Ovarian cysts are detected by physical examination. Why do some do not need treatment, while others require surgery?

Ask

Do I need surgery for my ovarian cyst?

Observe for two or three months.

Answer

Ask

Am I not already diagnosed? Why should I keep watching?

Many women in life find out that they have ovarian cysts during physical examination. The first question that comes to mind is:

“Is this a tumor? Could it be cancerous? Does it need surgery?”

For this kind of situation, the doctor usually does not give treatment, only regular follow-up visits, first observation for two or three months, or it is not a big problem.

However, for some people, the doctor may recommend surgery.

In fact, what we call “cyst” is just a morphological feature, just like a balloon, with a layer of skin on the outside, and something inside it, that is, because of this structure, we Call it a cyst.

The structure looks similar on the outside, but there are many conditions inside, some are diseases, that is, pathological cysts, and some are not diseases, that is, physiological cysts.

In pathological cysts, some are benign tumors, and some may be malignant tumors.

In general, ovarian cysts are divided into many types, usually most of the physiological cysts do not need treatment and disappear on their own.

Surgical treatment is required if the cyst diameter is greater than 5cm; for patients with cyst diameter ≤5cm, conservative treatment is usually adopted, that is, regular follow-up observation, or oral medication for some cysts , according to the results of the review to decide the follow-up treatment, the specific situation needs to be analyzed [1].

At present, the specific cause of ovarian cysts in women is not yet clear. It is generally believed that the occurrence of the disease is related to a variety of factors, including environmental factors, dietary factors, endocrine factors, and genetic factors. et al [2].

1. Environmental factors

If you have the habit of smoking, or long-term exposure to second-hand smoke, or if you live in a harsh environment, or suffer from ionizing radiation for a long time, etc.

These factors may have a certain impact on the female reproductive system, thereby affecting the function of the reproductive system and the secretion of hormones, causing ovarian cysts.

2. Dietary Factors

If you have an irregular diet, excessive cholesterol intake, or high blood lipids, it may cause a decline in body function and lead to abnormal tissue hyperplasia in the ovary.

3. Endocrine factors

Studies have found that the dysfunction of hypothalamus-pituitary-ovarian may lead to pathological hormone secretion disorders, and then induce ovarian cysts.

4. Genetic factors

If the mother or sister has ovarian cysts, the chances of developing ovarian cysts themselves are relatively high.

I accidentally found ovarian cysts through B-ultrasound during the physical examination. Don’t be nervous. If you don’t have any discomfort at this time, and the B-ultrasound indicates that it is pure cystic, it is transparent inside. Okay.

Then, no treatment is needed for now. It is recommended to wait for the next menstrual period to be clean and review it immediately.

If it is a physiologic cyst, it may disappear on review, avoidUnnecessary surgical treatment.

If the B-ultrasound indicates that the cyst is mixed, cystic-solid, it is recommended to check the tumor markers first, and then review it.

If it is found that the tumor markers are elevated, it is necessary to be alert to the possibility of malignant tumors, and timely treatment measures should be taken at this time [3].

The picture shows ovarian cancer

In addition, during the review process, timely treatment is required if the following conditions occur:

1

Persistent postmenopausal cysts, or newly discovered postmenopausal cysts

Ovarian cancer mostly occurs in postmenopausal women. Because women’s ovaries gradually shrink after menopause, the ovaries deep in the pelvis are usually difficult to touch during gynecological clinical examinations, which easily delays surgery. the best time for treatment.

Therefore, postmenopausal women with ovarian cysts require further diagnosis and evaluation, and women at high risk of ovarian cancer require prompt surgical intervention.

2

3 months later, the ovarian cyst did not disappear, but increased

This condition is considered pathological and surgery is recommended.

3

menstrual cramps are getting worse

If dysmenorrhea becomes heavier and even affects life, consider the possibility of a chocolate cyst and seek medical treatment in time.

4

Severe abdominal pain after exercise

Sometimes ovarian cysts twist or rupture, causing severe pain, especially after exercise.

5

Have a family history of ovarian cancer

Ovarian cancer is a manifestation of malignant ovarian cysts, and there is a certain familial tendency.

Ovarian cysts are mostly benign, but some can turn into cancer.

For this reason, it is recommended that you follow your doctor’s instructions and do a good job of review.

When a cyst continues to grow or is causing you a lot of trouble, it’s time to seek treatment.

Reviewer

Liu Haifang| Deputy Chief Physician, Department of Obstetrics and Gynecology, Huashan Hospital Affiliated to Fudan University

References

[1] Li Huajun, Ding Xiaoman, Leng Jinhua, Lang Jinghe. Discussion on surgical indications for ovarian cyst patients [J]. Advances in Modern Obstetrics and Gynecology, 2003, 012(006) :442-444.

[2] Song Ziling. Clinical research progress on the causes and treatment of ovarian cysts[J]. Clinical Medical Research and Practice, 2017:192-193.

[3] Sun Aijun. Li Xiaodong et al. A hundred questions and answers about common female diseases [M]. China Medical Science and Technology Press, 2018: 139-141.

[4] Fan Hong. Experience in the diagnosis and clinical treatment of ovarian cysts in postmenopausal women [J]. China Practical Medicine, 2013(15):34-35.

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