Paraovarian cyst of the ovary - located between the tube and the ovary of the broad ligament of the uterus. In connection with the development of the body, during puberty, the appendages reach a maximum size, which causes the appearance of a cyst. A cyst is a cavity that contains fluid of different consistency and structure. It is a benign formation of different sizes, consisting of one or several chambers with a liquid. Distinguish between cysts taken from the nature of the internal contents and the histological structure of the capsule. The disease is often laid during embryonic development, but is not inherited.
A cyst can appear and disappear by itself, without being characterized by any unpleasant symptoms or painful sensations. But there may be problem cysts, characterized by the appearance of pain, bleeding and even ruptures of the cyst itself. In such cases, surgery is required.
Unfortunately, a quite frequent disease is a paraovarial cyst that develops in women of childbearing age, in some cases it can be observed in adolescents. But there is one good point - a paraovarial cyst never goes into a malignant formation, therefore the development of oncology of the ovary is ruled out. However, the cyst can grow to large sizes, because of which the stomach is greatly enlarged, filling the entire space of the abdominal cavity.
The difference of the paraovarial cyst from the usual is characterized by the following features:
Composition. Inside the cyst is filled with clear fluid.
The look of the shell, it is very thin.
The cyst is most often diagnosed on the right ovary, but it can be formed on both the left ovary and two ovaries at once. With a small size of cysts, their presence may not be felt in any way, but a paraovarian cyst can cause certain complications:
Suppuration, characterized by the appearance of sharp pain. To eliminate it requires urgent medical intervention.
The formation of the leg, which can twist, also causing painful sensations arising in the lower abdomen, in the back, in the sacrum or lower back area. Treatment of cysts on the left and on the right does not have any differences between them.
Symptoms of paraovarial ovarian cyst
Symptoms of a paraovarial ovarian cyst fully depend on its size. If the size of the cyst is small, then no symptoms may appear at all, and treatment is not required. But if the cyst increases in size, the following signs may appear:
Pain manifested in the lower abdomen, back, sacral area.
Pressure on the bladder that causes pain when urinating.
The growth of the abdomen, the feeling of "bursting".
Rarely - failure of the menstrual cycle and infertility.
Pains in a paraovarial cyst appear periodically, they may appear sharply and disappear, often aggravated after physical exertion. The connection of pain with ovulation or menstrual cycle, as a rule, is not observed.
The sizes of a paraovarial cyst can be very different: from 1 to 30 cm (in diameter). The pain is observed when the cyst reaches 5 cm and higher. During the growth of cysts, adjacent organs can be squeezed, and the abdomen increases in size.
Causes of Paraovarial Ovarian Cyst
The causes of paraovarial cysts, which are a specific trigger for its development, can be very diverse, from poor ecology to medication.
The appearance of the disease can provoke various hormonal abnormalities in the female body, the malfunction of the endocrine glands, the interruption of pregnancy by artificial means.
Modern medicine revealed the following, the most common causes of cysts:
Disruption of follicle maturation.
Early menstruation, occurring in 11 years and earlier, or irregular menstrual cycle.
Treatment with Tamoxifen in breast cancer.
Disorders of the endocrine system.
The use of certain drugs.
Some infectious diseases.
Increased level of stressful situations.
With the use of oral contraceptives, the risk of developing a paraovarial cyst is reduced, since the pills interfere with egg production.
Paraovarial ovarian cyst and pregnancy
If a woman has a paraovarial cyst, then you should not worry. If the cyst was found during pregnancy, then there are several options for the development of events.
The first is a small cyst (up to 5 cm). It does not cause any harm and does not affect the ability of a woman to become pregnant. Often the woman does not even suspect the presence of a cyst.
The second is a large cyst (over 5 cm). In this case, the good is not enough, the fact is that large cysts often form legs, which tend to twist, causing severe pain and complications during pregnancy. There is a risk of rupture of a cyst, as a result of which its contents enter the abdominal cavity.
For these reasons, if a cyst is found in a pregnant woman, she should be under close medical supervision.
When planning a pregnancy, you must undergo a full examination by a doctor. If an operation is performed to remove a paraovarial cyst, then it is necessary to undergo a course of treatment, starting the planning of the child no sooner than after three monthly cycles. Do not interfere with a course of anti-bacterial anti-inflammatory treatment.
Laparoscopy of a paraovarial ovarian cyst (operation)
Unlike other species, the paraovarial cyst does not resolve and does not disappear by itself. Therefore, with a large cyst size (up to 10 cm) and, in the event that the cyst does not respond to treatment during three menstrual cycles, the doctor may prescribe surgery.
Previously, the paraovarian cyst was removed during abdominal surgery, after which a rather scarred scar remains. But nowadays they use laparoscopy, which is a more modern and sophisticated method. The recovery period during laparoscopy occurs several times faster, and practically no trace of surgical intervention remains on the body.
Laparoscopy is carried out using laparascopes - tubes that are inserted into the abdominal cavity through small punctures under ultrasound observation.
Often in hospitals perform abdominal surgery due to the lack of necessary equipment.
Education: The diploma “Obstetrics and Gynecology” was obtained at the Russian State Medical University of the Federal Agency for Healthcare and Social Development (2010). In 2013, graduate school in NIMU named after. N.I. Pirogov.
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Medical expert articles
Unfortunately, paraovarial cyst is quite common. This type of cyst occurs on the ovaries. Usually, they develop in sexually mature women of childbearing age. But sometimes these cysts are found in adolescent girls.
There are paraovarial cysts in about ten percent of all similar diseases. One thing is good that this type of cyst never degenerates into malignant tumors. That is, the risk of oncology of the ovary is zero.
Compared with other types of ovarian cysts, a paraovarial cyst can grow to large sizes. Usually there are cysts 8-10 centimeters in diameter. But there are cases when a paraovarial cyst grows and fills the entire abdominal cavity. At the same time the abdomen greatly increases in size.
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Paraovarian cyst on the right
Very often, a paraovarial cyst grows on the right ovary. Subject to this disease are mostly women of childbearing age. But such cysts can appear in girls in their teens.
The right paraovarian cyst can grow between the uterus and the ovary. Small cysts are without a leg, but large ones can form a leg. This leg may consist of the fallopian tube or the ligament of the ovary. Such a leg is fraught with complications, because it can twist and hurt a lot. In this case, urgent medical intervention or surgery may be necessary.
If the cyst grows large, then it will greatly increase the patient's abdomen in size. Also, the patient may experience pain in the right side, lower abdomen or lower back.
If the cyst grows without complications, the pain will not be strong and pulling. If there is a sharp and severe paroxysmal pain, it may indicate a twisting of the leg of the paravarial cyst.
Paraovarian cyst on the left
Paraovarian cysts often develop on the right ovary, but can be formed on the left or on both ovaries simultaneously. Such cysts can grow to fairly large sizes, but at the same time, they rarely burst and burst.
If the cyst is small, the woman may not even feel any anxiety caused by such a cyst. But a paraovarial cyst can cause a number of complications. For example, it may fester. Suppuration causes severe pain and requires urgent surgical intervention.
Also, a cyst can form a leg, and a leg can twist. In this case, there can also be a sharp pain in the lower abdomen and give it to the back, to the lumbar region and the sacrum. Treatment of a paraovarial cyst on the left is identical, treatment of the same cyst on the right.
Paraovarian serous cyst
Paraovarial serous cyst is a mobile cyst. Very often, such a cyst forms a leg. Due to its mobility, the cyst can not cause pain to the patient. Therefore, it is not always possible to diagnose such a cyst by symptoms.
Most often, a serovarial serous ovarian cyst is detected by a gynecologist during a routine gynecological examination. It is felt during the inspection. This cyst is filled with serous fluid. The shell of a cyst is relatively thin and feels flexible and mobile to the touch.
But if a cyst greatly increases in size, it can manifest itself through a not sharp and nagging pain in the lower abdomen or in the lower back. If the cyst is very large, it can press on different organs of the abdominal cavity. For example, on the bladder or on the intestines. Then additional symptoms appear, such as constipation, frequent bowel movements or pain when urinating.
Much less often, a paraovarial cyst leads to noticeable disturbances or disruptions in the woman's monthly cycle. These disorders can be expressed by a sharp increase or decrease in the volume of blood released during menstruation.
Paraovarial cyst and pregnancy
If a woman once had or has a paraovarial cyst during pregnancy, you should not worry. After all, such a cyst is not transmitted to the child at the genetic level and does not affect the development of the fetus in the womb.
If the paraovarial cyst is not very large, then this formation on the ovary does not in any way affect the woman’s ability to have children. Moreover, a woman may not feel the presence of such a cyst at all. After all, small cysts may not cause pain or other symptoms.
A paraovarian cyst during pregnancy is dangerous in that its leg can twist. Such a torsion can cause severe pain and require urgent surgery. Usually, small cysts grow without a leg, therefore, there can be no such complication.
But large cysts, as a rule, form the leg and can cause complications during pregnancy. After all, during pregnancy all the organs of the abdominal cavity are shifted and compressed, which can lead to a twist of the leg of the cyst.
Therefore, it is better to remove a large paraovarial cyst before pregnancy. After surgery, it is better to be treated, recover and plan the onset of pregnancy no earlier than in a few months.
Description of the disease
Paraovarian cyst is a benign cavity formation, formed from the appendages of the ovary. Inside it is filled with a high protein liquid, has a round or oval shape and consists of one section without separation. The walls are thin, about 2 mm, lined up from flat cylindrical epithelium, through them you can see the inner contents. Nutrition cysts comes from the mesenteric and its own cystic vessels and capillaries. In larger forms, a peculiar leg is formed, consisting of the ligaments of the uterus and ovary.
Paraovarial ovarian cyst is a fluid-filled cavity formation of a benign nature.
This species is found in 10% of cases of tumor formation of the urogenital system, but it never degenerates into a malignant form. Cysts grow very slowly, sometimes for many years, increasing due to the accumulation of internal fluid, which gradually stretches the walls of the formation.
Most often localized in the right ovary, but can be located on the left, as well as on both sides. At the same time, there are different manifestations:
- Paraovarian cyst in the right ovary is the most common due to increased blood circulation from this side of the appendages. Only in this case there is a risk of its growth to the tissues of the uterus. The manifestation of symptoms is more pronounced, due to enhanced nutrition on the right side, the tumor grows much faster, which often leads to various complications.
- Paraovarian cyst of the left ovary is much less common, and its manifestations are often almost imperceptible. The base is more flattened, which allows you to avoid torsion of the legs and possible suppuration.
- A bilateral cyst combines all of the above symptoms.
You can also select mobile and stationary formations. The former can shift under pressure and have a very thin leg, while the latter are very difficult to move, they less often lead to complications.
It is most often diagnosed in women aged 30–40 years, however, it can also occur at a younger age, as it sometimes forms during intrauterine development and increases in size at the time of hormonal jumps in adolescents.
The size of this type of cyst can be very diverse, from a few millimeters, which are sometimes invisible when viewed, to huge tumors with a diameter of 30 centimeters.
Causes of development
There are many factors that lead to the formation of a paraovarial cyst. It is not always possible to establish the root cause of the disease.
Sometimes even the bad habits of the mother during pregnancy, which affect the health of her unborn child (smoking, drug and alcohol use, treatment with unresolved drugs, poor nutrition), can affect the formation of the tumor.
The mechanism of cyst formation is known, it occurs as a result of violations of the embryonic development of the epithelial tubules (paraovaria). They either have poorly formed excretory ducts, or they can be clogged, and sometimes even completely absent, which is why secreted fluids do not find an outlet and accumulate, forming elastic bags.
On the image numbers are marked paraovarial ovarian cysts.
Experts note the following reasons for the formation of a paraovarial cyst:
- disruptions in the process of maturation of ovarian follicles, lack of ovulation,
- deviations in the ratio of hormones caused by various endocrinological diseases or tumor processes,
- the beginning of the first menstruation to 11 years, early puberty,
- abortion and pelvic surgery,
- taking anabolic steroids
- hormonal jumps during puberty and at the time of menopause,
- taking estrogen antagonists in the treatment of breast cancer (Tamoxifen),
- infectious lesions of the urogenital system and other internal organs,
- poor environmental conditions, polluted air,
- increased emotional stress, stress, depression,
- inflammations of the ovary and uterine appendages (oophoritis, salpingitis, adnexitis),
- misuse of hormonal contraceptives
- frequent sunbathing under the sun or in a solarium,
- overheating of organs due to taking hot baths, visiting saunas, baths, etc.
Signs of the appearance of a paraovarial cyst are completely dependent on its size, since small neoplasms may not manifest themselves at all for a long time. In the case of growth of more than five centimeters in diameter, the following symptoms are observed:
- sharp or pulling pain in the pelvis,
- strong pressure on the bladder, which causes discomfort and increased urge to urinate,
- constipation due to pressure of the cyst on the intestines,
- sensations of bloating
- pain during intercourse, after exercise,
- various digestive disorders,
- increase in the abdomen on the part of cyst formation,
- painful sensations are paroxysmal, they can disappear completely and suddenly appear,
- high temperature in acute conditions.
The menstrual cycle is usually preserved and does not change.
Diagnostics and differential diagnostics
Differential diagnosis is carried out to exclude other types of cysts, as well as acute appendicitis, endometriosis, cancer tumors and ectopic pregnancy.
It is possible to identify the disease with the help of an examination on the gynecological chair using the method of palpation. At the same time, tumor formations that are practically immobile, smooth to the touch and elastic when squeezed are found to the right or left of the uterus.
If a cyst is detected, the doctor sends for an examination with an ultrasound scan that is transvaginal.
Ultrasound detects different forms of darkening.
One or several oval or round neoplasms are found on the screen, with a fluid that is homogeneous or containing small patches.
Laparoscopic examination is sometimes used to confirm the diagnosis. With the help of special equipment, a doctor can examine education in detail, establish its character, location, size, take a tissue sample for careful examination.
Treatment: will conservative methods and folk remedies help?
A paraovarial cyst does not resolve itself and requires surgical removal with its large size. After the diagnosis is established, constant monitoring of growth dynamics is necessary. There are no conservative methods and folk remedies to eliminate this neoplasm.
Neoplasm removal operation
Previously, in the absence of modern equipment, serious abdominal operations were performed, after which large scars remained. However, with the development of technology, doctors switched to minimally invasive surgery. Small cysts may not be removed, but when planning pregnancy and preparing for IVF, it is advised to get rid of even small tumors.
At the moment, paraovarial cysts are most often removed laparoscopically. However, despite the fact that this method is very gentle, there are the following contraindications to the operation:
- recovery from infectious diseases, if 30 days have not passed,
- acute respiratory and heart failure
- severe hypertension,
- advanced stages of obesity
- abdominal hernia and adhesions,
- malignant tumors of the pelvic organs.
Before assigning the date of the operation, it is necessary to pass the following tests:
- blood for a general clinical analysis to determine clotting factors, the presence of HIV and various forms of hepatitis, biochemistry,
- urine for general research
- a vaginal smear to detect diseases and microflora,
- Ecg heart
- Ultrasound of the pelvic organs.
Laparoscopy and laparotomy
The operation itself is performed under general anesthesia, which is individually selected for each patient. For easy access to the internal organs, gas is pumped into the abdominal cavity. In certain places there are minimal punctures, through which surgical instruments and a laparoscope are inserted.
The image shows laparoscopic pelvic surgery.
With the help of the latter, the resulting image enters the external screen, and the surgeon can control the entire process. The surgery requires caution, as there is a high risk of damage to the ovary. The surgeon carefully performs the excision of the uterine ligaments and removes the cyst. Just in case, the neighboring ovary is also examined for the presence of formations. After the operation, the gas gently descends, and a cushioning patch or stitches are applied to the cuts, depending on the size of the wound.
Sometimes a cyst is punctured, with the help of special devices the internal fluid is drawn out and ethyl alcohol is poured into its place, which leads to sclerotization of the treated tissues.
The duration of laparoscopy is from twenty minutes to several hours, depending on many factors. Rehabilitation is very fast, after 3-5 days, patients can return to normal life.
In particularly difficult situations, doctors resort to a rather traumatic method, in which a large incision is made in the lower abdomen.
In more severe cases, especially when the size of the cyst is very large, the lower midline laparotomy is shown, in which a sufficiently large abdominal incision is made along the midline and sometimes the ovary must also be removed. Recovery after surgery is long and takes about ten days.
Paraovarian cyst during pregnancy
If a cyst is found in a pregnant woman, it is necessary to conduct frequent examinations, as there may be cases of torsion due to the increased pressure of the uterus on nearby organs. There are no special risks in the earliest terms. The neoplasm itself does not affect the condition of the fetus, but can significantly worsen the health of the mother as the child grows. Treatment is postponed until the postpartum period, if there are no emergency indications for surgery.
Treatment of cysts in pregnant women is delayed until the postpartum period
The process of delivery itself should take place under tight control in order to avoid possible rupture or impaction of the cyst. If this happens, then serious blood loss occurs, the patient may fall into a state of shock and stop responding to external stimuli. In particularly dangerous situations, the doctor may recommend a cesarean section.
Treatment prognosis and possible complications
In most cases, if the treatment is carried out in time, it is possible to preserve the integrity of the ovaries and avoid impaired reproductive function. You can start conceiving a child no earlier than four months after the operation.
Lack of timely treatment can lead to serious complications at any time:
- Suppuration due to infectious or inflammatory tissue damage. Accompanied by sharp pain and requires immediate surgical intervention.
- A cyst rupture due to mechanical injury, pressure, or various other causes. Content goes into the abdominal cavity, an acute inflammatory process is formed, called peritonitis. The pressure drops, the patient may lose consciousness. The treatment is entirely surgical.
- The formation of a special leg, which is prone to twisting. Due to squeezing of blood vessels, the blood does not flow to the tissues, necrosis occurs, and the pain spreads to the tailbone, lower back, sacrum, and lower abdomen. Sometimes the symptoms are similar to the acute stage of appendicitis. Immediate hospitalization is required with prompt removal of a cyst affected by the ovary and other necrotic adjacent tissues. Most often this occurs during pregnancy or at a younger age due to increased activity.
- Deformation of the fallopian tubes, leading to problems with the conception of a child.
Reviews of women on cyst removal
She felt a pulling pain in her stomach. At first she did not attach any importance, and when she realized that she needed to see a doctor, it was already too late. I was brought to the hospital. We looked at the doctors. They decided to operate in the morning. They prepared for the operation. I was offered to be operated on laparoscopically. I agreed. In the morning a catheter was inserted. They entered extremely carefully, after entering this catheter, I had two weeks of post-traumatic cystitis. That's how it happens too. The operation went quickly. An hour later, I was already in intensive care. Despite this, the extensive adhesions of the abdominal cavity did not bypass my side. And bothered for several years. Later I asked my doctor why this happened, because I started to get up almost immediately after the operation, I walked a lot, in general, I had a rather active lifestyle. The doctor said that this process sometimes develops even in such active patients as I ... unfortunately. But still, remember that the sooner you get up after the surgery, the more likely it is that you will avoid adhesions. It’s hard to work out very quickly. Just forgot in one stitch thread. She was “coming out” for a long time and the place kept festering all the time until the tail of the thread appeared. I pulled her out. And it all stopped.
During removal of the cyst, a part of the ovary was removed. The doctor warned that the ovary and the whole can be removed, it will be clear already during the operation. Now doctors do not immediately find him on the ultrasound, but he is still there. Even during the operation, I was flushed through the fallopian tubes and burned with foci of endometriosis. After the operation, a woman came to our ward, led a postoperative gymnastics to avoid adhesions. After me, the doctor prescribed hormone treatment and advised me to try to get pregnant four months after the surgery, as this is the best treatment for endometriosis. The doctor said that my cyst was already several years old, and I did not even suspect about it.
I had a paraovarial cyst a few years ago ... doing laparascopy. went to the hospital for 3 days: 1st day - prepare, 2nd - operation (3 punctures in the abdomen), 3rd day - inspection and send home. not scary! only a cyst was removed, everything else (in the sense of being female) was in place ... after some time I had two children.
It is very important that all women understand that a paraovarial cyst will not diminish, but can only increase over time. No popular or any other methods can eliminate this disease. Nowadays, you can perform an operation that is very safe and retains the ability to independently conceive a child.
What is paraovarial cyst
Paraovarian cyst of the ovary is a benign neoplasm formed from the appendages of the ovary (paraovarium). The tumor is located on the uterine ligament, between the ovary and fallopian tube.
The tumor has one chamber and develops as a result of accumulation of fluid in the paraovarium, which, in turn, consists of small non-functional tubules, gathering in one large duct.
Unlike other types of cysts, paraovarial has a thin capsule of increased elasticity and strength, increases with the accumulation of large amounts of fluid, is characterized by slow growth.
It can occur on both sides or on one side, with a considerable size (more than 8-9 cm) exerts increased pressure on the pelvic organs, as a result of which a pronounced clinical picture develops.
The danger of such a neoplasm is the possible rupture of the capsule, the development of a purulent process, and also the twisting of the leg.
The left paraovarian cyst is quite rare, does not provoke the development of a symptomatic complex and is practically not prone to growth.
Such tumors are detected only during the passage of a prophylactic examination, including ultrasound of the pelvic organs. The paraovarian cyst of the left ovary may increase slightly, but never grows to a dangerous size.
The paraovarial cyst of the right ovary is found in most patients, which is connected with the peculiarities of the blood supply system and innervation of the right organ.
The paraovarian cyst on the right is a tumor formation characterized by slow growth, however, if left untreated, it may eventually become large and exert pressure on the surrounding organs. Tumor of the epididymis of the ovary to grow into the tissue of the uterus.
Cyst of the fallopian tube is of several varieties:
- movable paratubar cyst - this species is distinguished by a thin leg, a less robust capsule, reaches a huge size and moves with ease,
- fixed formations - these serous formations are less inclined to grow compared to mobile ones, but they can also reach large sizes and provoke the development of a symptomatic complex.
Paraovarial formations of small size (up to 2.5-3 cm) do not cause symptoms. When a large amount of fluid accumulates, the tumors increase and, reaching more than 5 cm in diameter, they put pressure on nearby organs, provoking the development of the clinical picture.
Symptoms manifest as painful sensations in the side and lumbosacral region, which are independent of the menstrual cycle.
Signs of neoplasia
The first signs and symptoms of a paraovarian cyst manifest as follows:
- there is a periodic pain in the side of the arching or aching nature,
- discomfort and pain in the sacrum,
- urination disorders,
- frequent urge to defecate or inability to empty the bowel,
- a significant increase in the increase in the abdomen from its location,
- violation of menstruation.
With the development of complications in the form of rupture of the walls of the capsule or twist its legs, the clinical picture of acute abdomen develops. With a large tumor without treatment, infertility occurs.
The treatment of a paraovarial cyst is carried out mainly by surgery. However, in some cases, it requires the use of drugs to normalize the hormonal system, eliminate inflammatory processes (Ibuprofen, Voltaren) and kill microbes.
Medicines are used in the development of the clinic of the disease in order to eliminate it and prevent complications.
Treatment of ovarian cysts without surgery involves the use of recipes of traditional medicine that improve the functioning of the urogenital organs of a woman, eliminate inflammation and help slow the progression of the tumor in size.
Traditional recipes are used only with the permission of the attending physician.
For diseases of the reproductive organs, it is recommended to take decoctions from dandelion root, grass of the uterus, red brush and wintergreen.
Dried and shredded plants are poured with hot water and kept in a water bath for up to 15 minutes, after which they insist under the lid for another half hour. Take broths several times a day, 1/3 cup for 20 minutes before meals.
The effectiveness of homeopathic remedies to date has not been proven, but such drugs consist of biologically active substances and are used to treat many diseases.
The choice of a particular tool depends on the individual characteristics of the organism, the size of the tumor, the severity of symptoms. Homeopathy is prescribed by a qualified specialist in order to avoid the development of allergic reactions and complications.
For severe pains, Berberis 3 is prescribed, which contains alkaloids. Apis is used to treat hormonal imbalances in the female body.
Prevention and prognosis
A paraovarial ovarian cyst does not pose a danger to a woman; she is not prone to malignancy (the growth of healthy cells into malignant cells). Tumors of small size do not cause discomfort and do not affect the reproductive system.
After removal of the neoplasms, the prognosis is favorable, as a rule, there are no complications, the woman returns to her usual lifestyle. Reproductive function is preserved, and pregnancy planning is possible in the future.
Prevention of the disease is a regular visit to the gynecologist to undergo a routine examination: at least once a year.
Features of pathology during pregnancy and during menopause
During pregnancy, the paratubular cyst does not adversely affect the fetus, but as the embryo develops, the uterus increases, which begins to compress the tumor.
As a result, the risk of torsion of the leg with the subsequent development of severe pain in the lower abdomen increases. This situation requires urgent surgical intervention.
In women during the period of menopause, the formation of a paraovarium often develops on the background of hormonal restructuring of the body or as a result of previously transferred infectious processes of the urinary organs. Pathological process can aggravate climacteric symptoms.
Tactics of treatment depends on the size of the tumor, the individual characteristics of the woman’s body and associated diseases.
The effect of pathology on the possibility of becoming pregnant
These serous formations do not affect the functioning of the female reproductive system, so the ability to conceive and carry a healthy baby remains.
Despite the benignness of a paraovarial tumor, the accumulation of a large amount of fluid contributes to its growth, which subsequently causes unpleasant symptoms, and without therapeutic measures can cause serious complications.
Regular visits to the gynecologist will allow timely detection of the pathology and the necessary treatment.
Paraovarial cyst is located intraligamentally, in a space bounded by leaves of the wide uterine ligament, between the ovary and the fallopian tube. This is a single-chamber cavity formation that occurs when the embryogenesis is disturbed from the rudimentary formation of the tubules - the periotic appendage (paraovarium). Paraovarian cyst is usually detected in the period of puberty, aged from 20 to 40 years, less often in puberty. In gynecology, paraovarial cysts are found in 8-16% of all detected additional ovarian lesions.
Characteristic of a paraovarial cyst
A paraovarial cyst is a smooth-walled formation of an oval or rounded shape, of a tough-elastic consistency, located on the side or above the uterus. The walls of the paraovarial cyst are thin (1–2 mm) and transparent, inside they have a lining of single row, flat, cubic and cylindrical epithelium. A steam cyst encloses a homogeneous, clear, watery fluid with a large amount of protein and a low mucin content.
An extended fallopian tube passes along the upper pole of the paraovarial cyst, and an ovary is located at the back-bottom surface. Blood supply of the abdominal formation is carried out by the vessels of the mesentery, fallopian tube and own vessels of the cyst wall. The leg of a paraovarial cyst is formed by a leaf of a wide ligament, sometimes by its own ligament of the ovary and fallopian tube.
Paraovarian cyst is inactive, grows slowly and for a long time may have insignificant size. Cyst enlargement occurs due to accumulation of contents and stretching of its walls. The average size of symptomatic paraovarial cysts is 8-10 cm, in rare cases the size of a cyst can reach the head of a newborn. Paraovarian cysts never malignant.
Inflammation of the ovary and uterine uterus (oophoritis, adnexitis), endocrine diseases (including hypothyroidism), early sexual development, repeated surgical termination of pregnancy, STIs, uncontrolled hormonal contraception, insolation (tanning in tanning beds) can contribute to the growth and growth of paraovarial cysts. or under the sun), local hyperthermia (hot common baths, warming). A tendency to an increase in paraovarial cyst is observed during pregnancy.
Diagnosis of a paraovarial cyst
Detection of a paraovarial cyst occurs more often during a planned ultrasound examination or a gynecologist's consultation, sometimes when performing diagnostic laparoscopy for infertility. In a bimanual gynecological examination, a one-sided, painless tumor-like mass with smooth contours, elastic consistency, and limited mobility is palpated from the side or above the uterus.
In the process of transvaginal ultrasound, a round or ovoid thin-walled formation with a homogeneous anechoic content is determined, less often with a finely dispersed suspension inside. Visualization of an intact ovary is an ultrasound criterion for a paraovarial cyst. Paraovarian cyst differentiate with ectopic pregnancy, ovarian cyst, true ovarian tumors.
Treatment of a paraovarial cyst
Unlike functional retention formations of the ovary (cysts of the corpus luteum, follicular cysts), the paraovarian cysts do not disappear on their own. An asymptomatic small-sized paraovarial cyst may be left under dynamic observation. However, due to the fact that paraovarial cysts are diagnosed in patients of reproductive age, they are often complicated and not always correctly differentiated, in their regard, surgical tactics are preferable - enucleation of the cyst. Also, the planned removal of a paraovarial cyst is required before planning a pregnancy or IVF.
Removal of a paraovarial cyst, as a rule, is performed during operative laparoscopy, less frequently with laparotomy. In an uncomplicated course of a paraovarial cyst, an anterior leaflet of the wide uterine ligament is dissected during the operation, and the cyst is expelled from the intraligamentary space. The ovary and fallopian tube when enucleating paraovarial cysts retain. After the removal of a paraovarial cyst due to retraction properties, the deformed fallopian tube is reduced and takes on its former shape. In exceptional cases, it is possible to conduct sighting puncture of a paraovarial cyst with the aspiration of serous contents and the simultaneous introduction of alcohol into it, which contributes to obliteration of the cavity.
Complications of the paraovarial cyst
With intense physical exertion, abrupt changes in body position, excessive insolation, or local hyperthermal exposure, a paraovarial cyst may be complicated by torsion of the leg, suppuration of the contents, rupture of the capsule.
When torsion of the cyst is twisted, the uterine ligament, nerve and vascular trunks, and often the fallopian tube, are clamped. In this case, necrosis of the paraovarial cyst develops, which is accompanied by a sharp deterioration of health: cramping pain throughout the abdomen, not relieved by the use of analgesics, tension of the anterior abdominal wall, gas retention, tachycardia, a fall in blood pressure, pale skin, sticky cold sweat.
Suppuration of a paraovarial cyst is caused by lymphogenous or hematogenous drift of the pathogenic microflora. This complication is manifested by fever from t ° to 38-39 ºС, intoxication, severe diffuse soreness in the abdomen, and vomiting. At a break of a paraovarial cyst the general phenomena of shock, sharp pains, signs of internal bleeding are noted. All complications of a paraovarial cyst require emergency surgical intervention in volumes dictated by the clinical situation (for example, oophorectomy, adnexectomy).
Prognosis for paraovarial cysts
Conception on the background of a paraovarial cyst is quite likely, however, with an increase in the uterus and its exit beyond the pelvis, the risks of torsion of the cyst legs increase. Pregnancy management in patients with a paraovarial cyst requires constant dynamic monitoring of the state of education.
After the surgical treatment of a paraovarial cyst, no recurrences are noted, since the rudimentary tissues, from the elements of which the formation is formed, are completely removed. Modern gynecology recommends planning pregnancy no earlier than 3-4 menstrual cycles after surgery.