endometrial cysts of the ovary (ovarian cyst chocolate) - is filled with thick brown contents of the cavity bounded by walls of varying thickness and formed inside the ovary or on its surface.In most cases, the dimensions of this education is not prevyshayut12 SMV diameter.
According to medical statistics, most of this pathology is diagnosed in women of reproductive age (12 to 50 years).The main feature of endometrioid ovarian cysts is a violation of the integrity of their walls during menstruation, accompanied hit their contents into the abdominal cavity.This explains the rich symptoms of the disease and the difficulty in carrying out its diagnosis.
- 1 reasons endometrioid ovarian cyst
- 2 Symptoms of chocolate ovarian cysts
- 3 Diagnostics endometrioid ovarian cyst
- 4 Endometriod ovarian cyst: treatment
reasons endometrioid ovarian cyst
Despite the fact that currently there are many theories of the origin of endometrial cysts, the exact causes of
There is a hypothesis that the endometrioid cyst may be formed by retrograde menstruation, that is when the endometrial cells migrate from the blood and take root in the tissues of the ovaries, fallopian tubes and abdominal cavity.Skid these cells often occurs in the course of surgical procedures, traumatic uterine, including:
- gynecological operations;
- with diagnostic curettage;
- with medical abortion;
- cervical diathermocoagulation.
Some doctors believe that endometrioid ovarian cyst may be formed as a result of substitution of persistent residues embryonic tissue, weakening of immune responses or genetic defects.In addition, it is proved that there is an inextricable link between the development of this disease and endocrine malfunction in the body:
- giperestrogeniey and increased prolactin levels;
- decrease in progesterone levels;
- dysfunction of the adrenal cortex and thyroid.
Aggravating factors in the occurrence and development of endometrial cysts can act:
- prolonged use of intrauterine devices;
- emotional stress;
- abnormal liver function;
- unfavorable ecological situation.
Symptoms of ovarian chocolate cysts
The degree of ovarian cyst symptoms of chocolate depends on the following factors:
- degree of neglect of the cyst;
- presence of comorbidities;
- psychological state of the patient.
In most cases, the formation of endometrial cysts is transparent to the patient or seen as a violation of its reproductive function (infertility).The development of the disease is accompanied by:
- sharp pain in the lower back and abdomen, increases during sexual intercourse or during menstruation;
- copious menses;
- lengthening of the menstrual cycle;
- appearance of spotting before and after menstruation;
- manifestation of intoxication symptoms (weakness, nausea);
Increased endometrial cysts in size can lead to degeneration of eggs, the appearance of follicular cysts and scars that prevent the normal functioning of the ovary.If untreated, this disease develops in the pelvis adhesions, leading to dysfunction of the bladder and bowel.
Diagnostics endometrioid ovarian cyst
In some cases, endometrioid ovarian cyst may be detected during a pelvic exam: in this case reveals sedentary painful education in the ovary to grow in size before menstruation.In general, for setting the faultless use of the results of the diagnosis a laparoscopy, pelvic ultrasound with Doppler and magnetic resonance imaging.
Ultrasonography with Doppler detects the absence of blood flow in the shell of the cyst.In this case the blood level of tumor marker CA-125 may be normal or slightly elevated.When the diagnosis of infertility is performed hysteroscopy and hysterosalpingography.But the most reliable method of diagnosing endometrial cysts recognized by laparoscopy.
Endometriod ovarian cyst: treatment
Treatment of endometrial cysts can be:
- conservative (non-specific anti-inflammatory, analgesic and hormonal therapy, vitamins, enzymes, immunomodulators);
- surgery (organ-removal of a cyst laparotomy or laparoscopy);
In general, cysts, treatment should be aimed at eliminating the symptoms of the disease, as well as its prevention of progression.Strategy and tactics of therapy should be selected taking into account the symptoms, duration and stage of the disease, age of the patient, presence or absence of her problems conceiving, and related genital and extragenital disorders.
Upon detection of endometrial small size of the cyst, the patient can be administered a course of hormonal therapy with:
- monophasic low-dose combined oral contraceptives;
- norsteroidov derivatives;
- depot medroxyprogesterone acetate;
- synthetic agonist of gonadotropin-releasing hormone;
- androgen derivatives.
Pain caused by an increase in chocolate ovarian cysts, cropped use of nonsteroidal anti-inflammatory drugs, sedative and antispasmodic drugs.
With the ineffectiveness of bloodless treatment, with cysts having a size bolee5 see, as well as the presence of malignancy risk education and other complications of surgical treatment is indicated only.The most common operational methods considered resection and enucleation of heterotopic ovarian formations.Removal of endometrial cysts is performed with pre and postoperative hormone therapy.
In addition, patients in the postoperative period is a physical therapy aimed at correcting an endocrine imbalance, preventing adhesions and infiltration processes, as well as cysts relapse.