Ovarian Cysts
An ovarian cyst is a fluid filled sac that grows on or within the ovary. In the majority of cases these cysts are non-cancerous (benign) and will not cause problems. They are most commonly seen in women of childbearing age and form a follicle, containing the egg, as part of the normal menstrual cycle. Most ovarian cysts are ‘simple,’ containing only clear fluid, and resolve on their own without treatment over a few months. More ‘complex’ cysts can contain blood, sebum or solid areas and these are less likely to go away by themselves. The risk of a cyst being cancerous is low, but does increase after the menopause. If a cyst is found on a routine ultrasound scan, you may be referred to see a women’s health doctor to discuss whether or not you need any further scans, blood tests to help determine the type of cyst, or treatment.
Symptoms
- There are often no symptoms at all
- Pelvic pain, including painful periods if the cyst is due to endometriosis
- Pain during intercourse
- Swollen or bloated tummy
- Frequent need to pass urine
Treatment
If the cyst is described as simple, containing only clear fluid, it will most likely resolve on its own without treatment.
Larger cysts, or those described as complex, contain solid areas, blood and/or sebum, and require monitoring with further ultrasound scans. You may be asked to have a blood test for markers which can help determine whether the type of cyst is concerning and may be cancerous. The most common test is called Ca125, and is most often performed on women after the menopause with an ovarian cyst.
Cysts are at risk of causing the ovary to twist around on its stalk, or rupture, causing sudden-onset severe abdominal pain with or without vomiting, and if this happens, you should be seen by a doctor on the same day – either your GP or in the emergency department. If the ovary is twisted on its stalk, its blood supply can be cut off, causing the ovary to die. This situation requires urgent surgery.
If you have ongoing less severe pelvic pain, or the doctor has recommended removal of the cyst, this is most commonly performed by keyhole surgery, unless the cyst is too large. In women under the age of 45, usually the cyst is peeled from the ovary (cystectomy), whereas after the menopause, if a cyst has to be removed, it is simpler to remove the entire ovary; sometimes it will be recommended that after themenopause, both ovaries are removed at the same time to prevent further cysts from forming. When an ovarian cyst is removed, it is always sent to be checked under a microscope to make sure that no cancer cells, or other conditions such as endometriosis, are present.
Links
- http://www.nhs.uk/conditions/Ovarian-cyst/Pages/Introduction.aspx
- http://www.webmd.com/women/guide/ovarian-cysts
- http://www.patient.co.uk/health/ovarian-cyst-leaflet
Urinary incontinence is the accidental leakage of urine. It affects up to one in three women at some point in their lives, although it is more common after the menopausedue to lack of oestrogen, which can thin the tissues supporting bladder control. Obesity increases the risk due to increased pressure on the bladder. Urinary tract infections can cause temporary urinary incontinence. There are two types of incontinence:
Stress incontinence occurs during coughing, laughing, exercise and sneezing. The urethra, which leads from your bladder to the outside, is unable to stay closed in response to increased pressure inside the tummy, resulting in leakage of urine. This is the most common type of incontinence in women, and is improved by weight loss and exercising the pelvic floor muscles. If this does not help, specialist help from a pelvic floor physiotherapist can improve symptoms. Some women go on to require surgery to help strengthen the pelvic floor muscles surrounding the bladder; the most common procedure for stress incontinence in women is the transvaginal tape (TVT).
Urge incontinence when you have a sudden urge and often cannot reach the toilet in time. It is caused by an overactive bladder wall muscle; this muscle is called detrusor. This condition is also known as detrusor overactivity, or overactive bladder. It is also more common after themenopause, and the cause is unknown. Frequent urinary tract infections can irritate the bladder and make the symptoms worse.
Treatment includes life style changes such as exercises and diet, bladder training and medication to calm the bladder muscle. If all of these measures fail to help, surgical procedures may be offered.
Links
- http://www.nhs.uk/Conditions/Incontinence-urinary/Pages/Causes.aspx
- http://www.webmd.com/urinary-incontinence-oab/features/incontinence-womans-little-secret
- http://www.webmd.com/urinary-incontinence-oab/womens-guide/
- http://www.womenshealth.gov/publications/our-publications/fact-sheet/urinary-incontinence.html
- http://www.nhs.uk/Pages/HomePage.aspx
- http://www.webmd.com
- http://www.womenshealth.gov/index.html
- http://www.med-help.net/Female-Reproductive-Disorders.html
