Endometrioid ovarian cysts: causes, symptoms, treatment, reviews

Endometrioid ovarian cyst is most often diagnosed in women of childbearing age average (30 years). Endometriotic formation formed from endometrial cells inside its cavity is filled with blood residues, which is released during menstruation. Diameter cystic inclusions can reach 12 cm.

Causes of endometrioid ovarian cysts

Doctors are still not able to find out all the causes of endometrioid ovarian cysts. They appear in the cases where the mucous layer of the uterus falls on ovarian tissue.

The main predisposing factors for occurrence of endometrial structures are called:

• inflammatory diseases of the genitourinary system;
• strong stresses;
• frequent abortions;
• hormonal disruptions;
• intense physical activity during menstruation.

Doctors suggest that endometrial growths may occur due to:

• entering endometrial cells in ovarian tissue during operations;
• reverse casting cells in the fallopian tube during menstruation;
• transition endometrial cells with lymph and blood flow.

The appearance of these problems can cause disruptions in the functioning of the ovaries and the brain structures responsible for hormone production. The appearance of endometrial tumors may be due to decrease in progesterone, estrogen increased level of prolactin, dysfunctions of the endocrine organs.

Symptoms of endometrioid ovarian cysts

Suspected appearance on ovary endometrial cysts can be the characteristic symptoms. The women in the development of this disease there are such signs:

• painful periods, they may be accompanied by a general weakness, vomiting, limb cooling, dizziness;
• a slight increase in temperature;
• discharge of blood after menstruation;
• persistent pain in the area of ​​the appendages.

With the progression of the disease multiple adhesions are formed in the pelvic cavity. This leads to impaired urination, constipation. It is practically impossible to get pregnant at this pathology.

Pain in endometrioid ovarian cyst

Characteristic features of endometrioid ovarian cysts are the pains. Women complain that aching feeling in the lower abdomen pursue them consistently. Periodically, they can grow, spread to the rectal area, loin.

Condition worsens during menstruation. This is due to the fact that the capsule shell consists of endometrial uterine endometrium. At the beginning of menstruation the endometrium lining the cavity of the cyst starts to be rejected. This leads to formation of small holes, through which blood enters the abdominal cavity.

Reference! The pain may be so severe that some women come to the hospital with "acute abdomen." Pathology can confuse with appendicitis, ectopic pregnancy, ovarian apoplexy, cystic torsion legs.

Diagnostics

When carrying out a two-handed gynecological examination the doctor can find the seal on the left or the right ovary, in some women, tumors are formed on both sides. If during the examination the doctor feels elastic tight formation, which is one place and hardly shifted, it is possible to assume the existence of the right ovary endometrioid cysts.

To clarify the diagnosis is prescribed:

• analyzes;
• ultrasound;
• tissue biopsy;
• MRI, CT.

Recommend patients to donate blood to determine the level of ESR. In the formation of endometrial cancer rate will be increased. recommended pass tumor marker CA-125 To exclude malignant tumors.

US endometrioid ovarian cysts

Ultrasound examination is the most easy way to view the inside structure cystic formation and find out at one or both ovaries endometriotic cysts in patient.

With the examination the doctor can determine the exact location and size of the tumor, but to differentiate it from other tumors during ultrasound is not always possible. By ehografichesim endometrioma featured include:

• side and rear of the uterus;
• the presence of fine suspended matter nesmeschaemaya increased and mean echogenicity;
• Dual circuit capsules;
• relatively small size (diameter endometrioid ovarian cysts most does not exceed 8 cm).

Doppler allows to specify the diagnosis. The walls of the endometrioid cyst will not flow. Correct diagnosis of said echographic signs manages to deliver 94% of the patients.

MRI endometrioid ovarian cysts

In carrying out magnetic resonance imaging can detect pelvic endometriotic formation. Depending on the situation on the MRI visible single or multiple formation.

At T1 they differ homogeneous hyperintense signal. At T2 VI endometirioidnye formation give hypointense signal (the picture are visualized as a faint shadow), the intermediate or hyperintensive signal. For signal characteristics can be set in the blood levels of cystic cavity.

Histology endometrioid ovarian cysts

Establish an accurate diagnosis and differential diagnosis of endometrial cysts and cancer as possible after the laparoscopy. During surgery, the doctor not only removes cysts, but also takes part of the fabric. They are sent on a histology.

The main histological sign that surveyed patients endometrioid tumors is the absence of breast tissue capsule. They are similar to tumors of the endometrium, their walls Shots low single-row cylindrical epithelium endometrial type.

Endometrioid ovarian cyst: code according to ICD-10

In accordance with ICD-10 tumor are N83, to subsection N83.2, wherein grouped other and unspecified ovarian cysts.

Dangerous than endometrioid ovarian cyst

Persistence in ovarian endometrioma tissues causes proliferation of endometrial lesions in the abdominal cavity, activation of adhesions in the pelvic area.

The situation may be complicated by inflammation or suppuration cystic inclusion. Among the possible complications of cystic called torsion legs and disruption of other organs, which occurs due to the increase in tumor volume.

Can burst endometrioid ovarian cyst

If the diameter endometrioma left or right ovary becomes too large, its walls may rupture. This will lead to the outpouring of blood in the peritoneum and peritonitis.

How fast growing endometrioid ovarian cyst

Endometrioid tumors growth rate varies. When elevated levels of estrogen, they increase in size intense. If there is no deviation in the hormonal background tumors grow slowly.

Can dissolve endometrioid ovarian cyst

Independently endometrioma not disappear. When they identify the physician should prescribe treatment or refer the patient for surgery.

How to treat ovarian cysts endometirioidnuyu

Depending on the patient condition, size neoplasm symptoms physician may choose to assign conservative therapy or medical diagnostic laparoscopic surgery. In some cases, the assigned combination treatment: first carried out an intensive course of therapy, and then remove the cystic inclusion.

Laparoscopy endometrioid ovarian cysts

For removal of endometrioma doctors recommend to do a laparoscopy. To gain access to the ovary in the abdominal wall of the patient punctures are made through them introduce a video camera with illumination and surgical instruments.

Endometrial tumor appears as a dark blue tight capsule. Inside it are the remains of menstrual blood. Outwardly, it resembles the contents of liquid chocolate. In laparoscopy carried removal endometrioid ovarian cysts. The extracted tissue sent for histology.

See how you can carry out an operation on the video:

How to cure endometrioid ovarian cyst without surgery

For small tumors, doctors sometimes recommend conservative therapy. Endometriosis often a hormonal imbalance, so the main treatment is directed on its elimination.

Gynecologists prescribed hormonal therapy using:

• estrogen-progestin means: Mikrogenon-30 Femoden, Marvelon, Diane-35, Rigevidon;
• anti-estrogen medications: tamoxifen;
• anaboliticheskih steroids: Metilandrostendiol, Retabolil, Nerobolum;
• androgens: Sustanon-250 Metiltestostenon, Testenat;
• progestogens: Gestrinone, Medroxyprogesterone, Duphaston, Norkolut.

Plan of treatment each patient the doctor selects inividualno. Parallel to prescribe vitamins, anti-inflammatory and analgesic medications, immunomodulators. Sometimes treatment eliminates the need for the removal of endometrial cysts in the ovary. But the likelihood of recurrence of disease is high.

Duphaston with endometrioid ovarian cyst

Progesterone preparations used in the treatment of endometriosis. Dydrogesterone effect on the endometrium, it prevents the likelihood of its transformation into tumor formation and reduces the risk of hyperplasia with excess estrogen.

Assign it the course of the second phase of the cycle. But, as practice shows, to get rid of cystic formations with it difficult. Djufaston prescribed postoperatively to prevent formation of new tumors and endometrial appearance hormonal failures.

Longidaza with endometrioid ovarian cyst

Longidaza can prevent the development of adhesions, and reduce the number of adhesions. The drug is also used in the endometrium. Means may be included in combination therapy as a drug which has anti-inflammatory, immunomodulating action. Under his influence the connective tissue does not grow, even drug causes destruction of the modified structure and composition of the connective tissue.

Doctors recommend injections or put candles in the postoperative period to prevent the development of complications and recurrence of disease.

Treatment of ovarian endometrioid cyst folk remedies

Folk therapy methods can be used by a physician as a component of complex therapy. Some recommend the detection of endometrial cysts on the ovary to drink the juice of burdock. Take it should be three times a day for 1 tablespoon. It is advisable to use fresh juice. If necessary, it can be refrigerated up to 3 days.

Treatment after the removal of endometrioid ovarian cysts

The administered therapy after surgery for removal of endometriotic cyst Ovary directed at normalizing the hormonal balance. Many advise physiotherapy, with its help it is possible to prevent adhesions and prevent recurrence.

For therapeutic purposes, prescribe oral contraceptives for a period of 3 months. In some cases, recommend buserelin injections or pills Visan. Formulations administered in patient artificial menopause. With this amount of estrogen in the body decreases, gonads can relax.

Prediction and prevention

After removal of the tumor and passing endomterioidnoy assigned treatment, most patients are pain, restores the reproductive organs. Many women during the year after the removal of endometrioid ovarian cysts pregnancy occurs.

But endometrial tumor can arise again under the influence of provoking factors. It is therefore important to monitor the level of hormones, undergo regular checkups by a gynecologist and periodically do an ultrasound.

Can I get pregnant with endometrioid ovarian cyst

Chance of pregnancy in patients with endometriosis low. Even endometrioid ovarian cyst in size 3 cm can trigger the development of adhesions and inhibit conception. Often patients with endometrioid form on the ovaries are turning to gynecologists with complaints of infertility.

Attention! There are cases when the endometrial cysts detected in women during pregnancy. In such pathology increases the likelihood of miscarriage, so the patient should be under medical supervision.

IVF after endometrioid ovarian cysts

If attempts to become pregnant are unsuccessful, the gynecologist may recommend IVF. Reproductologist must select the protocol, and drugs to stimulate the patient's medical history, taking into account, because the risk of recurrence of cystic inclusions. But many women get pregnant using IVF after laparoscopy.

conclusion

Endometrioid ovarian cyst provokes the emergence of strong menstrual pain, constant pain in the lower abdomen, blood from the vagina after menstruation is completed. To identify this pathology can be integrated during a gynecological examination. Ride the disease is impossible. The physician may prescribe operative or conservative therapy.

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