Classification of diseases of the ovaries

  1. Tumor Diseases
  2. Tissue-specific diseases
  3. Acute emergencies

Tumor Diseases

Ovarian cancer

Ovarian cancer is diagnosed in around 10 out of 100,000 women annually and is the second most common malignant tumor of the female genital organs.

In the early stages, ovarian cancer is very rarely symptomatic, with vaginal bleeding after menopause in only 10-15% of cases.

In the late stages, there is constipation, diarrhea, indigestion, bloated stomach, increase in abdominal girth from ascites and decrease in subcutaneous fat with sunken cheeks. Unfortunately, there is no effective early detection method for ovarian cancer. The most important method of treatment is to remove all tumor tissue and carefully check for colonization of the tumor in the abdominal cavity during the operation. Once the tumor has spread beyond an ovary, chemotherapy is then given.

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Tissue-specific diseases

Ovarian cysts

Functional ovarian cysts are encapsulated accumulations of fluid in or on the ovary. They arise from disorders in the hormonal cycle of women and can be assigned to various causes: For example, one finds Follicular cysts and para-ovarian cysts.

Follicular cysts develop when an egg cell matures but does not ovulate. This happens more often in young girls and young women whose cycle is (still) irregular. The follicle (follicle) then continues to grow and can become several centimeters in size, causing pain. Follicular cysts usually resolve spontaneously after 6-8 weeks.

Paraovarial cysts are left over from the development of the internal genital organs in the womb and are located near the ovaries, for example in the surrounding connective tissue. They are benign but can be painful and therefore sometimes need to be removed with a laparoscopy.

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Endometriosis

Endometriosis describes a disease in which parts of the uterine lining (technical term: endometrium) are in the wrong place. Instead of just inside the uterus, it can also be found in other places in the abdomen, for example in the ovaries or the fallopian tubes.

The scattered mucous membrane is most often found in the posterior ligament of the uterus or in the ovaries, but can also be found in the vaginal wall, for example. Endometriosis is a fairly common condition: it is estimated that 6-10% of all women are affected.

The two most common symptoms are (cycle-dependent) pain and / or an unfulfilled desire to have children. The extent of endometriosis is hormone-dependent: Under the influence of estrogen (female sex hormone produced in the ovaries), the uterine lining grows both in the uterus and in the places where an endometrial foci (uterine lining in the wrong place) is located.

A definitive therapy is therefore possible through the withdrawal of estrogens (by removing the ovaries), which is fraught with many side effects, especially in women before the menopause. Usually, however, the therapy is very individual and ranges from hormone therapy to surgical removal of the endometrial foci. Unfortunately, one of the complications of endometriosis is infertility.

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If there is a lot of uterine lining in the fallopian tubes, they can stick together and limit normal function. In addition, one suspects a connection between endometriosis and impaired function of the ovaries, since even patients with only a low disease burden can have problems getting pregnant.

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Polycystic ovary syndrome

The polycystic ovary syndrome describes a common disease of the ovaries, which is characterized by many cysts in the ovary (PCO = polycystic ovaries). Polycystic ovary syndrome affects an estimated 4 to 12 percent of women of childbearing age and is triggered by a hormonal disruption of the menstrual cycle.

This leads to infrequent or absent ovulation and thus irregular cycles, an increased level of male sex hormones and other symptoms such as diabetes mellitus. Overweight women are affected much more often. Polycystic ovary syndrome is a common cause of female infertility.

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Acute emergencies

Pedicle rotation of the ovaries

Rotation of the stalk of an ovary is a complication of ovarian cysts.The ovary rotates one or more times around its own axis and thus constricts the supplying blood vessels. This leads to severe pain in the lateral lower abdomen, which can be accompanied by nausea and vomiting. An increased heart rate and sweating are also common.

The rotation of the stalk of an ovary is surgically treated with a laparoscopy. The ovary is developed and then it is observed whether the tissue is supplied with blood again. In many cases, blood circulation resumes and the ovary does not need to be removed. However, if the ovary has already died, it must be removed, otherwise the dead tissue can cause inflammation of the abdominal cavity.

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