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Yellow Ovarian Cyst

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Cyst of the yellow ovary body photo Cyst of the yellow body of the ovary is a cavity with a capsule and liquid contents of benign origin formed temporarily in a healthy ovary from the cells of the yellow body. Cysts of the yellow body are found less often. They do not have age preferences, so they can appear in 16 and 55 years, and are often accompanied by inflammatory processes of fallopian tubes, ovaries and / or hormonal dysfunction.

From external adverse effects, the ovary reliably protects the dense membrane. Under it, in the cortical layer of the "adult" ovary, there are many small formations, similar to vesicles, these are primordial follicles. Each primordial follicle is formed by an egg in the environment of the epithelial cell layer. The primordial follicle grows with the egg, feeding and protecting it until it ripens. At the same time, follicles are present in the ovary at different stages of maturation, but only one contains an adult, ripe, ovum. The ripened follicle( graafa vesicle) does not exceed 20 mm in size, it is filled with a follicular fluid and is surrounded by a granular membrane.

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For a time interval equal to one normal menstrual cycle, one follicle and, correspondingly, one egg in it, can fully form. In the process of ovulation of the Graaff, the vesicle bursts and releases an ovum from the ovary, and instead of it appears a temporary hormonal structure - the yellow body of the ovary.

The source of the formation of the yellow body is the granular cells that remain after the rupture of the follicle. They begin to multiply intensively and germinate with a network of new blood vessels. Cells of granulosa begin to gradually accumulate carotene and be replaced by luteal cells having a characteristic yellowish color. Despite the name, only the inner layer of the shell of the yellow body is colored in yellow, and the liquid filling it remains transparent and colorless.

The yellow body of the ovary serves as a source of progesterone and is intended to maintain the proper development of a potential pregnancy. It performs its function for the first four months, and then perishes and passes the baton to the formed placenta.

If pregnancy does not occur, the yellow body of the ovary is destroyed two or three days before the onset of another menstruation.

All events occurring in the ovary are accompanied by a cyclic production of estrogens and progesterone. Structural changes and cyclic secretion of sex steroids in the ovaries are controlled by pituitary hormones. Follicle-stimulating( FSH) hormone of the pituitary gland is responsible for the full development of follicles in the first half of the cycle, and its luteinizing( LH) hormone helps form the yellow body after ovulation.

Under the influence of adverse conditions, the normal process of ovulation is disrupted, instead of properly destroying the follicle remains in place and continues to accumulate fluid, forming a follicular cyst. A similar situation can occur at the time of the development of the yellow body, when it does not regress by the time of the next menstruation, but continues to exist, accumulating fluid and forming a cyst. Since only one yellow body can be formed in the ovary at a time, and only one cystic cavity can be formed from it, respectively, the cysts of the ovarian's yellow body always have a one-sided and a single character.

Cysts formed from the graafovyh bubble and yellow body, refer to the functional. Functional ovarian cysts are rare and do not belong to pathology. Their presence is recorded during ultrasound in perfectly healthy women. Most of them exist asymptomatically for no more than three months, and then undergo reverse development. Compared with the yellow body cyst, the ovarian follicular cyst is more common.

Some patients get confused in terms and use the phrase follicular cyst of the yellow ovary body to indicate their condition. Such a diagnosis can not exist. Indeed, functional cysts have a common localization, but they have completely different structure and purpose, and they are formed at different periods of the cycle. Therefore, there is a follicular ovarian cyst with its features, and there is a yellow body cyst with a completely different device, but the follicular cyst of the yellow ovary body simply does not exist.

Instead of a yellow body cyst, a cavity filled with blood sometimes appears, it is a hemorrhagic cyst. When the vessels of the capsule of the cyst of the yellow body are damaged, the blood fills the cystic cavity. Similar cysts may continue to break with continued bleeding, with subsequent complications, but a yellow body cyst with a hemorrhage after spontaneous hemostasis may regress like functional cysts.

The right ovary contains more blood vessels, so the cyst of the yellow body of the right ovary is more likely than the cysts of the yellow body of the left ovary to be revealed by instrumental survey methods. Reliable information about the presence of any cystic cavity in the ovaries, its structure and localization is provided by ultrasound scanning.

Cysts of the yellow body are accompanied by hormonal disorders, less often they can provoke moderate pain on the side of their formation. Usually the cyst of the yellow body of the ovary hurts only in the presence of complications. The most frequent among them is rupture of the cyst shell followed by hemorrhage in the ovarian tissue( apoplexy).The blood accumulating in the ovary is formed in the hematoma, which presses on the ovary from the inside and in the conditions of continuing bleeding provokes a rupture of the ovary. Spilled into the pelvic cavity causes the symptoms of an acute surgical condition and even hemorrhagic shock.

The infrequent cyst of the ovarian yellow body during pregnancy is formed after fertilization and provokes a change in the normal hormonal ratio.

The yellow body cyst often undergoes reverse development( regression) after two or three months. At this time, the patient is observed and carried out a medical correction of the existing disorders.

Surgical treatment is required in the absence of proper regression of the cyst of the corpus luteum for the prescribed time interval. If it continues to accumulate fluid and increase, then it is removed. Also, the cyst of the ovarian's yellow body with hemorrhage( hemorrhagic cyst) is removed in the presence of a large accumulation of blood in its cavity.

Causes of ovarian yellow ovarian cyst

All reliable causes of development of ovarian corpus cysts are not established. Their formation is associated with hormonal disorders and changes in normal lymph and blood supply in the ovarian tissue. Consequently, any pathological processes leading to hormonal dysfunction and disrupting the nutrition of the ovary at the time of the development of the yellow body can provoke the appearance of a cyst.

The cyst of the yellow body can result from its excessive increase in the normal menstrual cycle or to form after a hemorrhage into its cavity. The emerging cyst of the yellow ovary body during pregnancy in its early stages may be a consequence of preliminary hormonal stimulation.

Among the common causes of the appearance of the ovarian yellow body cysts are:

- Inflammatory changes in ovarian tissue. Inflammation not only leads to hormonal abnormalities, it also affects the blood vessels of the ovary - they become more fragile. At the time of development of the yellow body, such blood vessels can be damaged with subsequent hemorrhage into the cavity of the yellow body.

- Artificial termination of pregnancy. Abortions are a serious test for the hormonal function of the ovaries, and are often accompanied by inflammatory complications.

- Psychoemotional disorders on the background of severe stress, overwork or physical overload. During stress, there is a vascular spasm, a breakdown in the nutrition of the brain( hypophysis and hypothalamus), responsible for regulating the hormonal function of the ovaries.

- Endocrine pathology. Thyroid dysfunction, diabetes mellitus, and pathology of the adrenal glands provoke a violation of the normal ratio of sex steroids.

- Deficiency of weight, including after debilitating diets for weight loss.

- Incorrect use of drugs of hormonal nature or hormonal contraception. Incorrectly selected( more often without the participation of a doctor) hormonal contraceptive can change the correct function of the ovary, so after stopping the drug in the ovary, a yellow body cyst may appear.

Symptoms of the ovary's yellow body cyst

Since the ovaries have the identical structure, the cyst of the yellow body of the right ovary is clinically the same from the cyst of the yellow body of the left ovary.

Large cysts of the yellow body usually do not grow, and, as a rule, rarely reach a size of 8 cm( the size of a small plum).More often they exist no longer than two or three menstrual cycles, and then regress.

The asymptomatic course of most yellow body cysts in a normal menstrual cycle probably explains their infrequent detection.

An exception is cysts on the background of pronounced hormonal abnormalities. Long-term cyst of the yellow body sometimes leads to excessive content of progesterone and delay of regular menstruation up to secondary amenorrhea( absence of menstruation for six months or more).Also, with a yellow body cyst, patients may experience irregular menstrual function in the form of menorrhagia( profuse menstrual bleeding) or metrorrhagia( untimely menstrual bleeding).

Often, patients are asked when the cyst of the ovary's yellow body hurts and how dangerous it is. Indeed, sometimes large cysts of the yellow body provoke a minor soreness or discomfort in the corresponding inguinal area. If the cyst of the yellow body is formed in the ovary with inflammatory processes, the pains in the affected ovary are associated not with the cyst, but with the inflammation of the ovary, however severe pains accompanied by a sharp deterioration in the state of health arise only in complications.

The most frequent and dangerous complication of the ovarian's yellow body cyst is a sudden hemorrhage into the ovary with subsequent disruption of its integrity and the flow of blood into the pelvic cavity - ovarian apoplexy.

The largest number of episodes of ovarian apoplexy is recorded in the second phase of the cycle during the vascularization of the yellow body. Hemorrhage in the ovary occurs after rupture of the vessels of its capsule. Then in the ovary there is a hematoma, which, increasing, presses on surrounding tissues and provokes rupture of the ovary. Even the smallest, not exceeding 1 cm, the gap is capable of provoking profuse bleeding. The process is accompanied by severe pain, symptoms of acute surgical pathology and hemorrhagic shock.

The existing yellow body cysts in pregnant women do not have any particular symptoms. Contrary to the misconception of many patients, in most cases small cysts of the ovarian yellow body do not significantly harm the future mother and spontaneously dissipate by the time the placenta ripens.

Diagnosis of the yellow body corpuscle

Diagnosis of the cyst of the yellow body begins with a gynecological examination. Complaints in the patient may be absent or expressed in moderate pelvic pain and menstrual irregularities.

As a rule, most of the cysts of the yellow body are not large and do not show up clinically, so there will be no active complaints from the patient, and bimanual examination may prove ineffective.

Much less likely to be examined, an enlarged, moderately painful ovary or a marked cystic formation in its projection can be palpated.

Cysts of the ovarian's yellow body can simulate an ectopic pregnancy, an inflammatory process, or an ovarian tumor. Therefore, the data of gynecological examination for reliable diagnosis is not enough.

The most accessible and informative diagnostic method is ultrasound scanning of the pelvic cavity. It allows you to see the cyst, determine its size and consider the internal structure. Typically, the cyst of the yellow body is visualized as a clearly delimited small( usually 4 cm) rounded formation, which has a well-defined thin capsule.

The internal structure of the cysts of the yellow body is not always the same. By the nature of the internal contents are distinguished:

- homogeneous anehogennye formations;

- homogeneous anehogenous formations of irregular shape with multiple or single partitions inside, which may be complete or incomplete;

- homogeneous anehogennye formations with parietal structures of a mesh or smooth structure up to 15 mm;

- education, inside which is located the middle echogenic parietal region( this is how the blood clot looks on the ultrasound).

The term "anechogenous" means the presence of a site that can not pass ultrasonic waves, they look like ultrasound as dark areas. A similar property is possessed by the liquid medium, that is, filling the cyst with a liquid secret.

If a cavity of the cyst is filled with liquid only during ultrasound, the definition "simple" is used, if there are inclusions in it( the liquid mixes with the fragments of hard tissues), the cyst is called "complex".A "hard" cyst does not contain an obvious liquid, as, for example, in the case of the formation of a dense blood clot( hematoma) in its cavity.

If the diagnosis of cyst of the yellow body is not obvious, for the purpose of differential diagnosis resort to additional diagnostic measures.

Color dopplerography differentiates the ovarian cyst with a tumor. The method is based on studying the features of the blood flow in the tissues of the ovary. The results are displayed in the form of characteristic areas of different colors. Inside the tumor, the blood flow is determined, in the cyst of the yellow body it is not.

It is also possible to differentiate the cyst of a yellow body from a tumor when examining the blood for the oncoprotein CA-125, more often it is not found in benign cysts. The method has no auxiliary value and is carried out together with other diagnostic measures.

Since the presence of a yellow body cyst in the ovary does not exclude the presence of a pregnancy of a short term or an ectopic pregnancy, pregnancy tests are required if a similar situation is suspected.

In difficult situations with a diagnostic( and at the same time, a therapeutic) goal, laparoscopy is necessary.

In all cases, patients are evaluated for hemoglobin and blood coagulation.

The yellow body cyst is almost always accompanied by hormonal dysfunction. Determining the nature of hormonal disorders helps to establish the cause of the appearance of the cyst, determine the method of therapy and avoid relapse. LH, estradiol, FSH, testosterone are determined.

Consultations of other specialists are resorted to if necessary to establish the presence of endocrine pathology.

Treatment of yellow ovarian cyst

Small asymptomatic cysts of the yellow body allow one to observe their development during the next three menstrual cycles. During the observation, monthly ultrasound scanning is performed, fixing changes in the size of the cyst and the nature of its contents. During this time, most cysts regress and completely disappear. In case of ineffectiveness of expectant management, long-term uncomplicated cysts of the yellow body are treated conservatively. Conservative treatment is performed in the case of recurrent cysts and implies:

- Hormonal correction. Monophasic or biphasic oral contraceptives are most commonly used. Artificially created normal hormonal background helps to eliminate the cyst and restore the proper menstrual cycle.

- Elimination of concomitant inflammation in the tissues of the ovary with the help of anti-inflammatory therapy( selected individually).

- Physiotherapeutic procedures: medicinal electophoresis, magnetotherapy, laser therapy.

- Weight correction with a diet and a well-designed exercise program.

A good assistant in therapy is the use of medicinal herbs. Used vaginal irrigation and therapeutic bath with herbs that have a pronounced anti-inflammatory effect. In some cases, acupuncture and homoeopathic treatment are effective.

Upon completion of the course of conservative therapy, a control ultrasound examination is performed and the question of the patient's further management is decided.

A yellow body cyst that does not regress after 4 to 6 weeks with conservative treatment is subject to surgical removal. The operation is performed with the help of laparoscopy.

With any method chosen to remove the cyst, the surgeon seeks to preserve the ovary. Most often, the yellow body cyst is eliminated in two ways:

- Removal of only the cyst itself with the preservation of healthy ovarian tissue. The cyst is excavated from the ovary together with the capsule and the subsequent suturing of the cavity formed. After healing of postoperative incisions, the ovary restores its integrity and function.

- Resection of the ovary. If there is an unhealthy tissue around the cyst, the cyst is excised along with it in the form of a wedge. Healthy tissue in the ovary after this intervention remains less, which means - less follicles. The function of the ovary can be partially restored.

Self-treatment for cysts of the yellow body is unacceptable, as it can lead to complications and provoke rupture of the ovarian cyst. Contrary to the erroneous opinion of patients about the healing properties of "warming up", any excessive thermal procedures for ovarian cysts are dangerous. During such therapeutic activities, blood flow and the expansion of blood vessels in the cyst zone increase, which can lead to edema, increased exudation into the cystic cavity, and subsequent rupture of the cyst shell.

Independent reception at random selected antibiotics to eliminate the cyst will not help, but it is able to organize a dysbacteriosis. The fastest and easiest way to eliminate a cyst can be chosen only by a doctor.

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