1-What do we understand when we say ovarian cysts?
Cystic (inside) cysts develop in some places from the ovary, which is one of the main reproductive organs in women and has a diameter of approximately 3 cm. fluid-filled vesicles) are formations consisting of solid (hard tissue particles) structures in some places.
2-How often is it seen and at what ages?
Although it is most commonly seen between the ages of 20-44, it varies at almost every age. Each woman may encounter this problem at least once in her life due to its types having different characteristics.
3-Which complaints can women experience and what should women be suspicious of and consult a physician?
Pain in the groin, abdominal tension, irregular Although doctors are consulted with complaints such as menstruation, frequent urination and constipation, it is most often encountered during routine gynecological examination in women who have no complaints, which greatly increases the importance of routine gynecological examination, which should be performed every 6-12 months in cases of ovarian cysts.
4-What is the most important issue in the follow-up and treatment of ovarian masses?
Actually, this is the most crucial point of the subject. Whether an ovarian mass is encountered during routine gynecological checks or detected while investigating complaints, the primary target is whether these masses are malignant cancer or benign masses. To make this distinction, we first conduct a detailed ultrasonographic examination and search for tumor markers in the blood, and if necessary, apply advanced diagnostic methods such as PET-CT MRI and computerized tomography. If there is a suspicion of cancer, we first plan a surgical operation and try to make a definitive diagnosis after pathological examination without wasting time.
However, fortunately, only 7% of the masses formed before menopause and 30% after menopause carry malignant potential. It is necessary to distinguish whether these are cysts that are the result of ovulation that occur every month in the menstrual cycle) or a benign tumor.
Here, to make this distinction, be patient and try. You have to be polite. First, a detailed technical evaluation is essential, followed by drug therapy or observation of patients for 1-3 months. Most of the non-cancerous benign masses are functional cysts and they regress only by observing for 1-3 months or by using birth control pills, saving patients from unnecessary surgery.
However, if the cysts do not regress and continue to grow after 3 months of treatment and observation. In this case, it is necessary to plan a surgical operation.
5-Why is surgical treatment planned for non-functional benign tumors and how is it done?
There are 2 important problems in benign tumors. First; Depending on the type, 1-25% of them may have the potential to become cancerous over time, and this risk must be eliminated. A second important issue is that since these cysts mostly appear before menopause, as the cysts grow, they begin to steal from the ovaries and reduce and destroy the ovarian capacity, and after a while they may cause reproductive problems.
6-Is there a risk of ovarian cysts causing infertility?
Yes, in fact, all ovarian cysts, even functional ones, are closely related to infertility. Tumoral cysts destroy the ovary and reduce its volume, and as time progresses, ovarian reserves decrease. Especially endometriomas, popularly called chocolate cysts, increase the risk of infertility by both reducing the ovarian volume and causing adhesions in the tubes. Ovarian reserves should be investigated in women with frequent functional cysts and attention should be paid to the risk of early menopause. Because we see functional cysts more frequently in the pre-menopausal period when the quality of the ovaries decreases.
7-Is there a need to monitor functional cysts as they regress for a long time?
Of course, functional cysts should be monitored closely as they may rupture and cause internal bleeding, turning around and causing ovarian torsion. If what we say is delayed, it can pave the way for serious conditions that will completely destroy that ovary. Moreover, it is necessary to make sure that all functional cysts disappear, only then can it be sure that this cyst is not a tumoral cyst.
8-What is the importance of chocolate cysts?
Chocolate cysts The layer that forms the menstrual cycle in the uterus, which we call endometriosis, is damaged in the ovaries. It forms a cystic structure and can lead to infertility, severe pain, adhesions and sexual problems. It is vital for perfect treatment and follow-up to protect both the sexual and reproductive health of the person and to improve the quality of life. One of the most important treatment mistakes is performing late surgery as well as early surgery. An equally important issue is that a large number of cysts will recur after surgery, and even if a successful surgical treatment has been applied, care must be taken to continue medical treatment until menopause. It should not be forgotten that each recurring chocolate cyst causes more complex problems.
9- Are cysts important during childhood and adolescence?
It is definitely important because some types of ovarian cancers are observed at that age, and benign cysts that form may cause significant ovarian tissue loss, as they would never be considered at that age. Since this age group does not have the habit of going to the doctor, patients often come late. Young girls in these age groups who complain of meaningless groin pain, menstrual irregularity and abdominal swelling should be evaluated with ultrasound. 10-What method do you use in the treatment of these masses? Since most of them are working women or young girls continuing their education, surgical treatment is aimed to be a method that will cause the least cosmetic damage, as short a hospital stay as possible and to return to the social or work environment as soon as possible. In recent years, we prefer laparoscopic surgery (classical or robotic) in almost all our patients, except for advanced cancer patients. In this way, we can achieve all the surgical goals we aim for perfectly and the patients can go home the same day or the next day and return to their social environment after 1 week. 11-Removal of ovarian masses What should women pay attention to in order to be protected from the problems it may cause?
Women of reproductive age should not skip their routine gynecological check-ups, but young girls under the age of 20 should be referred to a doctor if they complain of menstrual irregularity, abdominal swelling or meaningless abdominal pain.
Post menopause The controls should not be interrupted until at least the age of 70. It should not be forgotten that while only 7% of ovarian masses before menopause carry cancer potential, this rate increases to 30% after menopause and they have the potential to encounter more serious conditions.
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