The ovarian follicular cyst is a benign neoplasm that belongs to the group of functional cysts that are formed in connection with disturbances in the processes of ovulation. The size of the follicular cyst usually does not exceed 10 cm.
The ovulation stage of folliculogenesis( growth and maturation of follicles) is disrupted when ovulation does not occur. As a result, the pathological growth of the follicle occurs. Ovarian follicular cyst is the most common form of ovarian cystosis( up to 80%).
The development of the follicular cyst is not accompanied by unpleasant symptoms, and for the time being does not disturb the woman. Typically, the fair sex does not even suspect about the presence of this pathology and learn about it only in time for another examination by a gynecologist.
What is it?
Why does the ovarian follicular cyst appear, and what is it? The follicular cyst is a benign ovarian neoplasm that develops from the dominant follicle in the absence of an egg from it. The increase in the size of the formation is due to the transudation of the liquid contents from the adjacent blood and lymphatic vessels or in the case of continued secretion by the cells that make up the granulosa epithelial tissue.
As a rule, cysts up to 4-5 cm size dissolve on their own during the next menstruation or several subsequent cycles. As such, the follicular cyst of the right or left ovary is not treated in this case.
Requires treatment with follicular ovarian cysts, which continues to grow and in sizes exceeding 5-6 cm. If drug therapy does not produce results and the formation continues to develop abnormally, surgical intervention is required.
Causes of
The aetiology of cysts from follicular tissue is not fully understood. It is assumed that, like most ovarian neoplasms, the follicular ovarian cyst is due to hormonal causes.
Among the factors that can provoke or cause a violation of the cyclic nature of the menstrual period and the process of ovulation itself, it should be noted:
- External adverse effects of ( physical overload, stress and nervous fatigue, hypothermia or overheating, etc.);
- Internal factors of the pathological effect of ( inflammation, infection, STDs, diseases, functional disorders).
All these conditions are accompanied by hormonal failures, which delay ovulation and promote further growth of the follicle.
Symptoms of the follicular ovary cyst
The brightness of the symptoms is directly related to the activity of producing estrogen hormones and the presence of chronic diseases of the female reproductive system. These are pathologies such as:
- adnexitis( inflammation of the appendage tissues);
- endometriosis,
- uterine fibroids.
In most cases with a follicular ovarian cyst, the only symptom is the delay in menstruation. It can last from 5 to 21 days, and sometimes longer.
Symptoms associated with follicular ovarian cysts can be:
- drawing pain in the groin, extending to the lower back and lower limb;
- dysuric phenomena( frequent urination);
- bowel dysfunction( bloating, diarrhea, constipation);
- bloody discharge between menstruation;
- pain and discomfort intensifies in the 2nd phase of the menstrual cycle, after physical exertion, after sex, long walking, with sudden movements( somersault, slope, sharp turn)
Cysts, whose size does not exceed 4 cm, and with active production of estrogens does not giveknow yourself no unpleasant symptomatology. At the same time, in most cases, it dissolves independently against the background of hormonal activity at the onset of menstruation.
With a cyst higher than 8 cm, it causes pain in the lower abdomen, in the ileum. If the pain in this pathology is localized on the right, then the cause is the follicular cyst of the right ovary. Similar symptoms, but with left-sided localization of the pathological process and complaints of pain on the left, will cause the follicular cyst of the left ovary. Accordingly, only the left ovary will be involved in the pathological process.
As can be seen, the symptoms of the ovarian follicular cyst are quite common and can be provoked by other diseases of the female genitourinary system. In this regard, it is important to conduct detailed diagnosis for competent differentiation of the disease.
Rupture of the follicular ovarian cyst
The rupture of the follicular cyst occurs spontaneously, more often in the middle of the monthly cycle during the period of ovulation. The cystic follicle grows in parallel with another, normal active follicle that performs the function of forming the oocyte.
Signs of rupture of the follicular cyst:
- acute, daggerache side, lower abdomen, in the area of cyst localization;
- the pain quickly becomes diffuse, diffuse;
- drop in blood pressure and pulse;
- strained abdomen;
- cold sweat;
- nausea, vomiting;
- possible fainting.
The first thing done under stationary conditions is to stop the bleeding, then the cyst is removed within the healthy tissues. As a rule, the ovary itself is not operated, resection or its removal is possible only in extreme cases.
Hemorrhage in the cyst cavity
If the rupture of the follicular cyst is localized next to the vessel, sudden bleeding in the ovary can occur, followed by bleeding into the cavity of the peritoneum or small pelvis( ovarian apoplexy).
With intra-abdominal hemorrhage, the skin and mucous membranes pale, palpitations occur, blood pressure decreases. Apoplexy of the ovary can usually occur in the case of rapid growth of the follicular cyst in combination with an unexpected change in the position of the body, sudden movement, straining.
Signs of torsion of the follicular cyst of the ovary
When falling, abrupt movement, after sex, complete or partial torsion is possible, regardless of the size of the cyst, and the nerve-vascular bundle of the ovary is squeezed.
It is characterized by such symptoms:
- heart palpitations - tachycardia, a sense of fear;
- dizziness, general weakness;
- drop in blood pressure, cold sweat;
- pallor of the skin;
- nausea, vomiting, bowel work is suspended;
- slight increase in body temperature;
- very intense pain on one side - on the right or left, where the neoplasm is located, neither the change of position, nor the rest do not contribute to the loss of pain.
If there is a complication of the follicular cyst( torsion, rupture, hemorrhage), treatment is required immediately, and it can only be surgical.
Diagnosis
Diagnosis of this type of cyst is performed based on the data of vaginal-abdominal examination, laparoscopy and ultrasound.
During the gynecological examination, anteriorly and laterally from the uterus, a round tumor with a tight, smooth surface is detected. In ultrasound examination, a single-chamber globose formation 3-8 cm in diameter with anehogenous homogeneous contents is determined. When performing dopplerometry, peripheral areas of the blood flow are detected at a low rate.
Follicular cyst during pregnancy
At 12 weeks, all pregnant women do ultrasound. If the follicular cyst is diagnosed during the study, and it is small, usually the gynecologist decides to wait until the 17th-18th week, and then perform a laparoscopic cyst removal. Operation at an earlier date may adversely affect the course of pregnancy and provoke miscarriage.
However, if the detected follicular cyst has a leg, then regardless of the gestation period, this tumor should be removed. A growing fetus and a change in the position of the internal organs will almost certainly lead to a twisting of the cyst leg and its subsequent necrosis. That is, here we are talking not only about maintaining the pregnancy, but also about preserving the life and health of the mother.
How to treat the follicular ovarian cyst
Treatment of the follicular ovarian cyst is selected depending on the size of the tumor and the rate of progression of the disease.
- Expectant therapy .It is used, as a rule, if the cyst in diameter does not exceed 4 cm and there is a probability of its self-dilation. In this case, the treatment of the follicular ovarian cyst, as such, is not applied, and the therapeutic process is replaced by observation. The observation time should not exceed three months. If during this time the follicular cyst of the left ovary or the right ovary, remained unchanged or continued growth, then another method of therapy should be chosen.
- In the case where the follicular cyst recurs or increases in size, the woman is prescribed treatment with combined oral contraceptives .As a rule, this method of treatment is shown to young girls who have not yet given birth. In addition to contraceptive drugs, anti-inflammatory treatment, a complex of multivitamin preparations and homeopathic remedies are necessarily prescribed.
- Surgical intervention .Of course, if the neoplasm continues to progress, the diameter will be more than 8 cm, during 3 months its regression will not occur, and in cases of recurrent cyst the doctors will insist on surgical intervention. Surgical treatment consists of laparoscopy, cyst extraction, ovarian resection or suturing of its walls.
The success of the therapy is correlated with the size of the follicular cyst: if the ultrasound examination is to reduce the size of the cyst, the therapy is considered successful and can be prolonged until it disappears completely.
Operation
Cyst removal is performed on a scheduled basis, after preliminary preparation of the patient for this operation. This procedure is quite simple and low-traumatic. According to the clinical situation, the follicular ovarian cyst can be eliminated in several ways.
- The most common is the cyst excision( cystectomy).In this case, only the capsule and the contents of the cyst are removed, and all healthy tissues surrounding the cyst are preserved.
- Complicated cysts require not only the removal of the cyst, but also the damaged surrounding tissue, so the "piece" of the ovary is removed in the form of a wedge( wedge resection).
- If due to complications of the follicular cyst in the ovary irreversible changes occurred, adnexectomy( removal of the entire ovary) is carried out.
Treatment after surgery is aimed at restoring normal ovarian function. Combined oral contraceptives, vitamins are used. It is also desirable to eliminate psycho-traumatic factors, to get rid of stress. A full-fledged dream and rest is important. We must refrain from hot baths. Sunbathing on the beach or in a solarium is not recommended for such patients.
Prognosis and prevention
To prevent the formation of a follicular ovarian cyst, timely treatment of inflammatory and dyshormonal pathology of the ovaries is necessary, preventive observation in the gynecologist. With a recurrent course of the cyst, it is necessary to identify and eliminate the cause of the pathological condition.
The prognosis of the disease is favorable. In most cases, the pathology can be treated well. However, cases of relapses are not excluded, when the follicular cyst after a while appears again, in the same or opposite to the ovary. Repeated cases require careful monitoring and identification of the cause that caused them.