Common Gynecological Diseases and Treatment

Information

The importance of prevention

With each passing year, the number of women with various gynecological diseases increases. Unfortunately, the age threshold keeps dropping. Prevention is of utmost importance for early diagnosis and more effective treatment of a number of diseases.

Periodic preventive gynecological examinations should be undergone by all age groups of sexually active women, at least once a year, and preferably every 6 months. They should include clinical examination, ultrasound, Pap smear, vaginal discharge testing. Due to the growing trend of increasing incidence of cervical cancer, we recommend that all women also add colposcopy to their preventive examination.

Types of Cysts and Treatment Methods

The diagnosis and therapeutic approach for cysts depend significantly on the patient's age, clinical complaints, ultrasound appearance of the finding, and the values of specific laboratory tests.

At a young age, patients are found with irregular or absent menstrual cycles, male-pattern hair growth, skin changes, and a characteristic ultrasound appearance of the ovaries. These symptoms are most often associated with Stein-Leventhal syndrome (Polycystic ovary syndrome). Treatment is usually conservative with hormonal medications. Cysts larger than 3-4 cm that do not respond to hormonal treatment should be surgically removed. According to modern standards, surgical intervention is performed laparoscopically.

Follicular cysts, resulting from a failed ovulation, are also characteristic of younger age. They also have a characteristic ultrasound appearance - with well-defined contours, thin wall, clear content.

Corpus luteum cysts are another type of cyst, in which the corpus luteum, formed after ovulation, does not regress.

Dermoid cysts are discovered incidentally during a preventive examination, usually without significant complaints. They develop from embryonic tissues and, due to their higher oncological potential, must be operated on.

It is worth mentioning here that endometriotic (chocolate) cysts are also increasingly found at this age.

Conservative treatment with hormonal medications for a period of 3 months should be applied to follicular cysts and corpus luteum cysts, but not to endometriotic, dermoid cysts, or cysts suspicious for malignancy. After this period, surgical treatment for laparoscopic removal of the cyst is recommended. It is important to note that, in order to preserve ovarian tissue and ovarian reserve in women who have not given birth, only the cyst is coagulated. In women who have given birth and have no plans for more children, the cyst is removed together with its capsule, which leads to some reduction in ovarian reserve.

Can an ovarian cyst turn into cancer?

Such a risk exists, especially with prolonged "monitoring" of cysts. Ovarian carcinoma usually affects women over 40 years of age, but unfortunately it is increasingly seen in younger women as well. This is why preventive examinations by an obstetrician-gynecologist should not be underestimated.

Cyst during pregnancy

A cyst during pregnancy is discovered incidentally, and normally disappears by the end of the first trimester. If the cyst does not disappear, but its size does not increase, the risk to the baby and mother is insignificant. Characteristic tumor markers should be monitored. In rare cases, surgical treatment is required even during pregnancy.

Endometriosis and Treatment Methods

There are various theories about the origin of endometriosis. The most popular of these is that cells from the interior of the uterus (endometrium) migrate into the abdominal cavity, affecting mainly the ovaries, uterus, fallopian tubes, intestines, peritoneum and bladder.

The most common clinical manifestations of endometriosis are painful menstruation, painful intercourse, painful defecation, disrupted menstrual cycle and infertility. Pain of varying intensity is the most characteristic complaint. As a result of the disease, so-called "chocolate cysts" of the ovaries develop, adhesions form, the patency of the fallopian tubes is disrupted, and in about 50% of cases infertility results.

Treatment can be medicinal or surgical, but the gold standard is laparoscopic surgical removal of the endometriotic cysts followed by medicinal treatment with drugs that block the menstrual cycle (GnRH analogues). This way the risk of endometriosis recurrence is lowest.

Uterine Fibroids and Treatment Methods

Uterine fibroids occur quite frequently at a certain age, affecting over 50% of women. Depending on size and location, women may have no problems. It becomes "fibroid disease" when characteristic complications and complaints arise - abnormal uterine bleeding, heaviness and pain low in the abdomen, infertility.

Treatment is tailored depending on the patient's age and reproductive intentions. It can be conservative (with various medications) or surgical - in a large percentage of cases with laparoscopic organ-preserving surgery.