Paraovarian cysts of the ovaries are benign formations that often require surgical removal, especially when they are large or pose a risk of complications. Treatment of paraovarian cysts of the ovaries in Israel attracts foreign patients due to precise diagnostics and successful application of gentle organ-preserving techniques. Gynecological departments in Israeli clinics use ultrasound and endoscopic navigation, minimally invasive laparoscopic surgical methods, which is especially important for tumour-like formations located near the appendages but not connected to them.
Convincing evidence of the high quality of treatment and the comfort of its process is provided by numerous grateful reviews from patients. The excellent organization of the treatment process and the management of the patient by a multidisciplinary team of doctors are noted. In addition, an accompanying person helps the foreign patient at all stages of treatment – from the moment of arrival in the country to the completion of postoperative observation. These advantages, along with reasonable treatment costs, make Israel one of the most sought-after destinations for medical tourism.
About the Disease
Paraovarian cysts are fluid-filled or semi-solid formations that develop near the ovaries. It is difficult to say how common the pathology is, as in most cases, painful symptoms do not manifest. Many are simply not diagnosed because they have no reason to see a doctor. Most often, paraovarian cysts form from embryonic remnants of the ovarian appendage, which gradually increase in size under the influence of hormones.
The risk of formation increases:
- during puberty;
- during pregnancy;
- in the presence of chronic inflammatory processes in the appendages;
- local disturbances in lymphatic and blood circulation in the appendages.
Small paraovarian cysts often proceed asymptomatically and are discovered incidentally during ultrasound. Signs of the disease appear as the size of the formation increases. Patients complain of:
- pulling pains in the lower abdomen;
- a feeling of fullness or pressure on neighboring organs;
- discomfort during physical activity or sexual intercourse;
- frequent urination.
In cases of significant-sized paraovarian cysts, there may be an increase in abdominal circumference and unilateral pain. A large cyst can cause displacement of the ovary or fallopian tube, which manifests as increased pain. The most dangerous symptoms – sharp pain, nausea, weakness – may indicate torsion of the cyst's pedicle or rupture, requiring emergency assistance.
The prognosis for paraovarian cysts is favorable. These formations almost never malignize and respond well to surgical treatment.
Treatment Methods for the Disease
The choice of methods is made on an individual basis and depends on the extent of the pathology, the size of the formations, the intensity of symptoms, and the overall condition of the patient.
Observation (Conservative Tactics)
Small asymptomatic cysts do not require immediate surgical treatment. In the absence of pain and signs of complications, dynamic observation is preferable. The patient should undergo a clinical examination and ultrasound every 3-6 months. This approach is justified for women of reproductive age planning pregnancy, as in most cases, cysts either remain the same size or decrease.
Laparoscopic Cystectomy
If the patient complains of painful symptoms, or the size of the cyst increases, surgical removal of the formation is indicated. In the Ichilov clinic, the operation is performed laparoscopically, under video control. The laparoscope and microsurgical instruments are introduced through several small punctures. The doctor excises the cyst capsule and carefully removes it, trying not to damage the ovary and fallopian tube. Minimally invasive types of operations, including laparoscopy, ensure minimal trauma to normal tissues, rapid recovery, and short hospitalization.
If malignancy is suspected, the material is sent for express histology.
Laparotomy (Open Surgery)
Open surgery is performed in cases of very large cysts, massive adhesive processes, suspicion of malignancy, or in emergencies when laparoscopy is not possible. Resection of the cyst is performed through an incision, and if necessary, a more extensive operation (removal of the tube along with the ovary) is carried out.
Removal of the Fallopian Tube (Salpingectomy)
If the cystic process spreads to the fallopian tube, or in the case of recurrent recurrences, removal of the tube is indicated. In the Ichilov clinic, salpingectomy is also performed laparoscopically. This operation significantly reduces the risk of complications and recurrences, but decreases fertility, so it is performed in cases of severe damage to the fallopian tube.
Endovaginal Puncture/Aspiration and Sclerotherapy
Under ultrasound control, puncture of the cyst and aspiration of its contents are sometimes performed, providing temporary relief of pain and can be used as a temporary measure for patients who cannot be operated on immediately. In the Ichilov clinic, after aspiration, the cyst capsule is filled with a sclerosing agent, which helps reduce the risk of recurrence.
Emergency Interventions for Complications
In cases of torsion or suppuration of the cyst, rupture of its capsule, urgent surgery is necessary. In such situations, surgeons perform rapid opening and decompression, and in the case of torsion – resection of necrotized tissues and restoration of blood flow, in the case of suppuration – drainage and antibiotic therapy.
Plastic and Reconstructive Surgery
In cases of wide resection of tissues, partial loss of appendages, or the need to restore normal anatomy, regional plastic surgery is applied. The procedure involves moving adjacent flaps of mucosa or soft tissues, suturing, and reconstructing the fimbriae of the fallopian tube. The goal of the operation is to restore patency and functions of the appendages, minimize the risk of adhesions, and preserve fertility.
Diagnostic Methods for the Disease
The high qualification of specialists at the Ichilov clinic, combined with modern diagnostic equipment, allows for the examination of the patient and accurate diagnosis within an average of three days.
First Day
On the first day of stay at the clinic, a primary consultation with the attending gynecologist is conducted. During the appointment, the doctor performs a pelvic examination, reviews the available medical documentation, and prescribes necessary examinations.
Second Day
Conducting examinations:
- Ultrasound – the main diagnostic method that accurately determines the size of the formation, its structure, and localization relative to the fallopian tube and ovary;
- MRI of the pelvic organs – performed when there are suspicions of malignancy or the development of complications;
- dopplerography – a study that allows assessment of the blood supply to the cyst;
- laboratory tests (including tumor markers) – conducted to exclude malignant processes.
Third Day
The results are reviewed by a medical board. The doctors collectively make a diagnosis and select effective treatment.
- Magnetic Resonance Imaging (MRI)
- Electrocardiography and Dopplerography
- Ultrasound
How Much Does Treatment Cost
The cost of therapy can vary in each case, as it depends on a number of factors. The clinic consultant will be able to provide you with an approximate cost of the upcoming treatment.
Advantages of Treatment in Israel
- Highly qualified doctors.
- Modern medical diagnostic equipment.
- Application of innovative treatment methods.
- Individual approach.
- Reasonable price.
Foreign patients can have an online consultation with an Israeli doctor without leaving home. By contacting the patient at a pre-agreed time, the specialist evaluates the provided medical documentation and recommends further treatment.