Ovarian cysts are very common, particularly in women between the ages of 30 and 60. They may be single or multiple, and can occur in one or both ovaries. Most are benign (non-cancerous), but approximately 15 percent are malignant (cancerous). Most of these cases are grossly misunderstood by many especially in our society.
Some women who suffer from these ailment ignore it until it degenerates to a level where the follicle sac bursts and the abdomen is filled with fluid.
When this happens, the stomach keeps protruding as if the woman is pregnant which is not true, and handling it at this time becomes complicated.
Consultant Surgeon, Dr. Emmanuel Enabulele spoke to Daily Sun on the rising cases of ovarian cysts. He revealed that most cysts are not cancerous, but care should be taken to prevent it from affecting the tubes thereby, causing infertility.
He also shed more light on the different types and possible treatment of ovarian cysts. Excerpts:
Ovarian Cyst
These are two words combined to form a common ailment in women. Ovary is part of a woman’s reproductive organs which releases egg for conception when fertilized by a healthy sperm. Cyst is a collection of fluid, pus and water in any part of the body. An ovarian cyst is any collection of fluid, surrounded by a very thin wall, within an ovary. Any ovarian follicle that is larger than about two centimeters is strictly termed an ovarian cyst. An ovarian cyst can be as small as a pea, or larger than an orange.
During ovulation (the process during which the egg ripens and is released from the ovary) the ovary produces a hormone to make the follicles (sacs containing immature eggs and fluid) grow and the eggs within it mature. Once the egg is ready, the follicle ruptures and the egg is released. Once the egg is released, the follicle changes into a smaller sac called the corpus luteum. Ovarian cysts occur as a result of the follicle not rupturing, the follicle not changing into its smaller size, or doing the rupturing itself.
Although there are five common types of ovarian cysts, they are clearly categorized into functional and non functional cysts. The functional cysts are made up of follicular cyst and corpus lutuem cyst. Both of these types of cysts develop as part of the natural function of the ovary. The follicular cyst occurs during ovulation when an egg is released into the fallopian tube or when a developing follicle fails to rupture. These cysts grow from 1 inches to 2 inches in diameter, and will usually dissolve within one to three months. While the Corpus Luteum Cyst is caused by a malfunction of the corpus luteum. Unless a woman is pregnant, the corpus luteum disintegrates. But in the formation of a corpus luteum cyst, it fills with fluid and remains in the ovary.
Non functional cysts consists of Dermoid cysts which are are also known as ovarian neoplasms and consist of skin or related tissue such as hair, teeth or bone instead of fluid like the cystadenomas. Dermoid cysts develop from the ovary’s germ cells (cells that produce the egg and the beginnings of all human tissues). Dermoid cysts may be present at birth but are not noticed until adulthood. They generally measure between 2 inches to 4 inches in diameter.
There is also the endometrioid cyst, or chocolate cyst which is caused by endometriosis, and is formed when a tiny patch of endometrial tissue (the mucous membrane that makes up the inner layer of the uterine wall) bleeds, becomes transplanted, and enlarges inside the ovaries. Endometriosis is a disease in which the endometrial tissue normally found in the uterus grows in other areas. After successive menstrual cycles, this misplaced endometrial tissue bleed, gradually forming endometrial cysts. In addition, there is also a polycystic ovarian cyst. A polycystic-appearing ovary is diagnosed based on its enlarged size, usually twice normal with small cysts present around the outside of the ovary. It can be found in child bearing women, and in women with endocrine disorders.
Symptoms
An ovarian cyst can cause pain if it bleeds, breaks open, is twisted or causes twisting which is known as torsion of the fallopian tube, when it twists along that way, blood flow becomes compromised. These symptoms include dull aching, sudden, and sharp pain or discomfort in the lower abdomen (one or both sides), pelvis, vagina, lower back, or thighs; pain may be constant or intermittent and this is the most common symptom. There is also severe pain during or shortly after beginning or end of menstrual period. Other symptoms include fullness, heaviness, pressure, swelling, or bloating in the abdomen, breast tenderness, Irregular periods, or abnormal uterine bleeding and change in frequency or ease of urination (such as inability to fully empty the bladder), or difficulty with bowel movements due to pressure on adjacent pelvic anatomy. Weight gain, nausea or vomiting, fatigue, infertility, and severe headaches are other symptoms.
Treatment
It has to start from proper diagnosis which involves a pelvic ultrasound scan. After the first ultrasound, there is a period of waiting to monitor the growth or regression of the cyst Treatment also depends on many factors, including the type of cyst, its size, its location, the type of material it contains and the woman’s age. For functional cysts a “watch and wait” approach is taken. Functional cysts tend to dissolve over time and treatment is not needed. The doctors however, require the woman to return after two menstrual cycles to get a pelvic exam and/or ultrasound again.
In the situation where the cyst causes abdominal pain and increases to about five to ten centimeters, then surgery is performed to remove the cyst or the ovary entirely. This is because when an ovarian cyst becomes symptomatic such as when it has undergone torsion, it has to be removed. The available procedures include: Ovarian cystectomy - removal of cyst, Partial oophorectomy - removal of the cyst and a portion of the ovary, Salpingo-oophorectomy - removal of the cyst, ovary and fallopian tube. This procedure is done dependent upon the size of the cyst and complications encountered such as bleeding, rupturing and twisting of the cyst. Total abdominal hysterectomy with bilateral salpingo-oophorectomy - removal of the cyst, both ovaries, fallopian tubes and uterus.
This procedure is rarely used unless the cyst is cancerous. Most cysts are benign and are not cancerous, but when it becomes cancerous, surgery is performed to remove all the components of the reproductive organs.
Mostly affected women
Once a woman starts menstruating, there is every tendency for her to develop an ovarian cyst. It affects women of reproductive age. After menopause, the risk of ovarian cyst is ruled out. It cannot rule out malignancies and other infections affecting women who have reached menopause.
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