| The reproductive age woman category, now that's the | | | | organs. But if the doctor sees a six-centimeter cyst, he |
| ones -if she's trying to get pregnant, then obviously | | | | is going to operate anyway, so most of the time that |
| she's not on any kind of birth control and most likely | | | | would be a procedure that would not have a purpose. |
| they're functional. What do you do? Well you can | | | | She needs a laparotomy to make sure that this |
| watch them month to month, and if they resolve, which | | | | particular ovary cyst isn't one of the other cysts, of |
| most of them will, the problem is gone. If such a cyst | | | | course the endometriomas, the sustatnomas, the |
| grows or causes more problems, then she should also | | | | dermoid cysts, the polycystic ovaries, which usually |
| have a laparotomy. Now, if that woman - well, the | | | | aren't going to show up as large cysts. |
| other way is of course, many of these women you'd | | | | And of course, the last category is the rarer cystic |
| say listen, what we need to do is put you on a short | | | | tumor that would be cancerous. So, the management |
| course of birth control pills to see if the cysts stop | | | | basically is one of just, in most women is, in the |
| forming. | | | | reproductive age group is going to be wait and see. |
| Birth control pills, the way they work, is they, they work | | | | You know, reassurance, come back in a month. You |
| on the complex mechanism that regulates ovulation, | | | | can take, if the cyst goes away, great, if it doesn't or if |
| interrupting all those pathways that I briefly described | | | | it slowly resolves fine, if it doesn't go away, you can |
| earlier and that complex pathway interrupted, no more | | | | offer a course of birth control pills. If that's not |
| ovulation occurs, no more functional cysts occur. And | | | | acceptable or not possible, then the last way is to of |
| the cyst that was there will most likely resolve | | | | course to actually take a look through an incision, a |
| because of less feedback from the other hormones | | | | laparotomy. |
| so birth control pills in a way you could say could cure | | | | And that I think that pretty much sums up the actual |
| cysts. But these are the cysts- | | | | treatment of cysts, at least as far as a diagnostic |
| That may not always be an option for some women | | | | program. There are other treatments of cysts, and I |
| that have problems with birth control pills or other side | | | | will mention these each by the category. So we got a |
| effects. | | | | functional cyst that are self-resolving or you're going to |
| For those women, those group of women who cannot | | | | use birth control pills. We've got the endometriomas |
| take birth control pills. If for whatever reason, and | | | | which begin the endometriosis on the ovary. This is a |
| there's a litany we won't get into here of women who | | | | case that needs to be treated with various |
| cannot take the pill for one reason or the other, then it | | | | medications. There are medications to suppress |
| would be expected management, that's basically just | | | | ovulations, stop the period which burns up in the |
| watching and seeing, cause most of these will go | | | | endometriosis and it's generally about 90% effective, |
| away within three menstrual cycles. If they do not, | | | | and also causes fertility when you get these to go |
| then, then most likely she's going to have a laparotomy. | | | | away. So the chocolate cysts once they are, they're |
| Obstetrician Gynecologist, Christopher Freville, | | | | usually removed at laparotomy, you can also cauterize |
| recommends you could also do a laparoscopy. A | | | | them, that's zapping them with electricity. Again, the |
| laparoscopy again is a very common term, this is | | | | patient is asleep because the endometriomas and |
| where a telescope like tube with a light on it is put in, | | | | endometriosis are usually multiple places in the pelvis, |
| the doctor is able to look through an incision in the | | | | and then follow up with medications to suppress |
| naval, while of course I might add the patient is asleep | | | | ovulation. |
| and fully anesthetized, is able to look at the pelvic | | | | |