Treatment of endometrioid ovarian cyst abroad
Endometrioid ovarian cyst is a pathological expansion of the tissue that is morphologically identical to the inner layer of the uterus (endometrium). This is one of the clinical forms of genital endometriosis.
This affects women of fertile age. Only 6% of patients around 50 years of age have been diagnosed for the first time. Endometrioid ovarian cyst either goes with endometriosis in some other location or another disease of the reproductive system.
Causes of endometrioid ovarian cyst
Endometrioid ovarian cyst is due to the expansion of the inner uterine layer tissues. Endometrial cells can get into the ovary via different means like:
- Through blood vessels
- Through the lymphatic vessels
- During pelvic surgery
- Result of the injury
- Together with menstrual blood, which seeps into the fallopian tubes and abdominal cavity
There are risk factors that contribute to the development of this illness. Women who satisfy the following factors especially with a medical history are under higher risk of developing endometrioid ovarian cyst:
- Had frequent gynecological invasive medical procedures or surgeries
- Went through complicated childbirth
- Have hormonal disorders
- Suffer from chronic inflammatory illnesses of the pelvic organs
Symptoms of endometrioid ovarian cyst
Pain is a clear clinical symptom of endometrioid ovarian cysts. It is experienced during premenstrual period and during menstruation. The pain is located in the lower abdomen.
Its appearance is due to:
- Swelling of endometrial tissue
- Accumulation of blood in a closed cavity
- Accumulation of glands secretion
Endometrioid ovarian cyst doesn’t always have symptoms of pain so a woman won’t consider it a reason for a doctor’s visit. Or she thinks that the discomfort is associated with her periods, which is fine.
Infertility can develop as a result of adhesions. Adhesion process is diagnosed when a woman doesn’t get pregnant during a year of regular sexual life with a fertile partner without any contraceptives. Sometimes, women who have endometrioid ovarian cyst, go to the doctor because of this infertility issue.
If a cyst ruptures and its contents enter the abdominal cavity, the symptoms of peritoneal irritation can appear (muscles tension in the lower abdomen on palpation, feeling of fullness in epigastrium, growing pain while soft push on the anterior abdominal wall and sharp arm retraction).
Diagnostics of endometrioid ovarian cyst
Doctor can suspect endometrioid ovarian cyst on the basis of patient’s complaints and through gynecological examination. Further, following visual techniques help to evaluate its size and location:
- Spiral CT
Majority of patients have just one cyst in one ovary. These form 81% of women. 16% of sick women have 2 cysts, 2.5% of women have 3 cysts and 0,5% have 4 and more endometrioid cysts. 90% of women patients don’t have a cyst more than 7 cm in diameter.
Stages of endometioid ovarian cysts are:
- Stage 1 is when there are small formations on the ovary surface that don’t have cavities
- Stage 2 means a cyst of one ovary that has cavity with a diameter no more than 6 cm
- Stage 3 means there is one cyst of more than 6 cm in diameter on one ovary and small formations of endometrioid tissue on the second
- Stage 4 means there are cysts on both ovaries, more than 6 cm in diameter
Laparoscopy can help to confirm the diagnosis. This method of surgical diagnostics and treatment protrudes into the pelvic cavity and take biopsy sample for analysis.
Treatment of endometrioid ovarian cyst abroad
The surgical treatment is a basic one. It is associated with oncological vigilance and low effectiveness of drug treatment. Any cyst that doesn’t regress during 8 weeks has to be removed.
Surgical treatment. All the patients have laparoscopy which is aimed at the removal of ovary part or endometrioid cyst. They resect the formations, otherwise, when a woman wants to preserve reproductive function it is possible to destroy them by ultrasound, laser, cryodestruction (by cold) or other methods of physical influence.
Meanwhile, surgeons remove the adhesions that violate permeability of the fallopian tubes and prevent the conception of the child. If necessary, endometrioid foci are removed in the other organs. Extent of the surgery depends on the extension of endometriosis and the necessity to preserve woman’s fertility, if she is in the fertile age and is planning to have kids in the future.
Treatment with medication presupposes the indication of hormonal drugs that slow down the growth of endometrioid ovarian cysts. It is administered after the surgery or instead of it, if a cyst is small and a woman doesn’t plan to have kids; the disease is asymptomatic and doesn’t influence her life quality.
Empirical drug therapy (without confirmation of the diagnosis by laparoscopy) is not usually advised, because supposed endometrioid ovarian cyst might be a tumour.
Endometrioid ovarian cyst - Prognosis
Life and work capacity for this illness is favourable. Risk of the recurrent cyst within next 5 years is 15-30% after the surgery.
Endometrioid cyst can become malignant. In this case ovarian cancer can develop. It is diagnosed among almost 1% of patients with endometrioid ovarian cyst. Risk is considerably increased if the formation is more than 9 cm in diameter.
Prognosis for the fertility is conditionally favourable. 50% of women have infertility on the basis of endometioid ovarian cyst, but the reproductive function is restored after the surgery. If pregnancy doesn’t happen during a long period of time, a patient can overcome it with the help of assisted reproductive technologies.