A paraovarial cyst is, in fact, a neoplasm of the tumor-like type that arises from the appendage of the ovary. This pathology may not have any pronounced symptoms at all, and may be the cause of periodic pain in the abdomen and lumbar region. It can also be the cause of menstrual disorders.
Very often, this type of cyst is detected by chance when a woman is not bothered by anything other than non-pregnancy. Pathology is often detected by chance during a comprehensive ultrasound, when a woman consults a gynecologist about infertility. The most complicated cases of the course of this disease are manifested in the form of purulent-inflammatory processes of the cyst, twisting of its legs and rupture of the capsule. Treatment involves the removal of cysts while maintaining the fallopian tubes and ovaries.
Location
The localization site of the paraovarial cyst is the cavity, the conditional boundaries of which are the ovary, uterine ligament and fallopian tube. The cyst itself has a picture of a cavity formation, the reason for the formation of which is a violation of the process of embryogenesis from the paraovarian - this is a rudimentary formation. In fact, it is an ovarian appendage.
The age at which this disease is most often detected is 20-40 years. It is rare in adolescence.
Anatomical and physiological features
The body of the paraovarial cyst has a rounded or oval-like shape, as well as a tight-elastic consistency. The walls are transparent, smooth and thin (no more than 2 mm), inside lined with flat, single-row epithelium of a cylindrical nature. The contents of the cyst are represented by a clear, uniform, watery fluid containing a significant amount of protein and a small amount of mucin. Cyst growth occurs rather slowly, and over time, the cyst can be very small.
The paraovarial cyst on the right is quite inactive, grows slowly and can be small for a long time. The accumulation of watery contents helps to enlarge the cyst and stretch its walls. On average, their size varies between 8-10 cm. There are cases when a cyst reaches the size of the head of a newborn baby.
Provocative factors
Factors contributing to the growth of cysts:
- inflammatory processes of the uterus and appendages;
- endocrine disorders;
- premature puberty ;
- abortion;
- uncontrolled use of hormonal contraceptives;
- sexually transmitted diseases;
- abuse of sun exposure and hot water treatments;
- pregnancy - against the background of hormonal changes, a tendency to growth of the neoplasm is observed.
Many are interested in what it is - a paraovarial cyst on the left. Let's figure it out.
Symptomatology
In the case of a small cyst (up to 2-3 cm), most often it does not have any clinical manifestations. And only with further growth can symptoms periodically disturb in the form of aching and bursting pains in the side or in the sacral region. Usually pains do not have a temporary relationship to the menstrual-ovulatory cycle, tend to increase with physical activity, and can appear and disappear completely suddenly.
A paraovarial cyst can have a compressive effect on the pelvic organs, which accordingly manifests itself with certain symptoms: urination disorder, constipation, or vice versa, unmotivated urge to defecate. The stomach can even slightly increase. Cysts often cause menstrual irregularities and infertility. The most complicated pathology options lead to the development of symptoms of an acute abdomen. Acute manifestations are, for example, cases of rupture of the capsule or twisting of the legs. In these cases, removal of the paraovarial cyst is required.
Diagnostics
We noted above that, since the expressed symptomatology of cystic formations is often absent, the disease is mainly diagnosed by chance: during a planned ultrasound scan or during a laparoscopic examination in search of causes of infertility. A cyst can be detected during bimanual gynecological examination by palpation. Tactile cyst is found in the form of a painless tumor-like formation with smooth contours, elastic consistency and with limited mobility, localized above the uterus or from the side.
Transvaginal ultrasound reveals a paraovarial ovarian cyst (right or left) of a round or oval-like shape, having a thin-walled structure and homogeneous anechogenic contents. In more rare cases, the contents may be presented in the form of a fine suspension.
Important is the diagnostic differentiation of ectopic pregnancy, ovarian cysts and other tumor-like pathologies.
What is it - a paraovarial cyst on the left or on the right, now it is clear, but how to treat it?
Treatment technique
Unfortunately, the phenomenon of a paraovarian cyst on the right or on the left does not belong to the category of ovarian formations capable of retinating, which, for example, include cystic formation of the corpus luteum or follicular cyst.
Having appeared once, she herself will not disappear anywhere. It can only exist for quite a long time absolutely asymptomatically and it is quite common practice when, if the cyst does not bother the patient in any way, the doctors leave this formation and simply observe the dynamics.
Nevertheless, we noted above that women of reproductive age are susceptible to this disease, which means that a cyst can cause pregnancy failure. In this regard, before planning the birth of a child or before preparing for the IVF procedure, it is subject to the desired surgical removal: laparoscopy or laparotomy (less common).
If the cystic pathology is uncomplicated, then the operation on the paraovarian cyst is limited to dissection of the anterior leaf of the uterine ligament and husking of the neoplasm. At the same time, both the ovary and the fallopian tube remain intact. It's a good news.
The fallopian tube deformed during the operation has the ability to contract and take its previous shape. In some cases, a different tactic may be required when performing targeted puncture of the cyst, followed by aspiration of the contents, at the same time with which alcohol is injected into it to obliterate the cyst cavity.
Modern surgical approaches for laparoscopy involve minimal intervention in the form of small incisions. The operation is simple and very well tolerated. Patients are discharged home soon. Consider the treatment of paraovarial cysts with drugs.
Drug treatment
Dynamic monitoring of cystic neoplasm suggests the possible use of anti-inflammatory drugs.
In case of menstrual dysfunction, hormone therapy with estrogen and progesterone can be carried out. For this purpose, oral contraceptives are prescribed - "Yarina", "Zhanin", as well as drugs with reduced hormonal content - "Premarin", "Proginova".
The main thing is that the treatment of paraovarial ovarian cysts is timely.
Effects
In itself, the cystic formation usually has a fairly calm course. Provoke the above-mentioned complications in the form of a purulent-inflammatory process, torsion of the leg or rupture of the capsule can be caused by such factors as sudden changes in body position, excessive and incorrectly organized physical activity, overheating of the abdomen and other aggressive factors.
Torsion of the cystic leg leads to clamping of the uterine ligament. In addition, nerve and vascular trunks and even the fallopian tube itself are clamped. All these clamps lead to necrotic lesions of the paraovarial cysts, which affects the well-being of the woman as a whole. The abdomen is covered by waves of cramping pain, while painkillers do not help. The anterior abdominal wall experiences significant tension, bloating, a rapid heartbeat may appear, the skin becomes pale and covered with cold sweat.
The purulent-inflammatory process of the paraovarial cyst can be lymphogenous or hematogenous. It is accompanied by a high temperature, often with general intoxication lesions of the body, sharp pains in the abdomen of a spilled character. Vomiting may occur.
Cyst rupture is accompanied by a painfully shock state, signs of internal bleeding are noted.
The above pathological complications of cystic formation require emergency surgical medical care.
Cyst during pregnancy
If there was already a cyst before pregnancy, then this should not become a cause for concern.
If the cystic formation was detected after the fact of pregnancy, then it is worth noting such subtleties depending on the size of the cyst:
- With a small cyst size of up to 5 cm, its presence in the body does not matter. It can simply be observed in dynamics.
- If the size of the cyst exceeds 5 cm, there is a potential threat of twisting of its legs, which can cause painful manifestations and thereby complicate the course of pregnancy. The larger the cyst, the higher the risk of rupture.
The very fact of the presence of a cyst requires compulsory observation of it in dynamics.
Forecast
We noted above that a cyst can cause female infertility. Nevertheless, conception against the background of its presence in the body is quite possible, but you must always remember that cystic neoplasm poses a threat not only to the woman, but also to the fetus. For this reason, dynamic observation of cysts during pregnancy is recommended. Monitoring the dynamics of the neoplasm is performed using ultrasound.
Reviews about the paraovarial cyst
What do experts say about this disease?
As noted by gynecologists, surgical removal of the cystic body avoids relapse of the disease, since during the operation, rudimentary tissues are removed, from which the cyst actually grows.
After laparoscopy, it is recommended to wait 3-4 menstrual cycles before proceeding to conception.