Causes, symptoms and treatment of uterine fibroids and ovarian cysts

Ovarian cysts and uterine fibroids are among the most common diseases of the female reproductive system. According to global medical statistics, these diseases occur in every 2-3 women of reproductive age and can lead to serious complications, including infertility.

In this article we will tell you what uterine fibroids and ovarian cysts are, what symptoms these diseases manifest, and what are the most effective methods of treating ailments that exist today.

Definition and symptoms of uterine fibroids

Myoma is a hormone-dependent benign tumor that forms nodes from the muscle tissue of the uterus. The reasons why this type of disease occurs are still not fully understood. However, most gynecologists agree that the appearance of a tumor may be due to:

1. Genetic predisposition;
2. Hormonal imbalances;
3. Endocrine disorders;
4. Injury to internal genital organs;
5. Long-term and extensive inflammatory process of the genitourinary system;
6. Inactive lifestyle, obesity, stress.

The development of uterine fibroids can be determined by a number of symptoms characteristic of the disease:

1. Heavy and prolonged menstruation;
2. Bloody discharge before and after menstruation;
3. Nagging pain in the pelvic area;
4. Discomfort during sexual intercourse, bowel movements and bladder;
5. Prolonged absence of pregnancy.

If the diagnosis is confirmed, the patient should be prescribed appropriate drug treatment, and in some cases, surgery to remove uterine fibroids.

Preparation for laparotomy and description of the operation

The operation is performed under general anesthesia. In the evening and in the morning, bowel cleansing is performed using an enema. After 19.00 in the evening before the operation, you must refrain from drinking and eating.

After treating the skin with an antiseptic, an incision is made parallel to the bikini line, or a vertical incision is made along the midline of the abdomen.

During laparotomy for an ovarian cyst or uterine fibroid, the tumor is removed and the surrounding tissue is inspected to exclude metastases or its growth into other organs. If necessary, one or both ovaries, or the uterus along with the appendages can be removed. Then the wound is sutured with a cosmetic suture.

The removed lesion is immediately sent for histological examination in order to quickly exclude a malignant tumor or determine its type in order to correctly prescribe a further treatment program.

Definition and symptoms of ovarian cyst

A cyst is a benign neoplasm in the ovary, the causes of which have not yet been precisely established. Cysts occur in women of different age categories, but most often the disease is diagnosed at the age of 25-40 years.

In modern gynecology, the following types of ovarian cysts are distinguished:

1. Follicular cyst
2. Endometrioid cyst
3. Corpus luteum cyst
4. Thecal lutein cyst
5. Parovarian cyst

Common symptoms for all types of cystic formations are:

1. Menstrual irregularities;
2. Pain in the lower abdomen, regardless of MC;
3. Feeling of pressure in the pelvic area;
4. Sharp pain during intense movements;
5. Increase in abdominal size;
6. Nausea, dizziness, temperature up to 39 degrees.

The peculiarity of this disease is that in the early stages of development, the cyst may not give any symptoms and may not provoke pain or discomfort. Moreover, a third of patients with this diagnosis did not experience menstrual irregularities.

Causes of fibroids and cystic formation on the ovary

The main etiological factor in the occurrence of uterine fibroids, as well as ovarian cysts, is considered to be hormonal imbalance.

An important factor today is the use of hormonal oral contraceptive drugs containing high doses of estrogens. Due to the latter, myomatous nodes appear and grow progressively. Another important feature is the dependence of growth and progression of both pathologies on the level of sex hormones in the blood. It is believed that under the influence of progesterone, the pregnancy hormone, the size of myomatous nodes and cysts increases. This explains the worsening of both pathologies when using intrauterine systems (for contraception).

The condition of the endocrine system is very important. The risk of cysts in the ovaries and fibroids in the uterus increases significantly with obesity.

It has been noted that women with underlying diabetes mellitus and hypothyroidism (decreased thyroid function) are more likely to become ill. Other causes of the described diseases include conditions such as abortion (instrumental abortion, medical termination), endometriosis of the uterus and other organs. Inflammatory diseases of the uterine appendages, cystic formations, along with obesity become a favorable background for the development of fibroids. Therefore, the same patient can have two pathologies at once: fibroids and cysts.

It is important to know that there is no such disease as ovarian fibroids. After all, the term itself means a tumor formation from smooth muscle tissue, which simply does not exist in the ovary. But it’s not without reason that the name “ovarian fibroids” has taken root among people, because usually when one organ is affected, changes are found in another. Like uterine fibroids and ovarian cysts, for example.

Surgery

The most effective treatment for these types of diseases is surgery to remove ovarian cysts and uterine fibroids. In gynecological surgery, the following surgical methods are used:

1. Laparoscopy (minimally invasive “closed” type surgery);
2. Laparotomy (open abdominal surgery);
3. Hysteroscopy (minimally invasive procedure with access to the internal genital organs through the vagina and cervix).

You can find out more detailed information about treatment methods and operations to remove ovarian cysts and uterine fibroids from specialists at our women's health center in Moscow.

To get a consultation, fill out an online application on the website or contact us by phone.

Advantages of laparotomy

• makes it possible to carefully examine the organs of the abdominal cavity or pelvis, as well as the surrounding tissue and groups of lymph nodes if cancer is suspected, if a cyst ruptures, etc.;
• laparotomy in the presence of a large ovarian cyst, especially with liquid contents, allows you to remove it without violating the integrity and prevent the contents of the cyst from entering the abdominal cavity;
• laparotomy in the presence of large uterine fibroids or a specific location also allows for complete removal of the formation without the risk of severe bleeding, etc.

Possible complications

Despite the different symptoms, both pathologies give similar complications:

• Infertility. The main cause is considered to be anovulation, a condition in which the egg does not leave the ovary and conceiving a child becomes impossible. And if pregnancy can occur against the background of small fibroids, then even a small ovarian cyst creates serious obstacles to motherhood. Before IVF, it is recommended to get rid of both fibroids and cystic formations;
• Miscarriage is relevant for submucosal myomatous nodes, which deform the uterine cavity and prevent the existence of the fetus in the mother's womb. Ovarian cysts usually do not interfere with pregnancy;
• Torsion of the fibroid stalk and rupture of an ovarian cyst clinically manifest themselves in a similar way: pain in the lower abdomen and bleeding. Ultrasound helps distinguish one condition from another;
• Malignization is not characteristic of either pathology. Ovarian cysts do not develop into cancer. Myoma, according to the latest data, is also considered an exclusively benign tumor.

This is how torsion of the pedicle of an ovarian cyst schematically looks like.

A sarcoma can be hidden under the guise of fibroids, and ovarian cancer can be disguised as a cyst. The final diagnosis is made after a complete examination, including histological analysis of the removed lesion.

Symptoms

A woman cannot always feel the appearance of new formations on her own. Being small in size, they live quietly in the body for a long time, without manifesting themselves in any way.

Although uterine cysts and uterine fibroids are considered completely different diseases, their symptoms are quite similar. They appear only when the tumors begin to grow:

• Changes in the nature of menstruation - they become more abundant, prolonged, painful;
• A lot of discharge (leucorrhoea, mucus) appears from the vagina;
• Pain occurs during sexual intercourse;
• A woman notices spotting mid-cycle;
• Constipation, frequent urge to urinate.

The described symptoms are similar to descriptions of other diseases.

Postoperative period and rehabilitation

After the operation, you will need to remain under observation in the clinic for 2-4 days. You can fully return to your previous activity within 4-6 weeks.

In the first few days, you usually experience pain in the area of ​​the surgical wound and discomfort in the abdomen. The doctor will prescribe painkillers and other medications that will minimize all these manifestations.

It is recommended to avoid heavy lifting and physical overexertion for 3-4 weeks. During the consultation, the doctor will give all the necessary recommendations that will need to be followed in the postoperative period.

In women of childbearing age, doctors always strive to preserve the ovaries and uterus as much as possible so that the patient retains the opportunity to have children in the future. In menopausal patients, both ovaries are often removed during laparotomy to prevent a new cyst.

Preservation of the uterus depends on the size and location of the fibroids. Restoring reproductive function, provided that the uterus and at least one ovary are preserved, is possible within several months.

Uterine cyst. Symptoms and treatment

A uterine cyst may not manifest itself in any way. Sometimes it leads to dyspareunia and causes discomfort for women. It is often determined during a gynecological examination.

There are several methods for treating uterine cysts, the symptoms of which are not defined. Most specialists in the field of gynecology are inclined to believe that the uterine cyst must be surgically removed and its ducts cleared of contents. The algorithm for surgery for a uterine cyst, the symptoms of which have been identified, is as follows:

• the patient is examined and prepared;
• punctures are performed on each uterine cyst;
• its contents are deleted:
• To avoid relapses, the sites of cystic formation are treated with a special solution.

After the operation, the woman needs to stay in the room for a couple of hours under the supervision of a doctor. A few hours after the operation, the patient can go home. This operation, as a rule, does not cause complications. For some time, the patient may be bothered by aching, mild pain in the lower abdomen and scanty bloody discharge from the vagina. These symptoms disappear after treatment of a uterine cyst within two days. After a few days, yellowish mucus may appear instead of this discharge. It resolves spontaneously within one week. To speed up the rehabilitation period, the patient is prescribed vaginal suppositories from the tenth day. During the rehabilitation period, sexual contact should be avoided.

In addition to traditional treatment methods, they now perform treatment for uterine cysts, which occur without symptoms, cryotherapy and laser therapy. When treating a uterine cyst using cryodestruction, the area where the formation is located is treated with liquid nitrogen. After this treatment, no scars remain on the uterus.

Laser treatment of uterine cysts is also used. It is more painful than cryodestruction. Its advantage is that laser therapy can be used to treat uterine cysts in nulliparous women. In this case, the cystic cavity is treated to the required depth.

Diagnosis of diseases

Methods for detecting diseases are almost the same. But, if the doctor notices the cyst during the examination, then the fibroid cannot be noticed immediately. It can only be suspected because the uterus will be enlarged.

If the gynecologist suspects the occurrence of tumors, he will definitely prescribe additional examinations to confirm or refute the presumptive diagnosis:

• Ultrasound on days 5-7 of the cycle;
• Colposcopy (the cervix is ​​examined under a magnifying glass);
• Smear for oncocytology;
• PCR method (a smear is taken for ureaplasma, trichoionases, chlamydia, papilloma virus).

The results of these examinations will show a complete picture of the pathology. Based on them, it will also be possible to make assumptions about the causes of the disease. Ultrasound for prevention is not often indicated for young women. But those who are over 30 need to undergo such a study once a year. This will allow us to identify young tumors that are more favorable to conservative treatment.

Recently, laparoscopy has become the most commonly used method. The method is considered minimally invasive and helps to accurately determine the location of the tumor, its size, and also determine methods for further action.

Pregnancy

You should start thinking about pregnancy only after examination by a gynecologist and making sure you are in absolute health. Although fibroids and uterine cysts have different origins, their effect on the reproductive system is the same.

Benign neoplasms can lead to infertility. They often cause early termination of pregnancy, as well as premature birth.

Clinical manifestations

Uterine fibroids are considered a tumor formation of the muscular layer of the uterus, which is benign. We are talking about a pathology characteristic of adult women of reproductive age. The main symptom of the disease is menometrorrhagia. This is bleeding outside of menstruation. Blood loss leads to the development of anemic syndrome. The larger the myomatous node, the more pronounced the anemia will be.

A cyst is a tumor-like formation. It resembles a bubble and is filled with liquid contents. An ovarian cyst can be present either from birth or from a certain point in a later period of a woman’s life.

The most common option is asymptomatic.

As the size of the cyst increases, pain appears. With a cyst of the right ovary, the pain radiates to the right and resembles appendicitis or an exacerbation of cholecystitis. But the nature of the pain in the case of a cyst is still aching and constant. Ovarian cysts usually do not lead to bleeding, but menstrual irregularities may occur. Menstruation is rare and does not always happen. With the simultaneous presence of both diseases, it is difficult to explain and predict how the menstrual cycle will change.

When the tumor enlarges, as well as when the ovarian cyst grows, pain occurs. It is associated with pressure on neighboring structures. A woman complains of pain in the lower abdomen. Sometimes there is heaviness in the lower back. By the end of the day, these sensations intensify. An examination of the lumbar spine may reveal signs of osteochondrosis, but you should not “write off” the symptoms and complaints that arise as back problems. It is necessary to conduct a thorough examination of the pelvic organs, because ovarian cysts with uterine fibroids are not uncommon in modern conditions. Therefore, ultrasound, hysteroscopy, vaginal and rectal examination are used. Treatment with nonsteroidal anti-inflammatory drugs and other analgesics usually does not help.

What are the symptoms of uterine fibroids and ovarian cysts if they exist simultaneously in one patient:

1. Pain in the abdomen or lower back. It is aching, pulling, permanent.
2. Menstrual irregularities.
3. Infertility.
4. Spotting or bleeding before or after your period.
5. Anemia – dry pale skin, weakness, fatigue, inability to perform usual physical activities.
6. Unpleasant sensations or discomfort when urinating or defecating.

A frequently described disease of the uterus and ovary is diagnosed in women of reproductive age. During and after menopause, tumors stop growing and involution of both organs begins. But together, uterine fibroids and ovarian cysts can subsequently become the cause and background for the development of a low-quality tumor.