Gynecology and Obstetrics


Ovarian Cysts

Ovarian cysts are growths which develop from ovarian tissue, are relatively common , especially in women of reproductive age, and the vast majority of which are benign. Some ovarian cysts which especially appear in advanced age develop as a result of ovarian cancer.

Generally speaking, if ovarian cysts negatively affect the daily life of a woman by creating various symptoms or it is uncertain if the cyst is benign or not, surgery is preferred.

Classification of Ovarian Cysts

  • Simple cysts: Most of the cystic growths during reproductive age are benign and are called " simple cysts " based on their ultrasound image . The term simple cyst is used to describe a cystic structure which is completely full of liquid and free from solid parts. This type of cysts can be monitored at regular intervals unless there is any reason for surgery.
  • Functional Ovarian Cysts: Functional ovarian cysts, i.e. cysts resulting from incomplete ovulation process in one of menstruation cycles are relatively common in women of reproductive age. The most important feature of this type of cysts is that it is most likely that it will disappear spontaneously at the end of one or more menstrual cycle(s). Therefore, in most cases, after diagnosis it is allowed to stand for some time.
  • Chocolate Cysts: Chocolate cysts are benign but they may cause menstrual cramps, ache during sexual intercourse and inability to conceive, accompanied by endometriosis so surgical removal of chocolate cysts is preferred. Such cysts have a typical image in vaginal ultrasonography do they can be easily recognized.
  • Dermoid Cysts: Dermoid cysts are also benign but they may cause serious problems if their contents are released into the abdomen as a result of rupture so usually surgical removal of these cysts is preferred. These cysts contain structures such as hair, bone tissue so it is relatively easy to recognize them in ultrasonography. In the case of this type of cysts, especially when they are big, a painful condition, called choking may occur.

Symptoms

  • Especially large cysts compress nerve endings in surrounding tissues or surrounding organs, causing irritating pain. Such pain may take the form of menstruation cramps or permanent pain on each day of a menstrual cycle.

One of the conditions where the cyst causes ache is a condition called torsion choking. It is caused by twisting of the cyst around itself and disrupting its own blood circulation. Ovarian tissue which has begun to lose its vitality because of disruption of its blood circulation causes very severe pain.

  • Particularly large cystic growths may adversely affect the functions of urinary tract, which is close to uterus. Cysts compressing the bladder may sometimes cause complications including urinary incontinence or inability to urinate.
  • In case of a pressure on bowels and especially large intestine, defecation function can be impaired.

Treatment of Ovarian Cysts

In the case of suspected cancer of an ovarian cyst, even if this probability is very low, it is preferable to carry out the operation in short time.

It is recommended that cystic formations which appear especially in advanced age, occur as multiple or double -sided, contain solid components, cause fluid accumulation inside the abdomen, do not resolve spontaneously or which show growth at the end of a certain period, are accompanied by increases in some blood parameters called tumor markers are operated because of the possibility that they are cancerous.

Cystic formations occurring during menopause or childhood should be removed surgically without waiting.

The most important advantage of the operation is that the tissue removed can be pathologically examined and its nature can be clearly identified.

The main objective of an operation for cyst in a woman of reproductive age is to preserve ovaries and only remove the cyst. However, where the cysts is associated with cancer, it is not sufficient to remove the ovary. The uterus should also be removed. Uterus has no known function other than accommodating the growing baby during pregnancy. Therefore, in the case of a woman who has completed her family, even though the cyst is believed to be benign, complete removal of both ovaries and even the uterus can be recommended rather than only resecting the cyst.

Type and size of the cyst determine the removal method of ovarian cysts. The technique used to remove a cyst is another issue affecting the risks associated with the surgery. Surgery can be applied by laparotomy, i.e. open surgery entering through the abdomen or laparoscopy, i.e. a method applicable through fine tubes using a camera, without opening the abdomen.

Cyst removal surgeries are performed under general anesthesia.

Especially chocolate cysts are cysts with relatively high probability of recurrence and therefore may require additional treatment to prevent recurrence after surgery.