Doctors will choose different treatments based on the patient's age, clinical symptoms, and the type and size of the ovarian cyst.
Ovarian cysts are clinically found but without any symptoms. Doctors usually observe the patient. If the cyst disappears on its own, no treatment is needed. If the cyst is small in size, the doctor may give medication; if the cyst persists, Surgical treatment is required when it exists or increases, has a risk of malignant transformation (such as ovarian cysts in postmenopausal women), or occurs rupture or torsion.
Acute phase treatment When an ovarian cyst ruptures or an acute abdomen such as pedicle torsion occurs, emergency surgery should be performed. Generally, patients have no conscious symptoms. Ultrasound shows that the cyst is small and filled with fluid. The doctor may ask the patient to wait and see whether the cyst will disappear on its own within a few months. At the same time, the doctor will recommend regular ultrasound examinations to detect whether the cyst volume has changed. For cysts that are not yet indicated for surgery, conservative treatment with Chinese and Western medicines can be used, depending on the nature of the cyst.
If it is an endometrioid cyst, oral short-acting contraceptive pills can be taken; if it is suspected to be an inflammatory cyst, oral antibiotics or traditional Chinese medicine can be used to promote blood circulation and remove blood stasis. Indications for surgical treatment: The cyst is large in size, with a diameter of ≥5cm; the cyst persists after 3 to 6 months of observation; the cyst grows rapidly; ovarian cyst rupture or pedicle torsion causes symptoms of acute abdomen; ovarian cysts appear in postmenopausal women.
Commonly used surgical methods include ovarian cystectomy (only the cyst is removed and the ovary is preserved), oophorectomy on the affected side, total hysterectomy, or adnexectomy (if the cyst becomes cancerous, the uterus may need to be removed, The removal of ovaries and fallopian tubes at the same time is called adnexectomy, and may require radiotherapy and chemotherapy after surgery).
The main surgical methods include open surgery or laparoscopic surgery. Laparotomy is mainly for cysts that may become cancerous. The doctor will make a large incision in the abdomen. Laparoscopic surgery is suitable for relatively small cysts. The doctor will make a small incision above or below the patient's belly button, and then insert a laparoscope with a camera into the abdomen to help observe the abdominal condition. According to the theory of traditional Chinese medicine, ovarian cysts cause imbalance of qi and blood in women, which can be dialectically divided into three types: qi, blood, and body fluid. Although the classifications are different now, they are all classified around their pathogenesis, and treatment recommendations are Start from the aspects of "qi stagnation", "phlegm-dampness", "blood stasis", "damp-heat poison" and other aspects.
Qi stagnation and blood stasis type: Treat by soothing the liver and regulating qi, activating blood circulation and removing blood stasis, softening and dispersing stagnation, and use the modified Gexia Zhuyu Decoction. Type of phlegm-dampness and congestion: Treat by promoting qi and resolving phlegm, dispersing stagnation and eliminating congestion, and use Cangfu Daotan Pills.
Moisture-heat stasis type: Treat by clearing away heat and detoxifying, softening hardness and dispersing stagnation, and use Xinjia Pills. In addition, there are acupuncture (commonly used warm needle moxibustion), physical therapy, traditional Chinese medicine enema and other traditional Chinese medicine treatment methods that can have certain effects and must be carried out in regular medical institutions under the guidance of a doctor.