Where does a cyst come from next to the ovary?
During intrauterine development, the embryo has ducts, some of which normally disappear in girls. Sometimes their remains remain in the appendage area. The cells lining them continue to produce fluid that has no outlet, and a thin-walled cavity gradually forms. It is located between the broad ligament of the uterus, next to the fallopian tube. At the same time, the ovary remains separate and healthy - this is clearly visible on ultrasound and is important for the prognosis: the ovarian tissue is not damaged and fertility does not suffer.
- Develops from embryonic remains of the epididymis
- Located between the ovary and fallopian tube
- No ovarian tissue involved
- The wall is thin, the contents are transparent
- Growth is slow due to fluid accumulation
Symptoms
Cysts up to 4–5 cm most often do not give any complaints. As you grow, you may experience a nagging pain or a feeling of heaviness in the lower abdomen on one side, which intensifies with exercise and sexual intercourse. Large cysts put pressure on neighboring organs, causing frequent urination or constipation, and sometimes a noticeable enlargement of the abdomen. The menstrual cycle is usually not disrupted because the cyst does not produce hormones. Sharp pain means a complication and requires immediate help.
- Most often asymptomatic
- Nagging pain in the lower abdomen on one side
- Feeling of pressure and heaviness in the pelvis
- Frequent urination with a large cyst
- Constipation due to intestinal compression
- The menstrual cycle usually does not change
Complications
The main danger is torsion of the cyst stalk along with the fallopian tube and sometimes the ovary. The blood supply is disrupted, the tissue begins to die, and acute pain occurs with nausea and vomiting. This condition requires emergency surgery: the sooner it is performed, the greater the chance of saving the tube and ovary. Less commonly, a cyst ruptures with fluid leaking into the abdominal cavity or suppuration. Complications can be caused by sudden movements, sports activities, jumping and heavy lifting with a large cyst.
- Torsion of the cyst stalk - requires emergency surgery
- Cyst rupture
- Suppuration of contents
- Compression of the ureter with large sizes
- Malignancy is an extremely rare phenomenon
Diagnostics
A small cyst is usually found during a routine ultrasound. Ultrasound shows a round, single-chamber formation with a thin wall and homogeneous content, located next to an unchanged ovary - this is a key sign for diagnosis. If there is any doubt, large size or atypical picture, an MRI of the pelvis is prescribed, which accurately determines the relationship of the formation to the organs. The CA-125 tumor marker is not used to confirm the diagnosis, but to assess the risk in unclear cases, since it also increases in benign conditions.
- Gynecological examination
- Ultrasound of the pelvic organs, transvaginal ultrasound
- Doppler ultrasound for suspected torsion
- MRI of the pelvis with an atypical picture
- Tumor marker CA-125 according to indications
- Control ultrasound after 3–6 months to assess dynamics
Treatment: observe or operate
There are no medications that dissolve such a cyst: hormonal drugs and physiotherapy are useless here, and thermal procedures are dangerous. If the size is up to 4–5 cm without complaints, observation with control ultrasound is chosen. Surgery is recommended for large sizes, growth of the cyst, persistent pain, compression of organs, planning a pregnancy with a large cyst, and if there are doubts about its benignity. The standard is laparoscopic removal of the cyst while preserving the ovary and tube. Relapses are rare. The decision is made together with the doctor.
- Observation at a size up to 4–5 cm without complaints
- Control ultrasound 1–2 times a year
- Laparoscopic removal for large or growing cysts
- Emergency surgery for torsion and rupture
- Hormonal medications and physical therapy are ineffective
- Heat and dirt with a cyst are contraindicated
