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Endometrioid ovarian cyst: symptoms and treatment, diagnosis

Endometrioid ovarian cyst - what is it?

Endometriosis is the most common disease among the many pathologies of gynecological nature. It is characterized by an abnormal growth of heterotopia (endometrioid tissue) in various areas and organs.

Endometrioid ovarian cyst is one of the benign pathologies included in the classification of external forms of endometriosis.

It belongs to the group of hormone-dependent diseases, developing on the background of the failure of the immune system due to inadequate reduction of immune reactions in the body (immunodeficiency).

This provokes the spread of endometrial cells outside the uterus to the organs, where, in principle, they should not be. Sometimes their drift to other organs may be due to reverse flow of menstrual blood (retrograde bleeding).

Endometrial Ovarian Cyst

Every month, the endometrium is subject to cyclic hormonal changes, while the cells “settled on the sex glands” show active growth and growth of endometrial tissues in the cortical (outer) gland layer and the formation of cystic formations with dark-colored contents - “chocolate cyst”.

Endometrioid ovarian cyst is a disease belonging to the group of genital endometriosis. It affects women of any age, before the period of menopause. Possible damage to the ovaries with unilateral and bilateral localization.


Causes of an Endometrioid Ovarian Cyst

There is no single version of the genesis of the disease today. One hypothesis suggests the possibility of developing an endometrioid cyst due to retrograde menstruation (a return throw of uterine epithelial cells), in which menstrual blood along with the cells falls on the surface of the reproductive gland and the cells are fixed on it.

This is facilitated by several reasons:

  • A wide volume of fallopian tubes, facilitating easy penetration of menstrual blood into the peritoneal cavity;
  • Narrowing or clogging of the cervical passage of the uterus, which creates an obstacle to the discharge and promotes free flow of secretions through the fallopian tubes;
  • Sexual intimacy during menstruation and vigorous exercise, facilitating the transfer of menstrual flow into the peritoneal cavity.

There may be other causes of the disease, due to the likelihood of cell drift after:

  • Gynecological operations;
  • Diagnostic curettage and abortion;
  • Coagulation procedures on the cervix (diathermocoagulation).

According to the results of research and practical observations, the following hypothesis is based on defects of a genetic nature - replacement of embryonic tissues and impaired immune reactions (immunodeficiency) due to certain reasons:

  • Imbalances in the body levels of progesterone and prolactin;
  • Disturbances in the secretion of hormones (disruptions in the thyroid gland)
  • Malfunctions in the hypothalamic-pituitary system.

Contribute to the growth and development of endometriosis gonads:

  • Nervous stress and depression;
  • Prolonged use of the intrauterine device;
  • Impaired hepatic function;
  • Inflammatory processes of the uterus;
  • Excess body fat;
  • Ecological factor and addiction to bad habits.

Degree of damage

The diagnostic characteristic of ovarian endometriosis is determined according to the degree of prevalence and localization of the pathological process.

  1. The first degree is characterized by small point foci of the endometrium on the surface of the gland. On adjacent organs and peritoneum there are no lesions.
  2. In the second degree, a lesion of one gland (ovary) with cystic formation not exceeding 6 cm is found. Concentration of small foci of the endometrium is localized on the peritoneum. In the area of ​​appendages - pathological tissue adhesions (adhesions).
  3. The third degree of damage is caused by cystic lesion on the surface of two ovaries, areas of the mucosal layer (endometrium) are found on the uterine surface, fallopian tubes and in the pelvic area on the peritoneum. The adhesions process spreads to the intestinal area.
  4. In the fourth degree, both glands are affected, cysts significantly exceed the size of the first stage. The mucosal layer is localized on the bladder and intestines. Adhesion process is distributed in different directions.

Symptoms of an Endometrioid Ovarian Cyst

Symptoms of an Endometrioid Ovarian Cyst

Symptoms of endometrioid ovarian cysts are manifested depending on the severity of cystic tumors and their size. In the initial period of education, symptoms may occur:

  • Irregular menstrual cycles;
  • Abundant secretions of menstrual blood;
  • Secretions in the middle of the monthly cycle;
  • Painful symptoms during menstruation and sexual intimacy.

If you ignore these symptoms, do not heal on time, the symptoms widen. Appear:

  • Signs of amenorrhea or menorrhagia (heavy or prolonged menstruation);
  • Dirty instead of menstruation ;
  • Apathy, weakness and nausea;
  • Increased abdominal pain ;
  • Fever and hyperthermia (fever);
  • Lack of ovulation processes (infertility);
  • Lumbar pain and sacrum;
  • Symptoms characteristic of "acute abdomen" (in violation of the integrity of the cystic capsule).

Adhesions provoke difficulties with the evacuation of faeces (chronic constipation), flatulence (accumulation of gases in the gastrointestinal tract), dysuria (violation of urination).

Signs of lesions of the left and right ovary

Signs of lesions of the left and right ovary

Endometriosis of the left ovary may develop as a result of intestinal diseases or after operations on the large intestine. Achieve large size (10-14 cm). Symptoms manifested:

On the right side, ovarian endometriosis is diagnosed more often, although it may not be felt for a long time without showing itself. The development of abdominal (at the opening of the abdominal cavity) surgical intervention. Characteristic features:

  • Irregular periods;
  • Pain in the lower right abdomen;
  • Intestinal problems;
  • Pathological processes in the bladder.

Detection of cystic formations on two ovaries at once, speaks of neglect of the process corresponding to the third stage of the development of the disease.

The effect of endometriotic ovarian cyst on pregnancy

When planning a pregnancy, it often raises the question of how compatible the endometrioid ovarian cyst and pregnancy are and whether there is a possibility of becoming pregnant with such a pathology.

With small cystic formations there is no danger of pregnancy. Quite the contrary. Throughout pregnancy, the yellow body of the gonads produces steroid hormones (progesterone), which suppresses the growth of heterotopia (endometrial tissue) and contributes to its reduction or complete resorption.

For large endometrioid cysts, it should be removed before pregnancy. With the growth of the fetus, the uterus increases and there is a threat of cyst infringement, damage to the capsule or torsion of the cystic base, if it is on the pedicle.

The result is one - an operation, but in a complicated form.

Treatment of endometrioid ovarian cyst, diagnosis

Diagnosis and extent of endometrioid ovarian cysts

Diagnosis includes:

  1. Transabdominal and transvaginal ultrasound with Doppler.
  2. MRI of the sex glands.
  3. Laparoscopic diagnostics, including biopsy sampling for histological examination.
  4. Cancer differentiation - analysis for tumor markers.
  5. Hysterosalpingography.
  6. Diagnostic hysteroscopy.

The choice of methods for treating endometrioid ovarian cyst is based on various factors and depends on:

  • on the duration of the disease and the age of the patient;
  • the degree of focal spread;
  • from diagnosing infertility;
  • background gynecological pathologies;
  • the presence of inflammatory processes.

The treatment protocol is compiled on the basis of various methods:

  • hormone therapy;
  • taking immunomodulating and anti-inflammatory drugs;
  • spasmodics and enzymes;
  • physiotherapy and vitamin therapy

Complemented therapy with various popular recipes. Treatment of endometrioid ovarian cyst by folk remedies is capable of suspending their growth or reducing the size of the lesions.

The main treatment is surgical techniques:

  1. Removal of the endometrioid cyst itself along with the capsule. This tactic is used to remove large formations that are well detachable from adjacent tissues.
  2. Excision of the cystic capsule with a small amount of gonadal tissue.
  3. Radical removal - together with the gland (laparotomy, open access).

Treatment of endometrioid ovarian cysts without surgery is carried out at an early stage of the disease. To combat education, its hormone-dependent factor is used. Medical therapy is prescribed to ensure the creation of an artificial menopause when the secretion of hormones is reduced. This leads to a decrease in cystic sizes.

Ideal, such treatment can not be called, rather, it is a temporary measure. When therapy stops, the disease almost always returns and the operation cannot be avoided.

The most optimal operating technique is laparoscopy. Minimally invasive and minimally traumatic method to preserve the vital activity of the body, or to remove it completely (for large sizes). During the operation, other endometrial foci in the peritoneal cavity are identified and removed.

In any operating procedure, after the removal of an endometrioid ovarian cyst, hormone therapy provides prevention of new formations.

Postoperative treatment includes methods of physiotherapy treatment:

  • electrophoresis and ultrasound sessions;
  • laser treatment and magnetic therapy;
  • galvanization or acupuncture.

The treatment regimen is prescribed according to the individual indicators of the patient.

Possible consequences

If the problem is not dealt with and let the disease take its course, the risk increases:

  • development infertility ( infertility );
  • the formation of functional ( follicular ) cystic formations;
  • development in the pelvic adhesions and scar tissue.

Despite its benignity, endometrioid cysts have the property of malignancy. Running untreated cysts increase the risk of transformation into a cancer in almost a quarter of patients with advanced form of the disease.


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