Ovarian cysts in prepubertal girls.

Visualization of follicles is perfectly physiological during childhood, their diameter generally does not exceed 10 mm. Ovarian cyst in childhood is well defined for a fluid image >20 mm. Generally mild and asymptomatic, ovarian cysts are fluid formations usually discovered incidentally by ultrasound. Some are hormonally active and cause the development of sexual characteristics. The natural history of functional cysts is eventual regression, and persistence is suggestive of organic tumor. The onset of pain is a sign of complication, and an abrupt sharp pain with vomiting is suggestive of ovarian torsion, in which case surgical intervention is urgent. In all cases, the diagnosis is based on pelvic ultrasound. MRI and tumor marker assays are required to determine the nature of an organic cyst before proceeding to surgery. These cysts may appear functional from the fetal period onward and will require management from the first days of life. Certain endocrine disorders such as precocious puberty, hypothyroidism, and aromatase deficiency cause functional cysts in girls. Recurrent bleeding is due to hormonally active cysts and suggests McCune-Albright syndrome. Although the persistence of a cyst suggests a neoplasm, a fluid character indicates benignity. Imagery is a useful aid in the diagnosis of epithelial tumors (cystadenomas) or teratoma (dermoid cyst).

[Treatment of ovarian cyst after ovulation-induction with sanjie zhentong capsule].

OBJECTIVE: To observe the efficacy of Sanjie Zhentong Capsule (SJC) in treating ovarian cyst after ovulation-induction. METHODS: Fifty-eight patients with ovarian cyst were randomly assigned to two groups, 33 in the treated group treated with SJC and 25 in the control group treated with temporization for 1 month. Changes of estradiol (E2), luteinizing hormone (LH) and follicle stimulating hormone (FSH) level as well as condition of cyst before and after treatment were observed and compared. And the time for complete disappearance (TCD) of cyst and the pregnant rate within 4 months were followed-up. RESULTS: Effective rate (no fluid cyst sized over 1.0 cm could be found in bilateral ovary and E2 <280 pmol/L) in the treated group was 81.8% (27/33) and 52.0% (13/25) in the control group, showing significant difference between them (P <0.05). Level of E2 decreased in both groups, but the lowering was more significant in the treated group, after 1 month, it being 220.54 +/- 96.23 pmol/L vs 372.56 +/- 330.62 pmol/L (P <0.05). The changes of LH and FSH levels were of no statistical significance (P >0.05). TCD in the treated group was 1.18 +/- 0.46 months, which was shorter than that in the control group (1.96 +/- 1.34 months, P <0.05). The pregnant rate within 4 months in the two groups was 60.6% (20/ 33) and 32.0% (8/25) respectively, showing significant difference (P < 0.05). CONCLUSION: SJC has good efficacy in treating ovarian cyst after ovulation-induction.

Pedicle torsion of ovarian cyst and acupuncture--a case report.

A case history is reported of a patient who presented with acute pedicle torsion in a left ovarian cyst, which had been diagnosed seven months previously. The diagnosis was established by sonography. She declined surgery for personal reasons, and was treated with acupuncture. Her pain was successfully relieved, and she continued to be observed. The acupuncture was repeated daily for 15 days, after which time repeat sonography showed reduction in size of the cyst, and no torsion of the pedicle. No relapse had occurred at 16 months follow up.

[Clinical study on endometrial ovarian cyst treated by integrated laparoscopy and Chinese herbal medicine].

OBJECTIVE: To investigate a new method of integrated laparoscopy with Chinese herbal medicine (CHM) in treating endometrial ovarian cyst. METHODS: One hundred and fifty-two patients with endometrial ovarian cyst were randomly treated with three therapies: Integrated laparoscopy with CHM (combination group), CHM (TCM group) and Danazol (WM group). To compare the clinical efficacy and side-effects of the three groups and to elucidate the therapeutic mechanism by detecting the serum CA125 reproductive endocrine hormone, plasma PGF1 alpha, PGE2 etc. RESULTS: The shrinking rate and disappearance rate of the cysts, and markedly effective rate of combination group were obviously higher than those of TCM group and WM group (P < 0.05, P < 0.01). The pregnancy rate of combination group was also higher than that of WM group (P < 0.05). Few side-effects were the most prominent advantage for combination group and TCM group. After treatment, the plasma PGF1 alpha lowered remarkably, serum p.o. increased and CA125 reduced obviously (P < 0.01, P < 0.05). CONCLUSION: The integrated laparoscopy and CHM combination therapy is a new method in treating endometrial ovarian cyst with significant efficacy, minimal adverse effect and maximal preservation of reproductive function.

Acupuntura y ginecología / Acupunture and gynecology

Se presenta el análisis de una muestra de 255 pacientes afectadas por distintas enfermedades ginecológicas como: mioma uterino, quiste ovárico, displasia de mama y enfermedad pélvica crónica (EPC). Como resultado del tratamiento aplicado según las distintas afecciones, se comprobó una mayor frecuencia de mejoría total sintomática en los miomas uterinos con el 42,9 porciento, le siguen en frecuencia la EPC con el 34,8 porciento, las displasias de mamas mostraron una mejoría total del 29,2 porciento y por último, los quistes de ovario con el 14,3 porciento. La mejoría parcial sintomática mostró su mayor frecuencia en los quistes de ovario con 84,7 porciento, las displasias de mamas con el 70,8 porciento, del 52,8 porciento en la EPC y en los miomas uterinos el 49 porciento. En las displasias de mamas y en los quistes de ovario se redujo la tumoración en el 66,7 porciento de los casos y en los miomas uterinos en el 49 porciento. En las EPC y los miomas uterinos no se observó mejoría en el 12,4 y 8,2 porciento respectivamente (AU)

Acupuntura y ginecología / Acupunture and gynecology

Se presenta el análisis de una muestra de 255 pacientes afectadas por distintas enfermedades ginecológicas como: mioma uterino, quiste ovárico, displasia de mama y enfermedad pélvica crónica (EPC). Como resultado del tratamiento aplicado según las distintas afecciones, se comprobó una mayor frecuencia de mejoría total sintomática en los miomas uterinos con el 42,9 porciento, le siguen en frecuencia la EPC con el 34,8 porciento, las displasias de mamas mostraron una mejoría total del 29,2 porciento y por último, los quistes de ovario con el 14,3 porciento. La mejoría parcial sintomática mostró su mayor frecuencia en los quistes de ovario con 84,7 porciento, las displasias de mamas con el 70,8 porciento, del 52,8 porciento en la EPC y en los miomas uterinos el 49 porciento. En las displasias de mamas y en los quistes de ovario se redujo la tumoración en el 66,7 porciento de los casos y en los miomas uterinos en el 49 porciento. En las EPC y los miomas uterinos no se observó mejoría en el 12,4 y 8,2 porciento respectivamente

Expectant management of functional ovarian cysts: an alternative to hormonal therapy.

OBJECTIVE: We studied whether the administration of oral contraceptives facilitates the disappearance of spontaneously formed functional ovarian cysts. METHODS: Eighty patients in whom ultrasonography revealed unilateral, mobile, unilocular, thin-walled ovarian cysts without internal echoes and greater than 30 mm but not exceeding 60 mm in diameter were enrolled into the study. Patients were randomized by stratification to receive a low-dose monophasic pill, a high-dose monophasic pill, a multiphasic pill or no therapy. Patients were re-evaluated after 5 weeks of therapy and at the end of therapy (10 weeks). RESULTS: The mean ages and the mean cyst diameters of the patients for each group were not significantly different. We did not find a significant effect of oral contraceptive administration on the disappearance rate of functional ovarian cysts over that of expectant management. CONCLUSION: We conclude that oral contraceptive therapy even with multiphasic pills is very effective in the management of functional ovarian cysts but expectant management achieves similar success rates and may be a good alternative to oral contraceptive therapy.

Caso clínico N§1 / Clinical case N§1

Paciente de 43 años, afectada de hipotiroidismo, glaucoma y quiste de ovario izquierdo es tratada con lachesis a diferentes potencias lográndose desaparición de su quiste y normalización de la función tiroidea. El glaucoma permanece sin variantes

Caso clínico Nº1 / Clinical case Nº1

Paciente de 43 años, afectada de hipotiroidismo, glaucoma y quiste de ovario izquierdo es tratada con lachesis a diferentes potencias lográndose desaparición de su quiste y normalización de la función tiroidea. El glaucoma permanece sin variantes

Caso clínico Nº1 / Clinical case Nº1

Paciente de 43 años, afectada de hipotiroidismo, glaucoma y quiste de ovario izquierdo es tratada con lachesis a diferentes potencias lográndose desaparición de su quiste y normalización de la función tiroidea. El glaucoma permanece sin variantes (AU)

A importancia da biopatografia na abordagem de uma paciente portadora de cisto ovariano / The importance of the biopathography in a case of ovarian cyst patient

A autora relata um caso de cisto ovariano, em paciente histerectomizada, reduzido atraves de tratamento homeopatico, ressaltando a importancia da historia biopatografica

A importancia da biopatografia na abordagem de uma paciente portadora de cisto ovariano / The importance of the biopathography in a case of ovarian cyst patient

A autora relata um caso de cisto ovariano, em paciente histerectomizada, reduzido atraves de tratamento homeopatico, ressaltando a importancia da historia biopatografica

Assessment of electric differential treatment (EDiT) and Endosan treatment for ovarian cysts and concomitant symptoms.

The mechanisms of action and clinical applications of electric differential treatment (EDiT) and Endosan in the treatment of ovarian cysts and concomitant symptoms are reviewed. Possible mechanisms of action include an increased level of cyclic AMP, stimulation of endorphin release, anti-inflammatory action, and steroidogenesis resulting from normalization of intercellular communication. Favorable results in the clinical setting were achieved in the treatment of ovarian cysts. Treatment success was reflected in a significant reduction in overall cyst size as well as amelioration of various concomitant symptoms, including fever, chills, inflammation, and abdominal pain. EDiT and Endosan were shown to have potent analgesic and anti-inflammatory effects. No adverse effects have been reported.

Homoeopathic treatment of ovarian cysts

Forty women suffering from ovarian cysts, diagnosed and measured by ultrasound, were treated with a single homoeopathic medicine according to their specific mental, general and local symptoms. The hormonal disorders suffered by these patients lead to several symptoms, some specifically gynaecological, others general or mental, demonstrating how the health deterioration process effects the general state of the sick person. The ultrasound examination was repeated after about nine months. Results were positive

Hypothalamic hypogonadism.

The reproductive system consists of a series of feedback loops involving the higher centers, the hypothalamus, the pituitary, and the gonads. The factors involved in physiologic restraint of the hypothalamic pituitary gonadal axis until the time of puberty are complex. The pattern (frequency and amplitude) of GnRH signal is important in regulating pituitary LH and FSH secretion. This signal can be amplified and modulated at the pituitary level at least in part by the sex steroids. Hypothalamic hypogonadism can be considered a disorder of the hypothalamic GnRH pulse generator that results in deficient or dysrhythmic GnRH release. The mechanisms underlying the abnormal GnRH release in acquired, functional disorders such as anorexia nervosa and amenorrhea of joggers remain controversial. Evaluation of patients with hypothalamic hypogonadism involves exclusion of hyperprolactinemia, space-occupying lesions, and other systemic disorders. The pulsatile administration of GnRH for induction of fertility represents a major advance in the treatment of these patients.