Two-chamber cyst of the right ovary treatment. Multilocular ovarian cyst. Abdominal surgery to remove a cyst with multiple chambers

Hormonal imbalance in a woman's body causes various neoplasms. Some of them are and do not pose a threat to life. Others - require close monitoring, can have serious consequences. Among these is a multi-chamber ovarian cyst.

The essence of pathology

A multilocular ovarian cyst (multilocular cyst) is a benign formation in the form of a cavity separated by septa.

Inside the cavity is a viscous liquid. This type is rare, but requires careful examination. The main danger of a cyst is high risk of rupture and transformation into a malignant one.

It occurs in women at any age, is localized on both ovaries, but more often on the right because of its better blood supply, compared with. According to the number of cavities, two-chamber and three-chamber neoplasms are distinguished.

Any single-chamber cyst can become multi-chamber. Partitions appear immediately or as the tumor grows. In medical practice, there are the following types multilocular tumor:

Follicular. It is formed at the site of a burst follicle, over time it can grow and acquire a multi-chamber type.
Endometrioid. Appears from the endometrium on the ovary, tends to grow and form several chambers.
. Its serous-papillary type is prone to internal growth and has a high risk of degeneration.
Dermoid. Formation with internal partitions, filled with adipose tissue with particles of skin, hair, etc.
Paraovarian. It does not grow from the tissues of the ovary, it is located next to it. It does not manifest itself for a long time, but tends to break.

Unlike a normal cyst, a multi-chamber one has a number of features:

The presence of dense partitions within the formation.
Big sizes.
It is difficult to treat conservatively.
The risk of malignant growths on the partitions.
Often gives serious complications.

Causes and symptoms of neoplasm

The appearance of this type of cyst can be triggered by several factors:

Hormonal disorders.
Inflammatory diseases of the pelvic organs.
Termination of pregnancy (abortion, miscarriage).
Disorders in the endocrine system.
Operations.
Pregnancy.
Hormonal stimulation (with IVF).

All of the above can have a direct and indirect effect on tumor formation.

Doctors distinguish the inflammatory process as the most common provoking factor.

Symptoms of a multi-chamber cyst are usually pronounced. Among main manifestations:

As the tumor grows, the symptoms become more pronounced.

Diagnostic methods

The diagnosis begins with a survey of the patient, palpation of the abdomen. Typically, these cysts can be palpated through the abdominal wall. A gynecological examination is also carried out.

Used to clarify the diagnosis instrumental research:

. This is the most informative method. Often used in conjunction with dopplerometry - the study of blood flow. Ultrasound shows the size of the tumor, the number of chambers, the presence of growth, the structure of the cyst, its contents.
MRI. Allows you to take a layered picture, determine the structure of the neoplasm.

Among laboratory research:

blood and urine to identify the inflammatory process.
A blood test for tumor markers and hormones to exclude malignant degeneration.

How is pathology treated?

In the case of small cysts and no risk of degeneration, treatment is carried out conservative methods. They include:

hormone therapy. Progesterone preparations (Duphaston) and contraceptives are prescribed, which prevent the growth of cysts and the formation of new ones.
Physiotherapy (mud therapy, balneotherapy, electrophoresis).
The appointment of antibiotics to eliminate the inflammatory process.
Vitamin therapy.

Folk methods are ineffective and are practically not prescribed.

Surgical treatment carried out in cases where:

the size of the tumor is large;
analyzes revealed the presence of oncomarkers;
there is a risk of rupture or suppuration;
conservative treatment did not bring results.

Used in medical practice two types of operations: laparoscopy and abdominal (laparotomy). Preference is given to the first, as it has a number of advantages: small incisions, little blood loss, a short rehabilitation period.

Laparoscopy involves the removal of only the neoplasm with the preservation of the ovary. A woman is able to become pregnant after the operation. In the case of a large formation, ovarian atrophy may begin; in this situation, the organ is removed along with the tumor.

In oncological processes, all reproductive organs and nearby lymph nodes are removed. The excised material is sent for histology. After the operation, the woman is prescribed a course of hormone therapy and vitamins.

Complications

Education sizes up to 5 cm are considered safe. In other cases, there are risk of serious complications:

Apoplexy of the ovary. With physical stress, the cyst ruptures, its contents permeate the tissues of the ovary. As a result, the organ may burst. This condition is fraught with the development of peritonitis and sepsis.
Suppuration. Occurs with hypothermia and reduced immunity. The contents of the tumor become purulent. The woman's pain increases, the temperature rises to critical levels, weakness and other signs of general intoxication appear.
Malignancy. This is the degeneration of education into a malignant tumor. A woman loses weight, becomes irritable, there is increased pallor of the skin and circles under the eyes.

All complications pose a serious threat to the life of the patient. If you suspect complications, you should immediately seek medical help, we are talking only about urgent surgical treatment.

The onset of pregnancy with a multi-chamber cyst, it is quite possible. The small size of the formation does not require treatment before childbirth. Doctors choose observation tactics.

If the cyst progresses, it can put pressure on the uterus, creating a threat of termination of pregnancy. After 16 weeks, laparoscopic removal of the tumor is performed. With timely and correct treatment favorable prognosis.

A multilocular cyst should not be taken lightly. This is a serious pathology that can lead to complications that threaten the life of a woman. But you should not resort to surgery in the absence of strict indications.

How to do laparoscopy to remove an ovarian cyst - watch the video:

A multi-chamber ovarian cyst is a non-malignant formation growing on the gonad, having an internal cavity divided by partitions into separate sections that are filled with liquid or viscous exudate. In 70%, a two-chamber ovarian cyst is formed, but when diagnosing, there are also three-chamber cavity structures.

Peculiarities:

The structure of a multi-chamber cyst is characterized by the formation of dense partitions of connective tissue, which divide the capsule into several cells.
Multi-chamber formations are larger than single-chamber ones.
Often, chambers are formed when several formations of different types grow together, with fluid being determined in one or two sections, and blood clots in the other.
A multilocular ovarian cyst is considered more dangerous. This is because the isolated accumulation of exudate in several chambers leads to rupture with a larger total volume of content.
In practice, a two-chamber cyst of the right ovary is more often detected. Gynecologists explain the intensive growth of nodes on the right by active blood supply from a large artery. If a two-chamber cyst of the left ovary is diagnosed, then it increases more slowly due to reduced blood flow to the left gonad. A multi-chamber cyst of the left ovary is treated in the same way, the symptoms are no different.

Among the cystic nodes, formations are recorded that more often than others form a cavity with several chambers:

. It is formed in utero during the development of the reproductive organs in the fetus, and is a bubble with liquid. Education begins to grow actively during the formation of the menstrual function, therefore, it is often found in girls 10-13 years old. Medicines and home remedies are not able to make the paraovarian cyst shrink, the formation requires only surgical removal.

. It refers to functional formations, that is, it is not a pathology and develops as a result of a malfunction in the cyclic functioning of the ovary. Normally, in the middle of the female monthly cycle, the dominant (mature) follicle should burst and release a healthy egg into the fallopian tube. If the follicle does not rupture, but begins to grow, filling with fluid, a cystic nodule is formed. Several chambers in the cavity are rarely formed.

Serous and mucinous. Serous and referred to as cavitary benign tumor-like formations, which are characterized by several chambers with liquid or thick exudate. Both are capable of malignant transformation. A serous cystoma without treatment can grow up to 20 - 30 cm. Papillary cystadenoma is considered a subspecies of serous cystadenoma. When growing, it is able to gain up to 10 kilograms and is a pathology bordering on a cancerous condition. Treatment involves only surgical removal.

Symptoms

Signs of the development of a cyst or cystadenoma do not depend on the number of chambers in the cavity. Until the node has grown to 5 - 6 centimeters, the pathological process does not give disturbing symptoms.

Basic features:

aching dull pains in the lower abdomen, which are reflected in the sacral, lumbar, inguinal region, or on the one hand, if the node has grown on one ovary;
distension in the abdominal cavity;
frequent urination, constipation associated with the fact that a large formation can compress the rectum, bladder;
an increase in the volume of the abdomen, if the tumor is large;
asymmetry and bulging of the peritoneal wall above the affected gonad;
failure of the period of menstruation, prolonged bleeding, spotting;
development of dropsy (ascites), if serous grows on the ovary.

Acute emergencies with a multi-chamber cyst, including rupture of the walls, hemorrhage into the peritoneum, twisting of the leg, suppuration, require emergency surgery, otherwise the patient may die quickly.

Similar life-threatening conditions are manifested:

acute pain in the abdomen;
hardening of the muscles of the peritoneum on the side of the lesion;
rise in temperature, drop in blood pressure;
great fear, perspiration, copious sweat;
rapid pulse;
loss of consciousness, development of pain shock, coma.

Diagnostics

Laboratory and instrumental studies:

Examination by a gynecologist, who determines the size, location, structure, mobility of the cyst, possible inflammation in the appendages.
Ultrasound diagnosis (on the 6th - 8th day after the end of menstruation) to clarify the type, size, number of chambers, exudate density.
CT and MRI (tomography) for a deeper study of education and confirmation of its type.
Sampling of venous blood for the quantitative level of tumor marker proteins (CA-125, 72-4) to exclude a tumor process, which is especially important in mucinous and papillary cystadenoma.

Treatment

Treatment of a multi-chamber cyst depends on the type, size, characteristics of the formation, the age of the patient, suspicion of malignant transformation, and internal diseases.

Peculiarities:

with functional education, if its size is not more than 30 - 50 mm, the gynecologist adheres to the tactics of waiting and observing. The node usually does not give serious deviations, regresses and disappears in 2-4 months. Surgery is required in acute conditions if the cyst is pedunculated or bursts;
when confirming the diagnosis of a multi-chamber paraovarian, mucinous, serous cyst, you should know that they never resolve under the influence of medications. And they can break at any moment. Therefore, with such ovarian formations, only surgical treatment is provided. Since in 20% of patients the cells of mucinous and serous cystadenoma degenerate into cancer cells, it is extremely dangerous to postpone the operation and treat yourself;
surgical treatment is accompanied by the use of combined contraceptives, hormones to prevent relapse.

Revealed in our separate article.

Types of surgery

The method of surgical treatment is determined by the type, size of the cyst, the risk of cancer.

The surgical strategy is aimed at respecting the ovarian tissue and preserving its functions. Women who plan to have children do not lose the ability to conceive after surgery even after the removal of the ovary.

Operation types:

Laparotomy. This is open, carried out with a transverse incision of 10 - 15 cm under the skin fold on the abdomen. Such a surgical intervention is prescribed if large growths are diagnosed or there is a suspicion of a cancerous process. In the hospital, if there are no complications, the patient stays up to 7-9 days.

Multichamber cyst and pregnancy

If the size of the formation is not more than 30 - 50 mm, doctors try to control its growth and not start treatment before childbirth.

If the formation begins to progress rapidly or a large cyst is immediately diagnosed that can break through at any time, surgical therapy is prescribed after 14-16 weeks of pregnancy, when the placenta is fully formed and fixed. If the operation is not done, then the growing cyst displaces the uterus, threatening to terminate the pregnancy, and the risk of rupture of the walls and torsion of the leg is very high.

Removal of education during childbearing is carried out by laparoscopy. With a timely and correct operation, the ability to maintain a pregnancy and bring the baby to a normal term is very high.

A two-chamber ovarian cyst is a benign neoplasm. With timely diagnosis, treatment will include only conservative methods. But the later a woman seeks help, the higher the likelihood that she will need to lie down on the operating table. Any benign cyst in the absence of response measures can degenerate into a cancerous tumor.

Causes of the disease

Modern medicine has not yet come to a consensus on what is the basis for the development of cystic education. At the same time, in the initial stages, a woman may not have any symptoms, which makes it difficult to determine the causes. During an appointment with a doctor, patients often cannot remember what events preceded the appearance of the first alarming signs.

A cyst can be an independent formation (for example, in situ) or develop from a follicle that has not burst. In the latter variant, a rapid increase in size is often observed, which further provokes the formation of a follicular-type cyst.

However, there are a number of provoking factors that many experts agree with:

disruption of the endocrine system;
when changes in the hormonal background occur;
transferred surgical intervention on the pelvic organs;
gynecological inflammation.

It is believed that the cyst largely depends on the hormonal balance. Therefore, the reasons for the development can still be attributed to the use of drugs that stimulate or suppress the endocrine system. Given this, the primary task of the doctor is to find out as much as possible the potential factors that provoked the disease.

Characteristic symptoms

The manifestation of the disease directly depends on its size and intensity of growth. In the initial stages, the patient may not even know that she has any disorder. But as the tumor develops, the woman will begin to have problems with well-being.

The presence of a cyst of the right or left ovary can be determined by the following conditions:

In the absence of any measures in relation to the neoplasm, the risk of probable or impaired blood supply to the ovary increases.

In this case, immediate hospitalization will be required. This condition can be identified by sudden pain in the lower abdomen, a sharp jump in temperature, clouding of consciousness, and even loss of it.

Diagnostics

Treatment is started only after the examination. Initially, the gynecologist conducts an examination, which evaluates the size of the ovaries. If the specialist has doubts or suspicions, the patient will be sent for a wider diagnosis.

To confirm or refute the diagnosis, a woman must undergo:

Be sure to take a pregnancy test. This allows you to exclude ectopic conception. To clarify the diagnosis, they may additionally prescribe an MRI (to determine a neoplasm that is not visible on ultrasound) and CT (if a cancerous tumor is suspected, together with testing for tumor markers).

After the results of the studies are ready, the doctor will select the treatment.

Methods of treatment

In the first stages, the treatment of cysts is carried out in stationary conditions. The therapy itself largely depends on the cause of the disease, the age and health of the patient.

Treatment may include the following approaches:

The appointment of hormones should be carried out only by a specialist. The active components of these drugs affect the hormonal background. Therefore, in case of improper intake or violation of the treatment regimen, there is a high risk of developing new tumor formations, but already in other organs.

Possible Complications

A double-chambered cyst is a health threat that requires an immediate response. This tumor forms malignant metastases much faster.

Also, a cyst can lead to a number of complications:

rupture of tumor tissues - occurs due to prolonged or sharp physical exertion, inflammatory processes;
purulent accumulations may occur inside the formation;
provoking hemorrhage in the uterine cavity.

In the advanced stages, the organs of the reproductive system themselves begin to be involved in the pathological process - the ovaries, fallopian tubes, uterus. And this is fraught with serious complications. The first alarming signs of cyst rupture are cramping pains in the lower abdomen, tachycardia, weakness, low blood pressure, false urge to urinate or defecate. In this case, immediate medical attention is required.

Prevention

Knowing about the potential causes, you can prevent the occurrence of the disease. It will be difficult to eliminate all factors, but it is partially possible to cope with some points.

Prevention includes the following activities:

weight control - excess weight affects the hormonal background;
follow an active lifestyle;
undergo a preventive examination by a gynecologist at least once a year;
if there were already cysts in the anamnesis, then it is necessary to avoid activities that stimulate the blood circulation of the pelvic organs - trips to the solarium, a long stay on the beach;
do not self-treat with hormonal drugs.

A cyst with a septum is not polycystic, that is, it does not threaten a woman with infertility. But this does not mean that such a neoplasm does not require control and treatment. Any tumor is unpredictable, therefore, an appropriate reaction is required - a visit to the doctor and the implementation of all his instructions.

A multi-chamber ovarian cyst is a benign formation that grows on the gonad. As a rule, the growth is formed from the tissues of the appendage. Pathology needs urgent treatment. This is due to the fact that there is a risk of developing serious complications.

The neoplasm is a kind of bubble filled with fluid. The growth of this tumor occurs due to the germination of the endometrium in the tissues of the uterine canal and other organs.

Most often there is a two-chamber cyst of the right ovary. The intensive growth of nodes on this side is due to the proximity of a large artery, which is involved in the process of blood circulation. In the case of damage to the left ovary, the growth of the growth occurs much more slowly.

The danger of pathology lies in the fact that when the leg of the neoplasm is torn or twisted, bleeding can begin, and nearby tissues die.

Causes

A multi-chamber and two-chamber cyst of the right ovary can occur for the following reasons:

anomaly of the reproductive system that arose in the prenatal period;
hormonal disorders;
inflammation of the appendages and other organs of the genitourinary system;
early abortion;
miscarriage;
surgical intervention in the reproductive system;
pregnancy;
disturbances in the activity of the endocrine glands.

It will be possible to accurately determine the cause of the onset of the pathological process only by conducting a comprehensive examination.

Symptoms of pathology

At the initial stage, the disease is asymptomatic, but with the further development of a multi-chamber cyst, the following clinical manifestations are observed:

pulling pains in the lower abdomen;
unstable periods;
the stomach increases in size;
hyperthermia;
acyclic bleeding;
impossibility of conception;
weakness;
sudden, unexplained weight loss;
male pattern hair growth;
false urge to defecate.

All symptoms of pathology are conventionally divided into several groups:

pain sensations;
hormonal disruptions;
clinical manifestations of intoxication.

If there is a rupture of the neoplasm, then the woman's condition worsens significantly. There is a sharp pain in the abdomen and dizziness. In this case, the medical institution must be contacted without delay.

Diagnosis of a two-chamber cyst

At the initial stage of diagnosing a two-chamber cyst of the left ovary, the doctor examines the woman on the chair, carefully examines the features of the clinical picture and collects an anamnesis.

In order to determine the location of the neoplasm, its size and the degree of neglect of the pathological process, the following studies are assigned:

Ultrasound using a transvaginal probe;
blood chemistry;
hormone analysis;
examination of the uterus by hysteroscopy.

To rule out the presence of malignant neoplasms, additional blood sampling can be performed to identify tumor markers. Treatment tactics are selected only after receiving the results of all diagnostic studies.

Treatment of a multilocular cyst

There are several methods of therapy for cystic multi-chamber education. Most often, they resort to surgical treatment, but at the initial stage of the development of the pathology, it is possible to eliminate the problem by using medications.

without surgery

If the size of the neoplasm is small, then the treatment is carried out with the help of hormonal agents. Often, oral contraceptives Yarina or Marvelon are prescribed. Thanks to their use, the volume of the tumor is significantly reduced, and in some cases the growth is completely absorbed.

Hormonal drugs based on progesterone can also be used. As a rule, it is assigned at the same time. With its help, the formation begins to gradually decrease in size.

The selection of medicines should be carried out exclusively by a doctor. Hormonal drugs have a number of restrictions on the use and often provoke the appearance of side effects. With the wrong treatment tactics, the condition can significantly worsen.

Sometimes an ovarian cyst is prescribed in the treatment, so we recommend that you familiarize yourself with additional information on its use.

Operating

In the process of therapy, surgical intervention is most often resorted to. It can be an abdominal operation or. The use of a laparoscope allows tissue excision with minimal damage and under strict visual control.

During the operation, several small incisions are made in the navel area and through them the peritoneal cavity is filled with gas to ensure normal visibility. Then a special device is introduced, equipped with a flashlight and a camera. Due to this, the image is transmitted to the monitor screen, and the doctor can monitor the progress of all manipulations.

In the next step, the affected tissues are removed. Next, cauterization of damaged vessels is performed. This stops bleeding immediately and reduces the risk of infection.

With small sizes of growths, it is possible to confine ourselves to excision of only the lesions. The tissues of the appendages are not affected. In advanced cases, the neoplasm is removed along with the ovary. The material obtained during the operation is sent to the histological laboratory.

Given that laparoscopy is a surgical intervention, it is worth familiarizing yourself with after it.

Puncture

The procedure is carried out by introducing a special substance into the neoplasm cavity. As a result of such actions, the walls of the cyst begin to subside - and the tumor regresses.

If the formation is multi-chamber, then the operation is carried out with the utmost care. This is due to the fact that in such an outgrowth there are a large number of partitions.

During this procedure, it is almost impossible to exclude a malignant process and conduct a biopsy. Only the contents of the tumor can be subjected to subsequent research. Puncture is performed only in the presence of special indications.

Possible Complications

When the pathology is neglected, there is a high risk of degeneration of tumor cells into malignant ones. In order to timely identify the onset of the oncological process, the affected tissues are taken and sent to the histological laboratory. After receiving the results of the study, the doctor decides on the appropriateness of surgical intervention and its volume.

The cyst may also rupture. As a result, severe bleeding begins and the state of health worsens significantly.

A large three-chamber ovarian cyst is especially dangerous. The probability of its rupture is quite high. At the same time, the heartbeat becomes rapid, weakness appears, a feeling of discomfort in the rectal area, a sharp pain in the lower abdomen, and blood pressure decreases.

At the beginning of a purulent process in the neoplasm cavity, a significant deterioration in well-being, a breakdown, an increase in body temperature, and throbbing pain in the abdomen are noted. A blood test reveals leukocytosis.

In addition, serious consequences such as tubo-ovarian abscess and hemorrhage can be observed.

A multilocular cyst is a serious disease that needs urgent treatment. Most often it is carried out by surgery. Sometimes it is possible to eliminate the pathology with the help of medications of the hormonal group, but only at the initial stage of its development. In the absence of proper therapy, there is a risk of developing serious complications.

Ovarian pathology is widespread among females with preserved reproductive ability. Leadership among them belongs to the cystic transformations of this organ. A two-chamber cyst of the left ovary, according to statistics, is slightly more common than the right one. This requires a separate consideration of the causes of development and features of the treatment of this pathology.

What does she represent

The ovarian cyst is represented by a cavity neoplasm, which is almost always filled with liquid contents. It can have different qualitative and quantitative characteristics, which is determined by the origin of the cyst. With a two-chamber cyst, this cavity is not one, but two. This means that cystic formations are enclosed in one capsule, but between them there is an additional partition that separates one cyst into two chambers.

Features of two-chamber cysts

More often occur in the left ovary;
Occur in young girls and women during the period of hormonal changes in the body, having a burdened gynecological history;
Relatively more frequent occurrence against the background of mental lability and stress;
Always have large sizes;
Often complicated by rupture or torsion of the ovary;
May cause infertility.

Clinical manifestations and diagnosis

It is impossible to single out individual symptoms that characterize a two-chamber ovarian cyst. All manifestations are nonspecific and can be observed in many diseases of the adnexal apparatus of the uterus. These include:

The diagnosis of a two-chamber cyst of the left ovary can only be confirmed with the help of an ultrasound examination performed in the transabdominal and transvaginal modes. In doubtful cases, tomography or diagnostic laparoscopy is performed.

Treatment options

The presence of a two-chamber cyst in the left ovary is a direct indication for surgical treatment. As a rule, such neoplasms do not resolve on the background of conservative therapy. The sooner this is realized by the patient, the less the risk of complications of such cysts. Their development is fraught with the loss of the left ovary.

Operative technologies for the elimination of this type of cysts are quite well mastered by all gynecological hospitals. The operation of choice is laparoscopic removal of the cyst. With this type of intervention, a classic incision is not needed, since all stages of the operation are performed through punctures under the control of a video camera (laparoscope). With the planned removal of the cyst, the ovary can be saved. Complication of a cyst by rupture or torsion may require open surgery through a standard approach.