What to do with ovarian cysts? Introducing various treatment methods

The structure of female reproductive organs is very complex, and it is easy to develop gynecological inflammation and tumors. For example, ovarian cysts are a familiar female reproductive disease. Patients may experience tenderness and water accumulation in the lower abdomen. The disease must be treated in time, because if it develops seriously, the harm is very serious. The relevant treatment measures are introduced below.

First, treatment

Surgical treatment: The treatment of ovarian cysts depends on factors such as the patient's age, whether it is malignant, the location, volume, size, growth rate of the cyst, whether the reproductive function is preserved, and the patient's subjective wishes.

1. Surgical treatment of benign ovarian cysts

(1) Ovarian cystectomy. This procedure is often used in young patients, especially premenopausal patients, while preserving normal ovarian tissue as much as possible.

(2) Salpingo-oophorectomy: Older patients (over 45 years old) or postmenopausal patients can undergo unilateral or bilateral salpingo-oophorectomy.

2. Surgical treatment of malignant ovarian cysts

(1) Most patients are already in the advanced stage when they seek medical treatment, so every effort should be made to remove the primary cyst and any visible pelvic and abdominal metastases.

(2) Consider placing a catheter in the abdominal cavity to facilitate the postoperative intraperitoneal injection of chemotherapy drugs.

Second, diagnosis

The diagnosis of ovarian cysts often varies in difficulty depending on the size and characteristics of the tumor. When taking a detailed medical history, attention should be paid not only to the reproductive organs, but also to the general condition and the relevant medical history of other important organs. Combining clinical manifestations with physical examinations, in addition to paying attention to the characteristics of the tumor itself, the general condition should also be understood. Therefore, not only gynecological examinations, but also general examinations, especially abdominal examinations, are extremely important. If necessary, other auxiliary diagnostic methods should be used, and a correct diagnosis can only be obtained after a comprehensive analysis of the medical history.

Patients with ovarian cysts may have a history of abdominal masses. Through abdominal palpation and bimanual examination, the boundaries and mobility of the uterus and the mass can usually be determined.

Third, check

Pregnancy test, gastroscopy, fiber colonoscopy, color Doppler ultrasound, MRI, serum tumor markers, etc., and in some special cases, abdominal puncture, laparoscopy, laparotomy, etc.

1. Laparoscopy

The general condition of the tumor can be directly seen, the entire pelvic and abdominal cavity can be observed, multiple biopsies can be taken at suspicious sites, and peritoneal fluid can be absorbed for cytological examination to confirm the diagnosis and provide postoperative monitoring. However, it is contraindicated for patients with huge or adhesive masses, and the retroperitoneal lymph nodes cannot be observed.

2. Radiological diagnosis

MRI, CT, etc. are helpful in diagnosing tumor metastasis to the liver, lungs, and retroperitoneal lymph nodes. A plain abdominal radiograph can aid in the diagnosis of intestinal obstruction.

3. Secondly

If the cyst is a malignant ovarian tumor, like other tumors, it can produce and release a variety of products such as antigens, hormones and enzymes. These substances can be detected in the patient's serum through immunological, biochemical and other methods. They are called tumor markers and indicate the presence of a certain tumor in the body.

(1) The antigen marker CA125 is a relatively sensitive tumor marker for ovarian tumors. AFP is the best tumor marker for endodermal sinus tumor. The AFP value may also be elevated in immature teratomas. The increase in AFP often precedes clinical signs, and it is of great significance in diagnosis and monitoring.

(2) The hormone marker human chorionic gonadotropin β-subunit (β-hCG) is a highly specific marker for gestational trophoblastic disease, and its serum concentration is often elevated in patients with ovarian choriocarcinoma. Estrogen levels are elevated in patients with granulosa cell tumors and theca cell tumors. 30% of patients with testicular blastoma have increased urinary 17-ketosteroid excretion.

(3) The excretion of enzyme marker/lactate dehydrogenase (LDH) is increased in patients with ovarian malignant tumors.