Cysts and fibroids

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Among the many medical terms, the term "tumor" most often gives rise to misunderstandings and gratuitous, unnecessary fears. A typical example: The gynecologist discovers cysts on the ovaries of the woman during the examination. He notes on the medical record or in the hospital admission the diagnosis "Adnextumor" and means thereby only that something schwwurnstartiges at the "Adnexen" (= appendix of the uterus), thus at ovaries or fallopian tubes, formed.

Cysts and fibroids are usually harmless

In the word "tumor," most people think of "cancer." However, ovarian cysts are almost always benign entities that have nothing to do with cancer. The same goes for fibroids. Even with these tumors of the uterine musculature, the risk of a malignant change is extremely low.

Both structures, cysts and fibroids, are widespread and are increasingly being discovered by gynecologists during routine ultrasound examinations. In many cases, the doctor will stop the diagnosis and only recommend to his patient: wait. This is especially true for the cysts. These fluid-filled cavities can occur at any age, singly or in large numbers, on one or both ovaries. They do not grow from proliferations of cells, but from the accumulation of tissue fluid.

The most common cause of ovarian cyst formation is a follicle that has not burst normally during ovulation. Small cysts usually cause no discomfort, but sometimes there is unilateral, pulling pelvic pain or an uncomfortable feeling of pressure. Even irregular or heavy bleeding occur. Large, stalked cysts can rotate around their stems and suddenly cause severe pain.

What gynecologists can do today

In many cases, it is worthwhile first to observe the growth of the cyst because it often regresses by itself. Also, taking the pill or other hormone preparations can stop their growth. However, cysts that are likely to be benign and do not cause discomfort should also be monitored regularly by ultrasound and palpation. If they are particularly fast-growing, do not respond to medication, cause more discomfort to the woman, or are suspicious of the ultrasound, the gynecologist will advise their removal.

Also fibroids are often harmless and sometimes only the reason for surgery. These benign tumors develop in the smooth muscles of the uterus and can be found in almost every third woman after the age of 35. If they do not cause any complaints, regular gynecological monitoring is sufficient. During the menopause, they are usually due to the declining hormone production completely back. However, depending on extent, fibroids can lead to strong and prolonged menstrual bleeding and a feeling of pressure in the lower abdomen. Sometimes they also press on the bladder or bowel causing discomfort. Even low back pain is often the result of fibroids.

When to wait, when to operate?

The gynecologist can try to shrink the fibroid with novel, hormonal counterparts of the estrogen (so-called GnRH agonists) to shrink. In this way many women today are spared surgery. In other cases, it is sufficient to remove only individual fibroids, so that the uterus is preserved. However, if the fibroids are very numerous, despite repeated medical treatment regrowth and cause discomfort, the gynecologist will recommend removal of the uterus (hysterectomy).

The procedures used in the examination and treatment of cysts and fibroids have changed significantly in recent years, emphasizes the professional association of gynecologists. In many cases, surgery can be performed today without a body cut. With the help of the so-called "keyhole surgery", many cysts and also some fibroids can be removed without opening the abdominal wall, as part of a laparoscopy (laparoscopy or pelviscopy).

The benefits of endoscopic surgery are not limited to the beneficial cosmetic effect. Originally developed by gynecologists, this method is also less stressful and causes less pain. The patients recover faster after the procedure and can leave the clinic soon. Also, the fears and mental stress of the operation are lower. As the patient recovers faster from the procedure, endoscopic surgery also contributes to the cost reduction in health care, it concludes in the message from the gynecologist association.

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