Throughout life, a woman has to deal with diseases of the reproductive organs. One of them is the formation of a cyst on the ovary. The development of this pathology in most cases affects women of childbearing age. The cyst is benign and, in general, is very successfully treated. But in the absence of therapy or under the influence of external factors, a complication such as cystic torsion can develop. How this pathology manifests itself and what consequences it can lead to, we will analyze in this article.
Definition
An ovarian cyst is a benign mass that is a sac with liquid contents inside. The leg of the cyst has vessels supplying it, lymph vessels and nerves. Education has a tendency to increase due to the accumulation of secretions. In this case, growth of the ovary itself is also observed. By its nature, the cyst is quite mobile, because of which its torsion can happen. This leads to a violation of the blood supply, which is fraught with the development of the inflammatory process. It can also spread into the abdominal cavity, causing peritonitis. Cyst rupture can also occur, leading to bleeding. With this pathology, timely diagnosis is very important, since the consequences of torsion pose a danger to a woman's life.
Types of Torsion
In medicine, the torsion of the cyst legs is characterized as incomplete and complete. Consider the status data in more detail:
- Incomplete (less than 360 °). In this case, only small vessels and veins are squeezed. Arteries continue to function, so the blood supply to the cyst does not stop completely. This condition is dangerous in that the symptoms are poorly expressed - this leads to a late diagnosis of pathology. The periods of occurrence of painful sensations alternate with their subsidence. On palpation, a dense tight neoplasm is palpated. When trying to displace it, a woman feels severe sharp pain.
- Full (over 360 °). With this type of torsion, the arteries are also involved in the compression process, which completely stops the blood supply to the cyst. Life-threatening conditions may develop without timely assistance. With a complete twist of the legs of the ovarian cyst, the symptoms are quite pronounced. This allows you to almost accurately diagnose pathology.
Causes of pathology
The causes of torsion of the ovarian cyst are quite numerous. Consider the most common of them:
- Sudden movements during which the press is straining.
- Weight lifting.
- Bladder overflow. Untimely emptying can lead to the development of many pathological conditions. Torsion of cysts is one of them.
- Weakening of the abdominal muscles.
- Pregnancy and childbirth.
- Constipation
- Individual structural features of the cyst. For example, a long leg.
- Disorders of the gastrointestinal tract.
- Intimacy.
- Increased blood pressure in the neoplasm.
- Dramatic weight loss. Due to the departure of excess fat, the organs are slightly displaced, which can provoke torsion.
Symptomatology
Symptoms of torsion of ovarian cysts in women depend on its type and rate of development. The signs of complete and partial torsion are very similar, the difference is only the degree of their severity. The following manifestations of pathology are noted:
- Painful sensations from the affected ovary, which give to the perineum and lower back.
- Disorders of the gastrointestinal tract.
- Increased gas formation.
- An increase in body temperature, indicating the development of the inflammatory process.
- Weakness and dizziness.
- Intense sweating.
- Pallor of the skin.
- Frequent urination, especially in cases where a torsion has formed around the bladder.
- Dry mouth.
- Nausea and vomiting.
- Uncontrolled tension of the abdomen. On palpation, a woman feels pain.
- Increased breathing and heart rate.
- A sense of some relief of symptoms occurs after a woman adopts an “embryo pose”.
It is important to know that during the development of necrosis with a complete torsion of the ovarian cysts, the symptoms may recede. This is a dangerous condition, since without immediate medical attention peritonitis can occur, which can lead to death.
Diagnostics
Diagnosis of torsion of the ovarian cyst includes a set of examinations that will allow you to assess the degree of the pathological condition and exclude other, no less dangerous conditions with similar symptoms (for example, ectopic pregnancy, intestinal obstruction, appendicitis). The following examinations will be required to confirm the diagnosis:
- A medical examination, which includes palpation of the abdomen to determine the pain and tension of the abdominal muscles. A gynecological examination is also performed. An important diagnostic value is the questioning of the patient. The following information can help in the diagnosis - the time of onset of symptoms, their duration and intensity.
- Complete blood count to determine the erythrocyte sedimentation rate (ESR) and white blood cell count.
- General urine analysis.
- Histological examination.
- Ultrasonography. It is the most effective diagnostic method in which the size of the cyst, the degree of torsion, the structure of the neoplasm and its effect on neighboring organs are assessed. It is recommended to carry out this procedure as soon as possible with the appearance of symptoms of torsion of the ovarian cyst. The ultrasound photo is presented below.
- Laparoscopy. This procedure is carried out using a special device - a laparoscope. The method is used not only for diagnosis, but also for treatment. At the same time, three cuts are made in the abdominal cavity through which the device is inserted. Also, the laparoscope is equipped with a camera that displays the image on a nearby monitor.
First aid
When symptoms of torsion of the ovarian cyst appear, it is necessary to call an ambulance as soon as possible. A woman needs to lie on her side in an “embryo pose” to reduce pain. Breathing should be quick, but not deep. The use of medications is not recommended, because they can lubricate the clinical picture and provoke a rupture of the cyst. When bleeding occurs on the lower abdomen, it is necessary to apply a cold.
Treatment
Treatment of torsion of the ovarian cyst is not carried out using conservative methods. The disease requires emergency surgical intervention. The earlier the operation, the less likely the development of complications.
Currently, the surgical method for the treatment of pathology is performed in the following ways:
- Laparotomy This type of surgical intervention is used in the most severe cases (for example, when more than 6 hours have passed since the torsion). The procedure is performed under general anesthesia. During the operation, the surgeon performs an abdominal incision, and then removes the cyst along with the appendage. When a cyst ruptures, cauterization of blood vessels is performed.
- Laparoscopy. It is prescribed if after torsion no more than two hours have passed and peritonitis has not been diagnosed. This surgical method is very effective and does not have a long recovery period. After removal of the cyst, the ovary persists and after a while begins to function normally. The rehabilitation period during surgery performed by this method is 3-4 days. Currently, there is a more gentle method of treatment using a laparoscope, which is used if the cyst is benign and the functionality of the ovary is not impaired. During the operation, the twisted organ is untwisted and blood flow is restored. After that, the cyst is removed. If blood flow is not restored, the ovary is removed completely.
After the operation, antibiotics are prescribed to exclude the development of the inflammatory process and therapy is carried out aimed at provoking the disease.
Possible complications
A cyst on the ovary is a very dangerous formation, because its torsion can lead to complications dangerous to health and life. Consider the most serious consequences:
- Cyst rupture followed by peritonitis.
- The formation of adhesions from connective tissue. This is a protective reaction of the body, which is aimed not to prevent further twisting. As a result of stagnation of venous blood, fibrin is produced on the cyst, which forms adhesions with neighboring organs. But they can interfere with their normal functioning and do not guarantee complete protection against further torsion.
- Bleeding.
- Violation of the integrity of the ovary.
- The transition of the inflammatory process to the uterus, which may be an indication for its removal.
- Infertility.
Prevention
The main preventive measure of cyst torsion is its timely treatment. If, after diagnosis, the neoplasm does not disappear within two to three months, the use of hormonal drugs is necessary for its resorption. In some cases, the doctor decides on a surgical method for its removal.
Also, prevention of torsion of the neoplasm is compliance with the following recommendations:
- Refrain from excessive physical exertion and sudden movements of the body.
- Monitor your diet and gastrointestinal tract, preventing constipation.
- Carefully monitor your health and systematically visit a doctor.
- Timely undergo the necessary examination, including ultrasound. It will help to identify the development of pathological conditions in the early stages.
- If there are signs of torsion of the ovarian cyst, an ambulance should be called as soon as possible.
Forecast
With an early diagnosis of pathology and timely treatment started, the prognosis in most cases is positive. Sometimes it is possible to save the ovary and completely restore its functionality. But due to the fact that in the early stages of the development of pathology, the symptoms can be blurred, torsion is diagnosed already at a more advanced stage and the chances of preserving the organ are significantly reduced.
Conclusion
Torsion of ovarian cysts is a dangerous pathology that requires emergency surgical intervention. It has a rapid development, and if delayed, it can threaten the life of a woman. You must carefully monitor your health and not neglect the scheduled visits to the doctor.