Ovarian Cysts

　　The occurrence of ovarian cysts is related to various factors such as endocrine, virus, genetics, environment, lifestyle, and drug influence.

　　1. Endocrine factors:The ovary, although small, is an important organ that produces eggs, ovulates, secretes endocrine hormones, and balances endocrine function. Ovarian cysts often occur in women of reproductive age with active endocrine function, so it is believed to be related to endocrine disorders.

　　2. Environmental and lifestyle factors:Long-term poor diet structure, unhealthy lifestyle, and excessive psychological stress can lead to physiological ovarian cysts and true ovarian masses.

　　3. Genetic factors:According to statistics, 20-25% of patients with ovarian tumors have a family history.

　　Ovarian cysts can be physiological, that is, they can naturally disappear with the normal changes of the physiological cycle; or pathological, formed due to disease. A normal ovarian cycle has only one mature follicle, and the rest growing follicles will shrink and atrophy successively in the process of maturation. The mature follicle does not ovulate and continues to grow, or the degeneration of the atretic follicle is incomplete, and the granulosa cells still secrete fluid to form a cyst.

　　1. Cause infertility: Ovarian cysts have great harm to female health. The ovary is the place where oocytes develop, mature, and are released. Different stages of follicles are located in the ovarian cortex. If the ovary is damaged, it will cause mechanical obstruction of the fallopian tube, thus affecting the ovulatory function of the ovary and leading to infertility.

　　2. Ovarian cysts and pregnancy: For patients with early pregnancy and ovarian cysts, it is advisable to wait until after the 3rd to 4th month of pregnancy to undergo surgery to avoid triggering abortion. If a cyst is found in the late stages of pregnancy, it should be waited until full term. If the cyst blocks the birth canal during labor, a cesarean section should be performed, and the cyst should be removed at the same time. If a malignant ovarian cyst is diagnosed, surgery should be performed as soon as possible, and the fetus should not be taken into consideration. The treatment principle is the same as that during non-pregnancy.

　　3. Malignant transformation of ovarian cyst: The malignant transformation of ovarian benign tumors often occurs in older individuals, especially postmenopausal women. The tumor may rapidly increase in size within a short period, causing symptoms such as abdominal distension, loss of appetite, and a significantly increased, fixed tumor volume. There may also be ascites. Those suspected of malignant transformation should be treated promptly.

　　4. Ovarian cyst pedicle torsion: This complication is relatively common and is one of the gynecological acute abdomen diseases. It is often seen in cystic tumors with long pedicles, medium size, high mobility, and the center of gravity biased to one side, which often occur during sudden changes in body position, in the early stages of pregnancy, or after childbirth. After pedicle torsion, due to obstruction of venous return in the tumor, congestion may occur, turning purple or brown, and even bleeding due to vascular rupture. Tumor necrosis and infection can occur due to arterial obstruction.

　　5. Infection: This condition is relatively rare and often secondary to tumor pedicle torsion or rupture. The main symptoms include fever, abdominal pain, elevated white blood cells, and varying degrees of peritonitis. Infection should be actively controlled, and an elective operation for exploration should be scheduled.

　　5. Tumor rupture: Spontaneous rupture can occur due to ischemic necrosis of the cyst wall or tumor erosion through the cyst wall; or due to external rupture caused by compression, childbirth, gynecological examination, and puncture. After rupture, the cyst fluid flows into the peritoneal cavity, stimulating the peritoneum, which can cause severe abdominal pain, nausea, vomiting, and even shock. During examination, there may be signs of peritoneal irritation such as tense abdominal wall, tenderness, and rebound pain. The original mass may shrink or disappear. After diagnosis, an immediate laparotomy should be performed to remove the cyst and clean the peritoneum.

　　Clinically, there are two stages of symptoms:
　　1. Early symptoms
　　Intra-abdominal mass: Large cysts should definitely be taken seriously because our ovaries themselves are no larger than walnuts.
　　Dysmenorrhea: Those who did not have dysmenorrhea before may start experiencing dysmenorrhea or the pain may become more severe.
　　Menstrual disorders: the previously regular menstruation becomes completely irregular, often making you feel busy and confused.
　　2, Late symptoms
　　Menstrual disorders: ovarian cysts can also cause menstrual disorders in women.
　　Abdominal pain: Many women have a sense of abdominal pain.
　　Abdominal circumference enlargement: when pressing the abdomen, a significant swelling can be felt.
　　Abdominal compression sensation: if there is a sense of compression, the cyst has grown sufficiently large, causing frequent urination and difficulty in urination.

　　1, Adolescence is the period of ovarian development and maturation, when the function is vigorous. During this period, the ovarian cells grow rapidly and are easily stimulated by various factors in the body, leading to ovarian cysts. If a girl has symptoms such as early breast development, early menstruation, early formation of a mature female figure, irregular menstruation, frequent urination, severe abdominal pain, and abdominal mass, she should go to the hospital for examination in time and should not delay the opportunity.

　　2, Regular gynecological examination. Many gynecological diseases have no early symptoms, so women should pay attention to gynecological examinations. Whether there is any abnormality or not, they should go for gynecological examinations consciously and regularly, especially for high-risk groups over 30 years old, it is best to have a check-up every six months, and at least once a year.

　　3, Diet. Patients with ovarian cysts should have a light diet, rich in nutrition, correct malnutrition and abnormal eating habits, and avoid eating刺激性 foods, seafood, etc. At the same time, avoid high tension and mental stimulation, maintain an optimistic mood and adequate sleep. Strengthen physical exercise, enhance physical fitness, and exercise more in the sun to sweat out the acidic substances in the body through sweat, and avoid forming an acidic constitution.

　　1, Ultrasound examination:Through ovarian cyst ultrasound examination, it can be known the location, size, shape and nature of the mass, and the concept stock can indicate whether the tumor is cystic or solid, benign or malignant, which is of great significance for the diagnosis of ovarian tumors.

　　2, Basal body temperature detection:Generally, if corpus luteum is formed after ovulation, the body temperature usually rises 2-3 days after ovulation, and a few may rise on the day of ovulation. If there is no ovulation, the body temperature will remain at the basal body temperature.

　　3, Cervical mucus examination and vaginal cell examination:If a row of ellipsoids can be seen on the smear, it indicates that the estrogen effect has been influenced by gestational hormone.

　　4, Cytological examination:Through culdocentesis, aspiration of peritoneal fluid for cytological examination, and through laparoscopy or laparotomy, it is also possible to simultaneously check the aspiration of fluid from the uterovesical pouch, which has a high accuracy rate for the diagnosis of malignant ovarian cysts.

　　5, Self-examination:Upon waking up in the morning, first empty the bladder, then lie flat on the bed, with the legs slightly bent, and feel from one side of the lower abdomen to the other. If a hard foreign body is found, it should be suspected to be a cyst. It should be noted that if it can be touched, it indicates that the cyst has grown very large, and the next step must be to consult a gynecologist for pelvic palpation.

　　It is recommended to

　　(1)It is recommended to consume more foods with anti-ovarian tumor effects: horseshoe crab, sea horse, turtle, dragon pearl tea, hawthorn.

　　(2) For hemorrhage, eat goat blood, Venerupis, light meat, cuttlefish, shepherd's purse, lotus root, mushrooms, Malan head, Shizi, Fugu, persimmon paste.

　　(3) For infection, eat eels, Venerupis pertusa, water snakes, needlefish, crucian carp,麒麟菜, celery, sesame, buckwheat, rapeseed, toon, red beans, mung beans.

　　(4) For abdominal pain and distension, eat pork kidneys, myrica rubra, hawthorn, orange candy, walnuts, chestnuts.

　　Avoid

　　(1) Avoid smoking, alcohol, coffee, cocoa, etc.

　　(2) Avoid spicy and刺激性 foods: scallions, ginger, chili.

　　(3) Avoid moldy and charred foods, such as moldy peanuts, moldy soybeans, smoked meat, etc.

　　(4) Avoid dog meat, mutton, and greasy, fried, smoked, and other hot and dry foods.

　　The treatment method for ovarian cysts depends on various factors such as the patient's age, whether it is malignant, the location, size, growth rate of the cyst, whether to preserve the reproductive function, and the patient's subjective wishes.
　　1. Surgical Treatment for Benign Ovarian Cysts
　　(1) Ovarian Cystectomy, young patients, especially premenopausal patients, mostly adopt this surgical method, and try to retain normal ovarian tissue.
　　(2) Salpingo-oophorectomy can be performed in older patients (over 45 years old) or postmenopausal patients, and unilateral or bilateral salpingo-oophorectomy can be performed. It is worth noting that for the surgical treatment of larger ovarian cysts, the size of the incision should not be taken into account, and complete resection is preferred to avoid the overflow of the contents of the patient's pulse into the abdominal cavity or incision. During the operation, attention should be paid to the rapid changes in abdominal pressure, which can cause changes in the patient's pulse, respiration, and blood pressure. In case of necessity, accelerate fluid infusion or blood transfusion, and oxygen supply, and especially prevent early detection of acute gastric dilatation, paralytic ileus, and the resulting imbalance of water and electrolytes.
　　2. Surgical Treatment for Malignant Ovarian Cysts
　　(1) Most patients reach the advanced stage when they seek medical attention, so it is necessary to remove the primary cyst and as many visible pelvic and abdominal metastases as possible. Since malignant ovarian cysts often adhere or infiltrate the uterus and adnexa, forming an inseparable whole and closely adhering to the pelvic peritoneum, it is now commonly adopted to remove the uterus and tumor together with the pelvic peritoneum in a carpet-style, such as resection of the omentum, partial resection of the intestine, and partial resection of the bladder and ureter.
　　(2) Consider placing a catheter in the abdominal cavity to facilitate the use of chemotherapy drugs for intraperitoneal injection after surgery.