain in the lower abdomen on the side of the lesion;
• The appearance of nausea and vomiting;
• Delayed stool and urination;
• Increase in body temperature.

Infection of the cyst requires mandatory surgical intervention. Additionally, antibiotics are prescribed to prevent the spread of infection. Without treatment, purulent inflammation threatens with the development of peritonitis and sepsis.

Cyst infection requires a hospital stay and a course of antibiotics.

How can a neoplasm affect pregnancy?

A simple serous cyst up to 3 cm in size does not prevent the conception of a child and cannot be the cause of infertility. Cystadenoma does not affect the hormonal background and does not interfere with ovulation, does not prevent the fertilization of the egg and the implantation of the embryo. Fetal development is uneventful. Childbirth with a serous cyst of small size goes through the natural birth canal.

A cystadenoma larger than 5 cm can cause miscarriage or premature birth. Such an education takes up a lot of space in the pelvic cavity and interferes with the normal development of the fetus. There are cases of successful bearing of a child with large cysts, however, throughout the pregnancy, there is a high risk of complications.

Other problems that occur with simple cystadenomas:

• Growth of a serous cyst. It is not known how pregnancy will affect the development of education. It happens that the cystadenoma begins to grow rapidly and leads to spontaneous miscarriage or premature birth;
• Torsion of the leg of education. During pregnancy, the growing uterus pushes back all the organs of the small pelvis. The ovary also gets, which leads to displacement of the cyst and torsion of its legs. This condition threatens to increase the tone of the uterus and terminate the pregnancy;
• Rupture of the cystadenoma capsule. It occurs mainly against the background of the rapid growth of cysts during pregnancy. Requires emergency surgery. It poses a threat to the life of the woman and the fetus.

Serous cystadenoma up to 3 cm in size does not require treatment. The exception is the conception of a child through IVF. The in vitro fertilization procedure does not always end successfully, and gynecologists try to eliminate all potentially dangerous factors. Before IVF, it is recommended to get rid of the cyst, regardless of its size.

A cystadenoma larger than 3 cm should be removed before pregnancy is planned. In anticipation of a child, such a pathology increases the risk of complications and causes an unfavorable outcome. It is recommended to remove the cyst 6 months before conception.

Surgery for an ovarian cyst can also be performed during pregnancy, but this is not the best option. Any operation can lead to spontaneous miscarriage, and even conservative therapy does not always cope. Removal of a serous cyst during pregnancy is performed according to strict indications:

• Rapid growth of education and compression of surrounding organs;
• The development of life-threatening complications: torsion of the leg or rupture of the capsule, suppuration;
• Suspicion of malignancy.

Elective surgery is carried out for a period of 14-20 weeks, emergency - at any time. After surgery, the woman remains under the supervision of a doctor. Preservative therapy is carried out, aimed at reducing the tone of the uterus. According to indications, drugs are prescribed that improve blood flow in the placenta and nutrition of the fetus.

Diagnosis of suspected serous cystadenoma

Examination scheme:

• Gynecological examination. On bimanual examination, a serous cyst is defined as a round, elastic, and painless mass. Localized in the projection of the ovary, easily displaced. Small cysts are not detected on palpation;
• Laboratory research. The growth of oncomarkers CA-125 and CA-19-9 is observed with malignancy of the formation. With a simple serous cyst, oncomerkers are not detected;
• ultrasound. Echo signs of pathology are determined by the type of cyst. Additionally, dopplerometry is performed to assess blood flow and detect atypical vascularization - a sign of a malignant tumor;
• MRI. Magnetic resonance imaging is indicated for the growth of tumor markers or the detection of symptoms of a malignant tumor on ultrasound. Allows you to evaluate the structure of the cyst and identify metastases;
• Laparoscopy is practiced with an unclear diagnosis, when it is not advisable to leave the cyst under observation. After removal, the tumor is examined in the laboratory, and the histologist has the last word. Morphological examination of tissues is the only method to reliably determine the type of formation, to distinguish a benign cyst from a malignant one.

The photo below shows a simple serous cyst of the right and left ovary:

The picture was taken with an ultrasound. On ultrasound, it is more often a single-chamber formation with dense walls, a smooth inner and outer surface with anechoic contents. The inside is lined with epithelium. When the epithelium atrophies, the cavity stops growing.

The following photo shows a mucinous cystadenoma of the ovary:

Such a cyst is almost always multi-chambered, with wavy contours. The contents are anechoic or hypoechoic. The inner lining synthesizes mucus - mucin.

Treatment Methods

The tactics for detecting a serous ovarian cyst is always the same - only surgical treatment. Cystadenoma does not resolve on its own and is not amenable to drug therapy. Physiotherapy does not work, folk remedies are not practiced. An operation is indispensable, and the only question is the choice of access and determining the timing of treatment.

Observation is possible only with serous cystadenoma up to 3 cm in size in a woman of reproductive age. Such a formation will continue to grow, and one day the operation will still have to be done. You should not hope for a miracle: the disease does not regress on its own, and even entry into menopause will not get rid of the pathology.

Indications for surgery:

• Cystadenoma larger than 3 cm;
• Serous cyst of any size before IVF;
• Any suspicious ovarian formation at menopause;
• Rapid growth of the cyst;
• Suspicion of malignant degeneration of the cyst;
• The development of complications (rupture, torsion of the leg, infection, compression of the pelvic organs with impaired function).

The doctor can postpone the operation for 3 months if a pathology is detected in a young woman. If during the specified period the formation does not resolve, it must be removed. If the cyst regressed, then it was functional (luteal or follicular).

Removal of cystadenoma up to 10-12 cm in size is performed laparoscopically. When identifying giant formations, abdominal surgery may be required.

Giant ovarian cystadenoma.

Surgical treatment options:

• Removal of only the cyst with the preservation of the ovary. Perhaps in the presence of healthy tissues of the appendage. With prolonged existence, cystadenoma displaces normal tissues, and only a thin non-functional strand remains from the ovary. It makes no sense to leave such an organ;
• Resection of the ovary - removal of part of the organ along with the cyst;
• Ovariectomy is the removal of the entire ovary.

Organ-preserving operations are possible only with benign serous cysts. In favor of a simple cystadenoma, the following factors speak:

• The age of the patient is less than 50 years;
• Absence of ascites;
• Identification during a gynecological examination of a unilateral mobile formation up to 10 cm in size;
• Definition by ultrasound of a single-chamber cyst with smooth walls and without inclusions;
• CA-125 within normal limits;
• Absence of signs of carcinomatosis (metastases of formation) of the peritoneum during diagnostic laparoscopy.

If malignancy is suspected, the cyst is removed along with the ovary. In menopause, it is also not recommended to leave the ovary even with a potential benign tumor. A simple serous cystadenoma can eventually turn into a papillary cystadenoma, and the likelihood of developing cancer will increase several times.

In all cases, except for a reliably identified simple serous cyst, the operation is performed in compliance with the principles of ablastic surgery. Before removal, the suspicious tumor is placed in a plastic container along with the ovary. If the formation is opened during the operation, its contents will pour out not into the abdominal cavity, but into the container. After completion of all manipulations, the cyst membrane and fluid remain in the container, after which they are aspirated. All obtained material is sent for histological examination. The formation is removed from the pelvic cavity in a container. This approach avoids the spread of cancer cells in the peritoneum if the cystadenoma turns out to be malignant.

The final decision about the malignancy of the cyst is made after the results of histological examination.

On a note

Removal of a suspicious cyst and urgent histological examination of the material during surgery is a standard practice in modern gynecology. Unfortunately, express methods do not always give reliable results. It happens that the histologist describes the cancer, the surgeon removes the ovary, and a second postoperative examination of the tissues reveals a benign tumor. There is also a reverse situation, when a safe cystadenoma is determined during express diagnostics, and cancer is detected during further research. In this regard, preoperative techniques are of great importance, allowing with a high degree of probability to determine the type of formation before its removal.

After laparoscopic surgery, there are traces of three punctures on the skin, after laparotomy - a scar in the lower abdomen. Recovery takes from 5 to 14 days and depends on the volume of the operation and the access chosen. In the postoperative period, antibiotics, agents for the prevention of adhesions, and physiotherapy are prescribed. Young women are recommended to take hormones (combined oral contraceptives) for 3-6 months.

After the operation, the control ultrasound is performed after 1, 3 and 6 months. In the future, annual monitoring by a gynecologist is recommended.

The prognosis for ovarian cystadenoma depends on the type of tumor and the stage of the pathological process. The sooner the cyst is detected and operated on, the higher the chances of a favorable outcome of the disease.

Useful video about cystadenoma and its treatment options

Ovarian cystoma and its main symptoms

A serous ovarian cyst is formed in the form of a cavity similar to a bubble, and covered on the walls with serous epithelium. The inside of the bubble is filled with a transparent liquid of light yellow-brown color. It is located inside the ovary and, depending on the number of chambers, has different sizes. Pathology is exposed to one or both sides, and the growth of the cyst can occur randomly or towards the abdominal cavity. This disease is also known as cystadenoma.

Causes of cystadenoma

The main reasons for the appearance of cystadenoma are hormonal imbalance, diseases of the endocrine system, inflammatory processes of the internal and external genital organs. A serious reason can be an unsuccessful surgical intervention, for example, during an abortion. Sometimes the disease occurs due to prolonged abstinence from sexual activity, and as a result of mental and physical overstrain.

The impetus for the appearance of a serous cyst is often infections and sexually transmitted diseases. Pathology may appear due to untimely and improper treatment of other diseases of the female reproductive system.

Symptoms and signs

If the size of the cyst is small, it may not manifest itself for a long time. In the case of the progress of the disease, the size of the neoplasm increases. Against this background, inflammatory processes develop. In such cases, cystadenoma manifests itself in the form of aching pain in the pelvic region, at the location of the ovaries. As the size of the cyst increases, the pain becomes paroxysmal.

A woman's menstrual cycle changes. Menstruation becomes painful, comes with a delay, there may be too much blood released or it is completely absent. The presence of subfebrile temperature from 37.5 to 37.8 degrees indicates inflammation. If pus appears in the ovarian cavity, the temperature can rise to 40 degrees.

The sick woman suffers from nausea and occasional vomiting. The abdomen becomes asymmetrical, with large cysts its shape changes. There is pressure in the lower abdomen and on the bladder. Compression of the colon or rectum causes stool disorders, mainly constipation, during which stool is difficult to move. Weakness sets in, working capacity decreases, the woman becomes nervous and irritable.

These symptoms are characteristic of many pathologies affecting the reproductive and digestive systems. Therefore, to accurately determine the serous cyst, instrumental diagnostic methods are used - ultrasound and diagnostic laparoscopy.

Diagnostics

In order to determine the serous cyst, first of all, a bimanual gynecological examination is performed, the essence of which lies in the vaginal examination. The specialist determines the presence of volumetric education. There is no pain on palpation, the cyst itself is inactive, has smooth contours and a dense texture. Education with small sizes is quite difficult to determine manually.

Ultrasound is considered a more informative method, which makes it possible to differentiate a serous cyst from other neoplasms, tumors, and possible ectopic pregnancy. With the help of ultrasound, not only the presence of a cyst is detected, but also dynamic monitoring of its growth is carried out. The diagnostic results define a cyst as a rounded or ovoid neoplasm enclosed in a thin capsule filled with homogeneous contents. The inner surface is smooth, there may be partitions in the cavity, there is no blood flow. Sometimes the cavity is filled with a finely dispersed suspension that moves with a changed position of the body.

In some cases, the serous cyst takes on a papillary shape, and its inner surface becomes velvety in appearance. Growths are observed in the cavities of the cyst, and its structure resembles a cauliflower.

No less effective is invasive endoscopic examination, better known as laparoscopy. This method is a surgical procedure by which a direct visual examination of the abdominal organs is performed. To conduct such a study, a special technique is used. This procedure is suitable not only for diagnostics, but also for therapeutic purposes, up to the removal of pathological neoplasms. If necessary, the doctor prescribes a blood test. According to its results, tumor markers contained in the blood are determined. In addition, human chorionic gonadotropin levels are checked, pregnancy tests are carried out.

Treatment of a serous ovarian cyst

When prescribing a course of treatment, the individual characteristics of the female body, the type of serous cyst and the stage of the disease are necessarily taken into account. If the formation of a cyst is in the initial stage, then in this case one conservative treatment can be dispensed with. It consists in taking drugs that accelerate the resorption of the neoplasm. At the same time, inflammation, vitaminization, hormonal and physiotherapy are being treated. Conservative treatment is complemented by traditional and alternative medicine methods, such as therapeutic mud or acupuncture.

In case of cystadenoma during pregnancy, treatment with hormonal drugs is prescribed. With small cysts up to 2 - 3 cm, pregnancy is not in danger. The danger arises from large neoplasms, due to the possibility of breaking the surgical leg. To avoid miscarriage, the serous ovarian cyst is removed surgically using laparoscopy.

The late stage of the disease is characterized by large cysts. The main method of treatment is its removal. In some cases, the affected ovary is removed, and in malignant processes, the appendages and omentum are removed.

According to researchers, this pathology is found in patients aged 15 to 70 years, most common in adulthood. It occurs in 10-11% of cases of tumor-like formations. It does not pose a direct threat to life. Subject to observation and .

Serous cyst- a tumor of a benign nature, formed by an epithelium similar in structure to the epithelium of the fallopian tubes and ovarian membranes. The cells produce a fluid that forms a cavity. It is located in most cases on one side, it is rarely possible to have a bilateral location. It may not have clinical manifestations and be detected by chance during a routine examination.

• In most cases (60-70%) it has one cavity, two-chamber cysts are less common. The presence of multi-chamber formation cavities may indicate a cystic tumor.
• Various sizes are characteristic, it can vary from a few centimeters to gigantic (20 -30 cm in diameter), large sizes are less common.
• The cavity contains a serous transparent liquid, yellow or straw-yellow.

The cyst has no hormonal activity and is usually does not degenerate into a malignant tumor. Due to its internal structure (homogeneous liquid formation) it can imitate functional types of cysts. In this regard, it is possible erroneous and difficult to diagnose.

At the initial stages, it is small in size, subsequently the epithelium continues to synthesize fluid, increasing the size of the cyst. Characterized relatively slow growth of education, can be detected during routine preventive examinations.

Causes

It is believed that the origin of this structure is outer serous membranes(epithelial cells) of the ovary, which for unknown reasons are introduced into the tissues of the organ. No clear opinion about the immediate causes of cyst formation. Predisposing factors may be:

• hormonal disorders (including diseases of the endocrine system);
• infectious or inflammatory diseases of the ovaries and fallopian tubes (including sexually transmitted diseases), especially chronic and advanced processes;
• prolonged exposure to the sun, thermal high-temperature procedures, local overheating;
• repeated artificial termination of pregnancy, inadequate use of contraceptives.

Classification

In clinical work distinguish:

• right-sided, left-sided or bilateral cysts;
• single-chamber or multi-chamber;
• uncomplicated (the most common option), complicated.

A special type of serous pseudotumor formations are papillary serous cysts. These structures are formed during the growth of epithelial tissue into the cavity of the cyst, require more attention due to the tendency to rebirth. into a malignant tumor.

Symptoms

More common benign course- oligosymptomatic or asymptomatic variant. Especially when the cyst is small, or its size is stable. Sometimes the first manifestations can be expressed in an increase in the abdomen or the tumor is independently detected by a woman when probing the abdomen. Even with a significant size due to the slow growth of the cyst can for a long time do not cause subjective anxiety, and for the first time it will manifest itself in the development of .

Can be:

• Discomfort pulling sensations in the lower abdomen. Pain syndrome, especially pronounced is not typical for the typical development of this type of cyst. Sometimes there may be pain in the projection of the cyst, spreading to the lumbar region, sacrum.
• Achieving large sizes (up to 10-15 cm, which is rare) leads to bowel dysfunction(constipation), urinary system(urinary retention, frequent urination, frequent urination).
• With a very significant increase in the size of the cyst, it is possible accumulation of serous fluid in the abdominal cavity(ascites).

signs acute surgical pathology (sharp pain in the abdomen of a diffuse nature, tension in the muscles of the abdominal wall, nausea, vomiting, retention of stool, gases, intoxication, shock, and others) are characteristic for the development of:, hemorrhage into the cyst or bleeding into the abdominal cavity,.

Diagnostics

Cysts are held using:

1. Gynecological bimanual examination.
   During a gynecological vaginal examination, a specialist determines a volumetric formation located to the right or left of the uterus (back and side), painless on palpation, with smooth contours, dense consistency, inactive. With a small size of the cyst, manual determination of the formation is extremely difficult.
2. (the most informative transvaginal examination) with color Doppler mapping.
   For differential diagnosis formations with other types of cysts (, and others), with true tumors or ectopic pregnancy, ultrasound diagnostics is performed. Ultrasound is the method of choice for detecting and dynamic monitoring of cyst growth, due to the fact that the main category of patients is women of reproductive age. It is defined as a rounded or ovoid formation with a thin capsule with a homogeneous (anechoic) content, with a smooth inner surface, may have partitions in the cavity, without signs of blood flow. Sometimes it has a finely dispersed suspension in the cavity, which shifts when the position of the body changes.

   At papillary form cysts, the inner surface acquires a velvety appearance, tissue growths in the cyst cavity are detected, solid structures, look like cauliflower. Requires diagnostics to teratoma, hydrosalpinx(accumulation of fluid in the cavity of the fallopian tube), cancer.

3. Endoscopic (laparoscopic) examination.
   Invasive examination - laparoscopy (a surgical procedure for direct visual examination of the abdominal organs using special equipment). It can be used for both diagnosis and treatment. Not used for routine or screening examination. The main area of ​​application is a diagnostic study in doubtful cases, removal of a cyst.

Also, the doctor may prescribe blood test for the content of tumor markers, levels of human chorionic gonadotropin, pregnancy tests.

X-ray methods(computed tomography and others) directly for the diagnosis of this type of cyst do not apply, but in rare cases it is used for differential diagnosis in complex cases, with concomitant diseases or anomalies of the pelvic organs.

Treatment

Not typical for this type of cyst self-disappearance or cure. After identifying the formation, the specialist selects one of the management tactics:

• monitoring the size of the cyst;

A cyst of small size, without clinical manifestations and stable in size for a long time can be left for routine observation.

• The discovery of a cyst that does not meet the above requirements is an indication for planned surgical treatment.
• Appearance is an indication for emergency .

1. used as adjuvant or symptomatic therapy.
   • With signs of inflammation - anti-inflammatory therapy.
   • With signs of an infectious process - antibacterial and detoxification drugs.
   • For pain - analgesics, antispasmodics.
   • In case of bleeding, shock - plasma-substituting drugs, anti-shock therapy.
2. Approaches to surgical treatment:
   • Planned removal of cystic formation. The method of choice in the treatment of cysts. Allows you to plan the time of the operation (at least 3-4 months before the planned pregnancy), compensate for possible concomitant conditions (for example, extragenital pathology).
     

     The most common technique is to remove the cyst along with the capsule using. With typical variants, as well as in reproductive age, seek to preserve unaffected ovaries and fallopian tubes. It is characterized by a favorable prognosis for later life and reproductive function.

     Major operation with a dissection of the anterior abdominal wall (laparotomy) used much less often.- with large cysts, adhesive processes in the abdominal cavity.
   • Emergency surgery. It consists in eliminating complications (stopping bleeding, removing necrotic tissues, eliminating inflammatory processes, etc.). The severity and likelihood of postoperative complications is significantly higher than with a planned intervention.
   • The volume of the operation is determined by the size of the cyst, its influence on neighboring organs, the state of the genital organs. Extensive Operations with the removal of appendages is carried out with a complete loss of ovarian function, for example, tissue atrophy, age-related involution.
3. Application (herbal medicine, etc.) for serous cysts do not have a significant positive effect. In the best case, the size of the cyst will remain stable, but there is a danger of rapid growth and complications in the future.
4. IN diet it is recommended to use a balanced low-calorie food with a high content of vegetable fiber, enriched with vitamins A, B. One-component diets should be avoided in the diet.

Complications

Possible associated conditions:

• , necrosis, hemorrhage(may provoke: increased physical activity, prolonged insolation) - manifested by sudden non-stopping pain, impaired bowel function and other signs of an acute abdomen.
• , bleeding into the abdominal cavity with the possible development of a shock state.
• Compression of surrounding organs(ovary, fallopian tubes, bladder, urinary tract, intestines). In severe cases, it can lead to infertility, acute intestinal obstruction, acute urinary retention.
• Seldom - tumor infection. Possible ways of infection - lymphogenous, hematogenous. Accompanied by a deterioration in the general condition, a sharp increase in temperature to febrile values ​​​​(38-39 0 C), signs of intoxication.
• Seldom - transformation into a malignant tumor.

Prevention

Includes general principles for all cystic formations:

• Regular preventive examinations at the gynecologist (including follow-up follow-up).
• Prevention of infectious and inflammatory diseases of the genital organs. Their timely detection and elimination.
• Passing blood tests for tumor markers (especially if tumor formations were determined in the family of relatives.

Content

The urgency of this gynecological problem is very high. A tumor with a clear, almost clear fluid is so common that it occurs in two-thirds of patients diagnosed with a cyst. A tumor-like formation on the ovary in women is dangerous for infertility, but there is a more serious threat if treatment is not started in time.

What is serous ovarian cystadenoma

The pathological formation got its name due to its appearance. Serous liquid formation in the ovary is a cavity with inelastic walls and clear contours. A clear liquid (serous), which gave the name of the disease, is located inside the formation. The specificity of the pathology is that the bubble with liquid can be of different sizes, and at first it is a benign formation, but the development of the disease can lead to the malignant nature of the tumor.

How does a serous cyst appear on the left ovary

A feature of a serous ovarian cyst is the asymptomatic onset of the disease. The appearance of a small pathological formation, the course of the disease does not affect the general state of health. Ultrasound helps to identify a benign formation and determine that this is a serous cyst of the left ovary. As the pathology develops, the following signs of the disease begin to appear:

• pain (dull, aching, cramping) under the pubis or in the lumbar region;
• frequent urge to urinate because the tumor begins to put pressure on the bladder;
• constipation;
• violation of the menstrual cycle;
• general malaise manifests itself in the form of fatigue, irritability, lethargy, loss of efficiency;
• temperature, nausea, asymmetrical shape of the abdomen are alarming signals that indicate a progressive inflammatory process.

Why is a cystadenoma of the left ovary formed

The factors leading to the appearance of pathology can be different in nature and degree. Common causes that most often provoke the formation and growth of a benign neoplasm are hormonal imbalances and sexually transmitted infections. Among other factors why cystadenoma may appear, there are such:

• disease of the endocrine system;
• inflammation of the appendages (adnexitis, salpingoophoritis);
• prolonged sexual abstinence or, on the contrary, promiscuity;
• excessive physical activity;
• diets;
• stress;
• non-professional gynecological examination;
• childbirth;
• a surgical operation performed on the abdominal cavity on one of the organs of the small pelvis.

How to diagnose a cystic formation of the left ovary of the serous type

Careful examination in the presence of symptoms precedes treatment. To prevent a serous ovarian cyst from developing into a more serious and life-threatening disease, the doctor uses certain methods to make a final diagnosis. The presence of a cystic formation of a serous type in the left ovary can be argued if the following studies were carried out:

• gynecological examination;
• Ultrasound transvaginal method to accurately determine the size, content, density, growths, blood circulation intensity;
• blood test, tumor markers;
• magnetic resonance imaging (MRI), computed tomography (CT) is performed for a detailed study of cystadenoma.

Treatment of ovarian cyst without surgery

Therapeutic tactics, as an alternative to surgical intervention, provides for conservative treatment with the use of drugs. This method is suitable only for treatment, provided that the serous cyst in the left ovary has the appearance, size, location and condition characteristic of the initial stage of the disease. The age of the woman will also influence the choice of drug treatment, and concomitant methods of treatment (acupuncture, physiotherapy, mud therapy, folk remedies) are discussed individually.

Medical assistance to solve the problem of benign education may include waiting. Some cases when the presence of a pathology is diagnosed do not require urgent or complex intervention - only observation by a doctor for a certain period of time. Often this approach is successful in the treatment of a functional tumor, and since with a small size of a pathological formation it is not always possible to accurately determine its type, the observation method justifies itself.

waiting tactics

In medical practice, this method is used at an early stage, when it is difficult to make a correct diagnosis. On ultrasound examination, the serous cyst of the left ovary is a black spot with clearly visible borders, which coincides with the signs of a functional neoplasm, which resolves itself over time. The use of expectant management, which can last from a month to three, helps to avoid unnecessary treatment and surgery. If the cystic formation does not go away, then this is a sure sign of cystadenoma.

Medical therapy

A serous cyst is a fluid in the ovary that is hidden in a hard capsule, often with a single chamber. If the cystadenoma has affected one organ, and its size ranges from 4 to 10 cm, then a medical method of treatment is used. Timely therapy helps prevent the appearance of a papillary (papillary) cyst, when the examination can detect overgrown formations. Both ovaries are covered with cystic tumors that have a stalk, and the next step in the development of a serous cyst is dangerous by degeneration into a malignant tumor.

A conservative drug method at an early stage of the pathology is aimed at resorption of a benign formation, therefore, anti-inflammatory drugs are prescribed. The intake of vitamin complexes and hormone therapy helps to inhibit the growth of a serous-type cyst. The latter is a combination of estrogens and gestagens, which simultaneously contributes to the normalization of the menstrual cycle. In case of bleeding, hemostatic drugs are prescribed, and in case of complications, rupture, surgery is indispensable.

Surgical methods

The indication for the removal of cystadenoma by surgical intervention will be the size, examination data, the age of the patient and the stage of the tumor. A serous-type cyst is a threat to life not only by the possibility of developing into a malignant tumor, but also by growth into the abdominal cavity. To remove cystadenoma, a less traumatic method of operation, laparoscopy, is often suitable. Just a few small incisions contribute to the rapid recovery of the body, reduce the risk of complications and prevent the formation of adhesions.

If there is a need for a traditional surgical operation, then the doctor will have to decide on one of the existing methods:

• wedge-shaped resection (excision of cystic tissues with maximum preservation of healthy ones);
• cystectomy (helps to preserve the function of the organ when the capsule is removed);
• oophorectomy (removal of the cyst along with the ovary);
• adnexectomy (removal of the ovaries, uterine appendages).

Video

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.