cyst corpus luteum of the ovary
cyst corpus luteum of the ovary - is formed temporarily healthy ovary cells of a yellow body cavity of the capsule and liquid contents of benign origin.There are corpus luteum cysts rarely others.They have no age preferences may therefore appear at 16 and 55 years, and are often accompanied by inflammation of the fallopian tubes, ovaries, and / or hormone dysfunction.
from external adverse effects of the ovary protects dense shell.Under it, in the cortical layer of the "adult" of the ovary, there are many small formations similar to the bubbles, it is - primordial follicles.Every primordial follicles formed egg surrounded by the epithelial cell layer.Primordial follicles grows together with the egg, nourishing and protecting it until fully ripe.At the same time in the ovary contains follicles at different stages of maturation, but contains only one adult, ripe, egg.The mature follicle (Graaf bubble) size of less than 20 mm, it is filled with follicular fluid
During the time period equal to one normal menstrual cycle, time to fully form one follicle and, accordingly, one which is in its egg.During ovulation, the bubble burst Graaf and release an egg from the ovary, but instead appears temporary hormonal structure - the corpus luteum of the ovary.
source of formation of the corpus luteum are granulosa cells remaining after the rupture of the follicle.They begin to proliferate and grow a network of new blood vessels.Granulosa cells gradually begin to accumulate carotene and replaced on the luteal cells with characteristic yellowish color.Despite its name, painted in yellow color only the inner layer of the shell of the corpus luteum, and fill it with the liquid is clear and colorless.
corpus luteum of the ovary is a source of progesterone, and is intended to maintain the proper development of a potential pregnancy.It performs its function first four months and then dies and passes the baton formed placenta.
If pregnancy does not occur, the corpus luteum of the ovary breaks for two or three days before the next menstruation.
All events occurring in the ovary accompanied by cyclic output of estrogen and progesterone.Structural change and cyclical secretion of sex steroid hormones in the ovaries is controlled by the pituitary gland.Follicle stimulating hormone (FSH), the pituitary hormone responsible for the full development of follicles in the first half of the cycle, and its luteinizing (LH) hormone helps shape yellow body after ovulation.
under unfavorable conditions of the normal process of ovulation is disrupted instead of proper destruction of the follicle remains in place and continues to accumulate liquid, forming follicular cyst.A similar situation could happen in the time of development of the corpus luteum regresses when it is not at the moment when the next menstrual period, and continues to exist, accumulating fluid and form a cyst.Since simultaneously in the ovary can form only one yellow body and out of it, respectively, can be formed only one cystic cavity, cyst of the corpus luteum of the ovary are always one-sided and single character.
graafova formed from a vial and corpus luteum cysts are functional.Functional ovarian cysts are not uncommon and are not related to the disease.Their presence is fixed during the ultrasound examination in perfectly healthy women.Most of them are asymptomatic, there are not more than three months, and then regress.Compared with the corpus luteum cyst follicular ovarian cyst is more common.
Instead luteum cysts sometimes a cavity filled with blood, it is - hemorrhagic cyst.When the vessels of the corpus luteum cyst capsules are damaged, the blood fills the cystic cavity.These cysts with continued bleeding can rupture and subsequent complications, but the corpus luteum cyst with hemorrhage after spontaneous hemostasis may regress like a functional cyst.
right ovary contains more blood vessels, so the corpus luteum cyst of the right ovary more often than the corpus luteum cyst of the left ovary revealed by instrumental methods of examination.Reliable information about the presence of any ovarian cyst, its structure and location offered an ultrasound scan.
luteum cysts are accompanied by hormonal disorders, sometimes they can provoke moderate pain on the side of their education.Usually it hurts cyst corpus luteum of the ovary only in the presence of complications.The most common among them is the rupture of cysts followed by bleeding into the tissues of the ovary (apoplexy).Accumulates in the blood is made in the ovary hematoma, which puts pressure on the inside of the ovary and the continued bleeding provokes rupture of the ovary.Izlivshayasya in the pelvic cavity of blood causes the symptoms of acute surgical conditions and even hemorrhagic shock.
infrequent ovarian corpus luteum cyst of pregnancy is formed after fertilization and provokes a change of normal hormonal ratio.
luteum cyst often regress (recourse) in two or three months.At this time, watch for the patient and conduct drug correction of existing violations.
Surgical treatment is required in the absence of a proper regression of the corpus luteum cyst of the provisions of the interim period.If she continues to accumulate fluid and increase, then it is removed.Also removed a cyst of the corpus luteum of the ovary with hemorrhage (hemorrhagic cyst) with a large accumulation of blood in its cavities.
reasons cysts of the corpus luteum of the ovary
All valid reasons for the development of cysts of the corpus luteum of the ovary are not installed.Their formation is associated with hormonal disorders and changes in normal lymph and blood supply in the ovarian tissue.Therefore, any pathological processes that lead to hormonal dysfunction and breaking the power of the ovary at the time of development of the corpus luteum, can provoke the appearance of cysts.
corpus luteum cyst can be a result of his excessive increase in the normal menstrual cycle or formed after hemorrhage in its cavity.Introduced cyst corpus luteum of the ovary during pregnancy on her early pregnancy may be due to pre-hormonal stimulation.
Among the common causes of ovarian corpus luteum cysts are present:
- Inflammatory changes in ovarian tissue.Inflammation not only leads to hormonal abnormalities, it also affects the blood vessels ovary - they become more fragile.At the time of development of the corpus luteum are blood vessels may be damaged, followed by hemorrhage into the cavity of the corpus luteum.
- Abortion.Abortion is a serious test for ovarian hormonal function, and are often accompanied by inflammatory complications.
- Psychoemotional disorders against the background of severe stress, fatigue or physical overload.During stress occurs vasospasm eating disorders of the brain (hypothalamus and pituitary), responsible for the regulation of hormonal ovarian function.
- endocrine pathology.Thyroid dysfunction, diabetes mellitus, adrenal pathology provoke disruption of the normal ratio of sex steroids.
- underweight, including after exhausting diets for weight loss.
- Improper use of drugs or hormonal nature of hormonal contraception.Invalid selected (usually without the involvement of a physician) hormonal contraceptive could change the correct function of the ovary, so after stopping treatment may occur in the ovary corpus luteum cyst.
Symptoms of ovarian corpus luteum cyst
Since the ovaries have an identical structure, the corpus luteum cyst clinically right ovary cyst on the left ovary yellow body is no different.
large cysts of the corpus luteum usually do not grow, and as a rule, rarely reach 8 cm (the size of a small plum).In most cases there are no more than two or three menstrual cycles and then regressed.
Asymptomatic most corpus luteum cysts in a normal menstrual cycle, probably explains their infrequent detection.
exception is a cyst on the background of pronounced hormonal abnormalities.Long existing corpus luteum cyst sometimes leads to excessive progesterone and delay until the next menstruation secondary amenorrhea (absence of menstruation for six months or more).Also, when the corpus luteum cyst patients may experience menstrual dysfunction in the form of menorrhagia (heavy menstrual bleeding) or metrorrhagia (delayed menstrual bleeding).
Often patients ask when it hurts cyst corpus luteum of the ovary, and how dangerous it is.Indeed, sometimes large corpus luteum cyst provoked a minor pain or discomfort in a corresponding groin.If the cyst is the corpus luteum in the ovary formed with inflammation and pain in the affected ovary are not associated with a cyst and inflammation of the ovary, but severe pain, accompanied by a sharp deterioration in health, only if complications arise.
most common and dangerous complication of ovarian corpus luteum cyst is sudden bleeding into the ovary, followed by a violation of its integrity and flow of blood in the pelvic cavity - ovarian apoplexy.
largest number of episodes of ovarian apoplexy recorded in the second phase of the cycle at the stage of vascularization of the corpus luteum.Hemorrhage in the ovary occurs after bursting its capsule.Then there is a hematoma in the ovary, which is increasing, pressure on surrounding tissues and provokes break the shell of the ovary.Even the smallest of no more than 1 cm, the gap is able to provoke excessive bleeding.The process is accompanied by severe pain, symptoms of acute surgical pathology and hemorrhagic shock.
Available corpus luteum cyst in pregnant women do not have the particular symptoms.Contrary to the erroneous opinion of many patients, in most cases, a small cyst corpus luteum of the ovary significantly harm the expectant mother does not bring spontaneously resolve by the end of the maturation of the placenta.
diagnosis of ovarian corpus luteum cyst
luteum cyst diagnosis begins with a pelvic exam.Complaints about the patient may be missing or expressed moderate pelvic pain, and menstrual irregularities.
Usually, most cysts of the corpus luteum is not large and is not manifested clinically, so active complaints, the patient will not, and bimanual examination may be no result.
much less during the inspection can be palpated increased moderately painful ovary or severe cystic formation in his projections.
Cysts of the corpus luteum of the ovary may feign an ectopic pregnancy, inflammation or swelling of the ovary.Therefore, the data gynecological examination for a reliable diagnosis is not enough.
most accessible and informative diagnostic method is an ultrasound scan of the pelvic cavity.It allows you to see the cyst, to determine its value and examine the internal structure.As a rule, the corpus luteum cyst is visualized in the form of a clear demarcation of a small (usually 4 cm) rounded education, having a well-defined thin capsule.
internal structure of the corpus luteum cysts are not always the same.By the nature of internal contents are distinguished:
- homogeneous anechoic education;
- homogeneous anechoic formation of irregular shape with multiple or single partitions inside, which can be full or part;
- homogeneous anechoic formation with wall structures mesh or smooth structure up to 15 mm;
- education, within which is located sredneehogenny parietal region (so look for an ultrasound of a blood clot).
term "anechoic" means that the site is not capable of transmitting ultrasonic waves, they look at the US as a dark-colored sections.Similarly, the property has a liquid medium, that is filling the cyst fluid secretion.
If during ultrasound visualized cyst filled with fluid only, used the term "simple", in the case of the presence in it of inclusions (liquid mixed with fragments of hard tissue) cyst is called "challenging.""Solid" cyst contains clear fluid, such as in the case of education in its cavity dense blood clot (hematoma).
If the diagnosis of cysts of the corpus luteum is not obvious, the purpose of differential diagnosis of resorting to additional diagnostic procedures.
Color Doppler differentiate cyst ovarian tumor.The method is based on the study of a blood flow in the tissues of the ovary.The results are displayed in the form of characteristic regions of different colors.Inside the tumor blood flow is determined by the corpus luteum cyst not.
also differentiate the corpus luteum cyst from tumors in the study of possible blood tumor marker CA-125, it is often not detected in benign cysts.The method does not have a subsidiary importance and is conducted in conjunction with other diagnostic procedures.
Since the presence of cysts in the ovary yellow body does not exclude the presence of a small duration of pregnancy or ectopic pregnancy is suspected such a situation need pregnancy test.
in difficult situations diagnostic (as well as curative) aim requires a laparoscopy.
In all cases, patients evaluated hemoglobin levels and indicators of blood coagulation system.
corpus luteum cyst is almost always accompanied by a hormonal dysfunction.Determining the nature of hormonal imbalance helps to establish the cause of the cyst, to determine the method of treatment and avoid relapse.Determined LH, estradiol, FSH, testosterone.
To consult other experts if necessary resorting to establish the presence of endocrine pathology.
Treatment of ovarian corpus luteum cyst
small asymptomatic cysts of the corpus luteum allow to observe their development in the next three menstrual cycles.During the observation conducted monthly ultrasound scanning, fixing change the brush size and the nature of its contents.During this time, the majority of cysts regress and disappear completely.In case of failure of expectant management is long existing corpus luteum cyst uncomplicated treated conservatively.Conservative treatment is carried out in the case of recurrent cysts and involves:
- hormonal correction.Most used monophasic or biphasic oral contraceptives.Artificially created the normal hormones helps eliminate brush and restore the proper menstrual cycle.
- Liquidation accompanying inflammation in the tissues of the ovary using anti-inflammatory therapy (selected individually).
- Physical therapy: drug elektoroforez, magnet, lazerolechenie.
- Correction of weight through diet and correct programming exercise.
good helper in therapy is the use of herbs.