Endometriosis is a disease in which the walls of the uterus grow beyond its limits. Today it ranks third among all gynecological pathologies. Its exact causes are still poorly understood. The disease can take various forms. One of its most common manifestations is an endometrioid cyst of the left or right ovary. With improper treatment, pathology can lead to hormonal disorders, infertility.
Medical certificate
Endometrium is the layer lining the uterine cavity from the inside. It is responsible for the attachment of a fertilized egg. Every month this layer grows and thickens, and in case of no pregnancy, it is rejected. Endometrial cells are able to implant in soft tissues. They can germinate and fully function. This phenomenon is called endometriosis.
ElementsThe inner layer of the uterus enters the ovary through the fallopian tubes during menstruation. There may be several reasons for this violation:
- wide oviducts;
- narrow cervical canal;
- sexual intercourse during menstruation.
In many women, endometrial elements penetrate the ovary, but a cyst forms in only 10% of them. Therefore, other factors play an important role in the development of the disease. These include heredity, the state of immunity and hormonal levels. More details about the causes of endometrioid cysts will be discussed below.
The elements of the inner layer of the uterus after entering the ovary are in favorable conditions for growth. The sex glands are well supplied with blood, have a rough surface, and during ovulation, the integrity of the capsule does not suffer. Endometrial cells easily attach to the ovary. From the moment they begin to germinate, a cyst is formed.
At first, the pathological focus affects the ovarian tissue slightly. It gradually deepens. Under the influence of certain factors, the endometrial glands enlarge and form a cyst. In her cavity, secretions accumulate every month. After a while, they become dark brown. Therefore, such a cyst is often called "chocolate".
Causes of pathology
In a he althy body, if endometrial cells enter the ovarian tissue, they do not take root. With violations of the hormonal state or a decrease in immune defense, pathology develops. Doctorsthere are several factors, the presence of which provokes the growth of a cyst:
- surgical interventions in the uterine cavity;
- abortions;
- obesity;
- bad habits;
- abdominal injury;
- diseases of venereal and inflammatory nature;
- immunodeficiency states.
Endometrioid cysts grow under the influence of hormones. Elevated estrogen levels lead to their rapid increase. In a he althy body and with a normal content of sex hormones, the neoplasm grows slowly and may not manifest itself in any way.
First symptoms
Clinical manifestations of neoplasms depend on several factors: the size of the pathology and its prevalence, the presence of concomitant he alth problems, and so on. Most often, the growth of an endometrioid cyst is accompanied by pain in the lower abdomen and groin. They are aching or pulling in nature, can spread to the lumbar region and perineum. The pain syndrome intensifies during intimacy, during menstruation, during physical activity.
Menstruation with this pathology is profuse and painful. In the intermenstrual period, the appearance of spotting discharge with a brownish tint is not excluded. A long pathological process usually leads to adhesions in the pelvis. As a result, intestinal obstruction occurs, a woman suffers from constipation and bloating.
Endometriosis, as a rule, develops against the background of hormonal disorders. Therefore, the clinical picture can be supplemented by a violation of the female cycle. Due to heavy or prolonged menstruation, oftenanemia occurs. It is manifested by pale skin, dizziness, tachycardia and shortness of breath.
Complicated pathology
If you do not start treating an endometrioid cyst when the first symptoms appear, the pathology can lead to various complications. Growing and increasing in size, the neoplasm begins to compress the ovarian tissue. This process often ends with hormonal imbalance and infertility. The menstrual cycle is disturbed, hair growth increases throughout the body. Many women complain of mood swings and increased fatigue.
Rupture of a cyst entails the outpouring of its contents into the abdominal cavity. The result is peritonitis. This process is accompanied by severe pain that appears suddenly. The woman's pulse increases sharply, the skin turns pale and covered with sweat.
The temperature is gradually rising. In critical situations, it reaches 39-40 degrees. The clinical picture is complemented by nausea, loose stools and vomiting. Any touch on the abdomen causes severe pain. This situation requires emergency surgery. The endometrioid ovarian cyst is removed, and with it, almost always the ovary itself. Any delay could cost the woman her life.
Diagnostic Methods
To diagnose a pathological process, several methods are usually used. The very first of them is an examination on a gynecological chair. Already during the examination, the doctor may assume the presenceneoplasms along enlarged appendages. Often, a two-handed examination is painful for a woman, indicating inflammation of the internal genital organs. To confirm the preliminary diagnosis, ultrasound, MRI and laparoscopy methods are additionally used.
On ultrasound, the endometrioid cyst is clearly visible. It looks like a small spherical formation that practically does not move. It is usually necessary to repeat this procedure in different phases of the cycle in order not to be mistaken with the diagnosis. For example, a corpus luteum cyst looks the same, but over time it decreases or disappears altogether. Endometrial growth will only increase.
MRI of the pelvic organs allows you to assess the prevalence of the pathological process and its nature. With laparoscopy, the doctor can examine the cyst with his own eyes. This procedure does not require skin incisions, but is performed using local anesthesia. Often during laparoscopy, the doctor makes a puncture for subsequent examination of tissue under a microscope.
Based on the results of a comprehensive examination, the doctor selects the therapy. It can be both medical and surgical in nature. All treatment methods will be discussed later in the article.
Non-specific therapy
The main goal of such therapy is to alleviate the symptoms of pathology. Non-specific treatment will not remove the endometrioid cyst, but it will help to stop pain and heavy bleeding. For this, non-steroidal anti-inflammatory drugs are prescribed:Diclofenac, Rofecoxib, Indomethacin. The listed medicines are used situationally, for example, in the period before and after menstruation. However, they should be used strictly on the advice of a doctor. Uncontrolled treatment is by no means harmless and can provoke serious liver damage.
Hormonal drugs
If the appearance of a neoplasm is caused by a hormonal disorder, surgical removal of the endometrioid cyst is postponed for several months. At this time, the patient is prescribed contraceptives. They allow you to slow down the work of the ovaries, normalize the hormonal background and the menstrual cycle. These changes contribute to a reduction in the size of the neoplasm. Of the variety of combined oral contraceptives produced, doctors prefer dienogest-based products. For example, "Janine" and its analogues "Bonade", "Klayra".
Progestogen drugs have proven themselves well in the treatment of endometrioid ovarian cysts. They are analogues of hormones that prevail in the II phase of the female cycle. As a rule, patients with this disease have an excess of estrogens. Progestogens can balance the imbalance and suppress the growth of new lesions.
Drugs are available in the form of tablets and solutions for injection. It is convenient to drink pills, it is easy to choose the right dosage and cancel with the development of allergies. Injections are done every few days. However, with the development of an allergic reaction, the effect of such a drug cannot be immediately canceled, because it is absorbed slowly and gradually. Of the tablet preparations, most oftenappoint "Duphaston", "Visanne" and "Norkolut". As for intramuscular agents, Depo-Provera and Medrixiprogesterone-Lance are preferred.
When taking medication, the nature of menstruation may change. Around the second or third month of therapy, spotting from the vagina sometimes disappears altogether. Some women experience symptoms of estrogen deficiency. They are manifested by palpitations, hot flashes and dry mucous membranes.
Physiotherapy
Additional therapeutic effect is provided by various physiotherapy. If a woman has been diagnosed with an endometrioid cyst of the right or left ovary, the treatment complex can be supplemented:
- phonophoresis;
- radon baths;
- reflexology;
- plating;
- magnet therapy.
Physiotherapy enhances the effect of medications. They are selected on an individual basis, taking into account the general he alth of the woman.
Surgery
When the disease is advanced, an operation is indicated. An endometrioid cyst is most often removed by laparoscopy. The advantages of this method of treatment are obvious to the doctor and the patient. The operation does not require deep incisions and sutures, and the recovery period is almost painless.
During the procedure, the doctor introduces instruments for manipulation through several punctures, through which the neoplasm is excised. As a result, all reproductive organs are preserved inintegrity, so the probability of getting pregnant is quite high.
Another surgical option is laparotomy. Surgery with an incision in the abdominal wall is used in extreme cases. For example, if a woman has already had interventions in the abdomen, and the risk of developing an adhesive process is high. In this case, it will not be technically possible to go through all departments with a laparoscope.
Depending on the variant of the operation, the following procedures can be additionally assigned:
- ablation (cauterization of endometriotic lesions);
- ablation of the sacro-uterine nerve for relief of pelvic pain;
- presacral neurectomy (removal of some nerves).
The volume of intervention is determined by the doctor, taking into account the clinical picture and the presence of concomitant he alth problems in the patient.
Recovery period
The recovery period after surgery largely depends on its volume. For example, after laparoscopy of an endometrioid cyst, the sutures are removed on the seventh day. Discomfort and pain are practically absent. By the time of discharge, and this happens after 9 days, the patients feel well and can return to the usual rhythm of life. After open surgery, discomfort may persist for up to 2-3 weeks. To stop the pain, the woman is prescribed analgesics.
Help of traditional medicine
Can an endometrioid ovarian cyst resolve on its own? The answer to this question will always be negative. To get ridfrom a neoplasm, it is necessary to undergo a course of treatment. However, some women prefer to replace conservative therapy with alternative options.
To the help of traditional medicine, doctors advise resorting only as an addition to the main course. Recipes of doctors can only stop unpleasant symptoms. They can also be used during the recovery period. Baths based on medicinal decoctions have proven themselves well in these matters. All of them are prepared according to a single scheme: pour 2 cups of vegetable raw materials with 2 cups of boiling water, heat in a water bath and cool. Strained broth should be diluted in 2 liters of boiled water. Baths should be taken in the morning and evening for about 25 minutes. The course of therapy includes 12 procedures.
Which plants are best for making baths? Folk healers recommend the following fees:
- coltsfoot leaves, nettle, bird cherry and juniper fruits;
- blueberry and birch leaves, tansy flowers, upland uterus;
- chamomile flowers, oak bark, tricolor violet.
Prognosis for recovery
Many patients are interested in: what are the prognosis after removal of the endometrioid cyst? The doctors' comments are encouraging: if the medical recommendations are followed, the likelihood of a relapse is reduced to zero. After a course of therapy, in most cases, the menstrual cycle is completely restored. Pain disappears, and a woman can try on the role of a mother. For several years after surgery, it is recommendedvisit a gynecologist regularly. In addition, it is required to take an analysis for the CA-125 tumor marker. This is the only way today to control the work of the endometrium.
Prevention Methods
As you know, the best way to avoid illness is to prevent it in a timely and correct manner. Regular examinations on the gynecological chair and ultrasound help to detect cystic formation, which is especially important for women of reproductive age. In addition, you need to monitor the menstrual cycle, the amount and nature of the discharge. When initial alarming symptoms appear, you should immediately consult a doctor. This is especially true for cases with painful periods.
Endometrioid cyst of the left ovary is much less common than the right one. However, the treatment of such a common disease does not depend on the location of the pathology. Modern diagnostic methods make it possible to detect the disease in a timely manner and immediately begin its treatment. It is important to choose the right course of therapy and not try to overcome the disease on your own. Only in this case can one hope for a favorable outcome, to avoid a complicated course of the pathology.
