Introduction
The body abdomen is a cavity holding numerous vital body organs needed for proper body functioning and survival purpose. Certainly, pathological and non-pathological activities may attack/occur in any of these organs located at the four different imaginary chambers/ quadrants of the abdomen. This obvious brings about a certain change in the body organ functioning and feelings commonly known as abdominal pain, which is a common problem brought about by anomalies or dysfunction of the certain parts and organs found in the abdomen.
While it’s barely hard to localize feelings in the body, abdominal pain has been defined in the four virtual localities of the abdomen, viz: left upper, left lower, right upper and right lower abdominal pain. Such differentiation only emanates from the idea of the pain source, meaning from where the pain is spread from in the specific abdominal part/chamber to the other chambers and then finally to the entire body (Uphold, 2003).
Ovarian cyst is one of the common causes of abdominal pain. It may cause both left lower and right lower abdominal pain conditions in the life of the girl-child. Therefore, ovarian cysts have been defined as fluid-filled sacs located in the ovaries, which may or may not be harmful and painful depending on the nature and characteristics. In this sense, ovarian cysts have been contemplated and viewed in two ways: one, they are seen as growths which indicates normal functioning of the female ovaries, and secondly they are considered as abnormal growths acting as precursors of an underlying malignancy.
Ovarian cysts are thus categorized into functional and complex cysts. The functional cysts type include follicle and corpus luteum cysts, which are fluid filled and small in size, less than seven. They are less threatening to human life as they are non-harmful and cause pain in a few instances particularly when ruptured. The complex category comprises of those cysts which are solid masses and mostly cause severe pain to the human. Included in the group are dermoid cysts, cystadenomas cysts, polycystic ovaries and endometriomas cysts (Gambone te al, 2009).
Formation
Ovarian cyst develops during the process of ovulation. The female right ovarian follicle releases the mature egg to the oviduct in the process of ovulation. However, due to certain factors, the normal ovulation may get interrupted leading to the development of the ovarian cysts. The ovulation process may be interfered with making the egg to stick within the follicle, or on the walls of the ovary. Subsequently, the stuck egg would gradually develop into an ovarian cyst, that is, it becomes a fluid-filled sac. In other cases, the follicle and the ovary may have the normal egg release, but the ovulation process gets interfered with through hormonal reactions/ activities.
Oestrogen dominance exemplifies such hormonal reactions and remains to be a major cause of ovarian cysts in women. If we assert the hormonal factor as the only mode through which ovarian cyst can be developed, we would have committed a scientific flaw in part of histology in which cancerous activities have the power to produce such kind of ovarian growths (Gambone te al, 2009).
Epidemiology
The occurrence of the ovarian cysts problem is not race selective, thus, no significant differences of ovarian cysts result noticed among and between racial groups.
Ovarian cysts are specifically problem experienced by females, as it affects the ovary organs in the female body. Furthermore it is extremely prevalent problem, which affects all ranges of female individuals, right from neonatal through pre-menopausal and menopausal to post-menopausal women. It estimated that 7% of females at both extreme ends in term age grouping have their live affected by ovarian cysts.
This is to imply that approximately 7% of females in their pre-menopausal stage and about 7% of women in their post-menopausal stage have to cope with the problem of ovarian cysts couple with abdominal pain. In addition also almost 5% of women living in the U.S fall victim of primary ovarian cysts diagnosis. Surprisingly, it is estimated that four out of a hundred pregnant women suffer from the ovarian cyst problem, while its prevalence exceeds 30 % in the causing cancerous effects in fetus and infants. The high percent of morbidity is well understood when in one contemplate that young people and infants are more susceptible to environmental attacks as their immune system is not much adapted to the conditions of the environment (National Women’s Health Information Center, 2010).
Diagnosis
An ovarian cyst is very difficult health problem to diagnose particularly due to its associated way with the lower abdominal pain. The large spectrum of other gynecological malignancies that cause pain at the lower abdomen exacerbates the situation of diagnosing the problem. However, with the advances in medical technology, there has been some improvement in diagnosing ovarian cysts by the use of ultra-sonography technique. The ultra-sonography technique is mainly used together with color Doppler method. The technique enables physicians or any other responsible person to observe both morphological and physiological changes within the ovaries (Coylar and Cynthia, 2003).
Apart from this, ultrasound method and CAT scan are also commonly used for the detection of ovarian cysts together with the size of the cyst. There are a number of differentials diagnoses which should performed for suspected victims of ovarian cysts with right lower abdominal pain. Such differential diagnoses include acute appendicitis, diverticulum disease, endometriosis, inflammatory bowel disease, Meckel diverticulum, large bowel obstruction, small bowel obstruction, ovarian cancer, ovarian torsion, pelvic inflammatory disease, polycystic ovarian syndrome, ectopic pregnancy, renal calculi and urethral diverticulum.
Other included in the differential diagnoses are acute salpingitis and tubal disease as they all have similar of symptom of right lower abdominal pain. The need to have all these differential diagnoses arise in the view wrong and mistaken feeling may lead to the wrong identification of the pain source. Such uncertainties however would means performing diagnostic tests of all diseases and problems with abdominal pain as the main indicator. There is impossibilities of doing so his discouraged by the fact that it’s uneconomical way of disease detection in terms of time saving as well as in financial terms (Baldor et al, 2009).
By focusing of the issue of specificity and sensitivity, the US has the ability to detect at ovarian cysts with right lower pain with sensitivity and specificity of 78 and 85% respectively. Overtly, the values of the sensitivity showed some kind of similarities and also differences with those of ovarian cysts with left lower abdominal pain. The sensitivity value of the right lower abdominal pain was much lower as compared to the left lower abdominal pain.
The low sensitivity value of the right lower abdominal pain should have been true due to the pain source being located at a far distance from one of the sensitive organs in the body, the heart. Specificity values of the left and the right lower abdominal pain as result of ovarian cysts would almost be the same because, the problem does not involve heart, but affects same organs found both in the lower left and right abdominal portions (National Women’s Health Information Center, 2010).
Symptoms
In most cases, many individuals do not realize the existence of an ovarian cyst in their body, hence, most ovarian cysts are said to be asymptomatic. Individuals affected by ovarian cysts in their right lower abdomen would show the following symptoms:
Severe right lower abdomen pain, general moderate lower abdominal pain or sometimes pelvic pain, irregularities in monthly periods, frequent urge of urination, bloating or swelling up of the lower abdominal part, uncommonly hemorrhage, internal surface irritations, nausea as well as general tenderness of the abdomen. The greatest challenging question arises from the focusing at the uncommon hemorrhage which might arise from other pathological infections which cause internal perforations on the surface or cause some other serious internal injuries (Shiver, 2010).
Treatment
The majority of the ovarian cysts are not treated, but they just evade away without human interventions. It takes 1 to 3 period cycles for most functional and complex cysts/growths to go away the natural way. Those cysts which fails to burst or are not gotten rid within the three periods, thus becoming persistent and live threatening through growth, it demands for treatment by the intervention of a qualified health practitioner (National Women’s Health Information Center, 2010). Two main methods are applied in the treatment of ovarian cysts by doctors or any other qualified medical officer, namely: surgery and chemical treatment methods.
Surgery method:-this is an operative technique involving the removal of the growths by cutting them out. It is employed mostly in cases involving severe and live threatening conditions. Surgical method may be accomplished in two ways, either using by using the laparoscopy which is a minimally surgical technique, or by using lapartotomy. Laparoscopy method is much more preferred method than any other because of its high reduction of operation time, improved and quick recovery as well as overall lessening of felt pain during the time of operation and in post-operation period.
Under the chemical method, the patient is put under treatment of the problem using prescribed chemical drugs aimed at shrinking of the ovarian cyst, or elimination of the growth (Desai, 2009). However, this is much undependable method as there are no drugs specifically designated for the treatment of the problem. This implies there is related drug abuse usage as it mostly relies on the assumptions to the functioning of abortive drugs. The patients are further advised to refrain from sexual misbehavior in order to avoid development other kinds of cysts which would complicate and worsen the situation of the ovarian cysts.
References
Baldor,R., Domino, F., Grimes,J., Golding, J. & Taylor, J. (2009). The 5-Minute Clinical Consult 2010: Lippincott Williams & Wilkins.
Coylar, M. & Cynthia, E. (2003). Ambulatory Care Procedures for the Nurse Practitioner: F.A. Davis Company.
Desai, P. (2009). Clinician’s Guide to Laboratory Medicine: Md2b.
Gambone,J. Hacker, N. & Hobel, H. (2009). Hacker & Moore’s Essentials of Obstetrics and Gynecology, With Student Consult Online Access: Saunders.
National Women’s Health Information Center, (2010). Ovarian Cysts. Web.
Shiver, E. (2010). Menstrual Irregularities. Web.
Uphold, C. (2003). Clinical Guidelines in Family Practice: Barmarrae Books.