A dark blister on the ultrasound: Most of the gynecologist discovered an ovarian cyst by accident at the check-up. As a rule, the tumor is not a cause for concern. Only rarely is there a serious illness behind it.
An ovarian cyst (ovarian cyst) is a baggy tumor on the ovary surrounded by a capsule. It is filled with a thin or viscous content. The term "cyst" has purely descriptive character. He does not say anything about whether the change is benign or malignant. But ovarian cysts are for the most part benign.
Most ovarian cysts are benign changes that can arise, for example, by an excess of certain sex hormones. These so-called functional cysts usually cause no pain, disappear by itself and do not require therapy.
Nevertheless it is important that the doctor determines the cause of the new formation und Eierstockkrebs and other diseases requiring treatment such as polycystic ovarian syndrome (PCO) or endometriosis excludes.
Ovarian cysts are no independently growing tumors such as ovarian tumors (ovarian carcinomas), but caused by a Accumulation of liquid. There are different types of ovarian cysts with different causes and developmental mechanisms. In general, cysts can be divided into ovaries in:
- Functional cysts that have hormonal causes and
- Retention cysts that arise when a gland does not release its secretion, but collects it in the gland
In women of childbearing age it comes once a month Ovulation. The egg first ripens in a vesicle, the so-called Graaf follicle, in the ovary approach. On the day of ovulation, the follicle bursts and releases the egg in the Fallopian tubes, so that it can be fertilized.
Under certain conditions, however, it may happen that the follicle continues to fill with fluid and grow without bursting. Graaf follicles are usually no larger than two inches. If ovulation fails, a follicle can to a cyst up to 15 centimeters in size become. It can come to this exaggerated growth, though
- the body too much of the follicle-stimulating hormone (FSH) forms or
- the follicle too sensitive to a normal amount of FSH responding.
Corpus luteum cysts
A corpus luteum cyst is a cyst-shaped enlarged yellow body. The yellow body (corpus luteum) arises after ovulation from the remnants of the cracked Graaf follicle. In the pregnancy the corpus lute remains in the first three months and forms Hormones that sustain the pregnancy. Sometimes it happens that in this time Blood in the yellow body collects. This swells then to the cyst.
Even with non-pregnant women occur corpus luteum cysts. Normally, the yellow body forms when the ovum is not fertilized. This reduces the hormone level and triggers menstruation. Certain influences - about a hormone therapy - but can cause larger amounts blood in the yellow body. Then it does not initially develop, but grows up to the cyst.
Lutein cysts usually form in both ovaries, when the production of certain hormones is greatly increased, which is the Oocytes in the ovaries to mature. These include hormones
- the so-called human chorionic gonadotropin HCG, which forms the placenta (placenta) in the first months of pregnancy as well
- the hormones FSH, LH and prolactin, which are derived from the pituitary gland.
Unusual large amounts of HCG For example, the placenta forms when a Fraumit is pregnant with several children is. Sometimes, however, there are also certain illnesses behind it, for example tumors or a developmental disorder of the placenta (called bubble mole).
FSH, LH and prolactin get infertile women given as part of a hormone therapy. The hormones can cause ovulation and thus increase the likelihood of pregnancy. Lutein cysts can arise as a side effect of this treatment.
Lutein cysts usually return on their own if their causes are eliminated - for example, after the birth of multiple births or after stopping hormone treatment.
Cysts in PCO
PCO is a hormonal disorder that causes ovulation to stop. The affected women have a surplus of male hormones. This causes the follicles do not grow into fertilizable ova. Instead, the follicles become too small cysts that are beaded line up at the edge of the ovaries.
Another disease, which can lead to cysts on the ovaries, is the so-called Endometriosis. The affected people settle down Tissue of the uterine lining in other organs on, sometimes in the ovary. During menstruation, these pieces of uterine lining begin to bleed. Unlike the uterus, there is in the ovaries, however, no outflow for the menstrual blood. Therefore, cysts are formed there.
Endometriosis cysts have a characteristic appearance. They contain dark brown, thickened blood breakdown products and are therefore also called Chocolate cysts.
A retention cyst develops when glandular fluid builds up. Glands form fluid (secretions) as so-called excretory organs and divert them - for example, through a corridor. If the drain is disturbed, more and more secretions accumulate. This retention causes the gland to swell into a cyst.
Retention cysts include, for example, the so-called Dermoid cysts. Dermoid cysts are derived from germ cells, congenital malformations. They can be hair, sebum, cartilage or bone tissue as well teeth contain. Dermoid cysts are benign changes and account for about one-third of all benign neoplasms on the ovaries. They occur especially in younger women. In rare cases, a dermoid cyst degenerates into a malignant Tumor.
Often, an ovarian cyst is only a few inches tall and causes no symptoms. The doctor usually discovers it fortuitously in the framework of gynecological ultrasound examination. If a cyst reaches a certain size, it will exercise Pressure on the neighboring organs out. This can manifest itself in the following symptoms:
- Dull or drawing Lower abdominal pain
- Frequent urge to urinate
- Emptying disorders of the intestine
- Pain during intercourse
- Back pain
If an ovarian cyst bursts, this is often through severe pain noticeable. Usually such a so-called rupture is harmless. But in some cases can do it vessels Get damaged. Resulting from this Bleeding in the abdomen the doctor needs eliminate it surgically.
Strong pain in the lower abdomen and other symptoms like diarrhea and however, nausea may also indicate that the cyst has rotated around its own axis. This so-called handle rotation can cause the blood supply to the ovary is interrupted. In this case also an operation is necessary.
At the gynecological screening the doctor scans the uterus, the fallopian tube and the ovaries of the patient. With this so-called palpation can detect large cysts. Small cysts usually fall within the scope of ultrasound examinations on, which are also part of the check-up.
If the doctor has discovered a cyst, he will first try sometimes the ultrasound images give an indication of which cyst type is present.
If not, are further investigations necessary. The doctor can say something like:
- the blood examine the patient for specific tumor markers and inflammatory and hormonal levels to examine and / or
- perform a laparoscopy
In addition to laparoscopy, the doctor can tissue samples remove it from the ovarian cyst and examine it under the microscope. In this way, for example, he can distinguish an endometriosis cyst from a malignant tumor.
If there are indications of a dermoid cyst from the ultrasound image, the doctor checks in a subsequent scan surgery, whether it is actually this form of ovarian cyst. Cyclic occurring pain and circulatory disorders in younger women, the first point to one functional cyst out. Here an operation is usually not necessary because they usually regress spontaneously. At check-ups, they are often no longer detectable.
The therapy depends on the type and size the cyst.
Functional cysts usually require no therapy, as they often regress spontaneously and only cause discomfort at a certain size. However, it makes sense the cyst regularly checked by the doctor to rule out malignant changes. This is particularly important in patients after the Menopause.
If a cyst persists for several menstrual periods, does not change in size, grows and / or causes discomfort, the doctor may remove it as part of a laparoscopy.
The doctor may also remove endometriosis cysts as a part of a laparoscopy. However, many women develop new cysts after a few years. In patients with severe symptoms then there is the possibility of the completely remove ovaries, so that they no longer produce sex hormones. Without these hormones, the endometrial cysts and other endometriosis foci in the body can not continue to grow. However, this one is intervention with strong side effects because the sudden disappearance of these hormones often causes severe discomfort.
More tolerable is the therapy with hormonal agents that inhibit the body's own hormone production in the ovaries. These include contraceptives like the Birth control pills. (For patients with fertility this is of course unsuitable.)
Also patients with PCO can the birth control pills help. The hormonal contraceptive counteracts the excess of male hormones. This can often be the typical for PCO complaints acne and relieve excessive body hair.If the victim wishes a child, therapy with Clomiphene may be required help to ovulate and one pregnancy to allow.
Functional cysts usually persist for only a few weeks and then form back by themselves.
Serious complications are rare. The cyst can burst, which can lead to severe pain. This so-called rupture is usually harmless. In some cases, however, can be caused by the tearing of vessels bleeding in the abdomen that the doctor has to stop with surgery.
Sometimes it happens - for example, as a result of jerky movements - that a cyst turns around its own axis. Such a so-called handle rotation can the blood supply of the ovary affect. In this case, the doctor may surgically remove the cyst to restore the blood supply to the ovarian tissue and protect it from dying.
Functional ovarian cysts formed by the influence of sex hormones. Theoretically, the production of these hormones could be inhibited by drugs. However, that's usually neither useful nor necessary: many functional ovarian cysts form spontaneously back and do not re-emerge. In addition, an inhibition of endogenous sex hormones is associated with side effects and is not suitable for women with Fertility.
The situation is different polycystic ovarian syndrome (PCO): This condition may be preventable. Although the cause of PCO is not yet clear. However, doctors assume that overweight and a preliminary stage of diabetes (the so-called insulin resistance syndrome) favor the development of PCO. With a healthy nutrition and enough Sports These risk factors can be minimized.