Paraovarian Cyst - Causes, Symptoms, and Management

What Is a Paraovarian Cyst?

A paraovarian cyst or paratubal cyst is a fluid-filled sac that is encapsulated. This cyst develops near the ovary or fallopian tube and does not attach to any internal organ. Since these cysts frequently dissolve on their own or go undiagnosed, the frequency with which they arise is unknown. Women in the third or fourth decade of life are the most likely to develop small paratubal cysts. Younger women are more likely to have enlarged cysts. Paraovarian cysts can range in size from 0.5 cm to 20 cm. They may resemble an ovarian cyst if they are close to an ovary.

What Are the Symptoms of Paraovarian Cyst?

• Paratubal cysts are typically small and usually asymptomatic. The doctor could discover it during a routine gynecological exam or an unrelated surgical operation.

• Paratubal cysts that are large may burst or get twisted, causing-

  • Abdominal pain.

  • Heaviness in the abdominal area.

  • Pressure.

  • Constipation

  • Frequent urination.

  • Pelvic pain.

What Are the Causes of Paraovarian Cyst?

Paratubal cysts are not associated with any known risk factors. The following process explains the causes of these cysts-

• The Wolffian duct is an embryonic structure that all fetuses have when they form. Male sex organs are produced in this part of the embryo. The duct diminishes when a fetus begins to create female sex organs. The duct's remains can occasionally be detected. They might transform into paratubal cysts.

• The remains of the paramesonephric (Müllerian) duct can also cause cysts. Female sex organs develop in this embryonic tissue.

• Mesonephric ducts can also cause paraovarian cysts. During the early development in the womb, these kidney ducts are connected to the Müllerian and Wolffian ducts.

How Is Paraovarian Cyst Diagnosed?

After taking a thorough medical history, checking symptoms, and physical examination for tenderness, the doctor might recommend the following investigations-

• Ultrasound- Pelvic or abdominal ultrasonography might be used to check for abnormal growths. Ultrasonic frequency vibrations are used in these medical imaging procedures to convey visual images of the pelvic region to a computer screen.

• Magnetic Resonance Imaging (MRI)- An MRI takes comprehensive photographs of the organs using a magnetic field and radio waves. This test aids the doctor in determining whether or not a cyst is cancerous. It can also be used to track the progression of a cyst.

• Blood Tests- The doctor may recommend blood tests such as a complete blood count (CBC) and a tumor marker test if malignancy is suspected.

• Laparoscopy- On ultrasound, paratubal cysts might resemble ovarian cysts. Thus the doctor may recommend this surgical procedure. A diagnostic laparoscopy necessitates a minor abdominal incision. A tube with a tiny video camera attached to its tip is inserted into the incision by the doctor. The doctor can observe the entire pelvic region through it.

How Is Paraovarian Cyst Treated?

• The doctor may advise patients to "wait and see" if the cyst is small and asymptomatic. Check-ups regularly are essential to keep an eye on any changes.

• If the cyst is larger than 10 cm, the doctor may recommend surgery to remove the cyst, known as a cystectomy, irrespective of whether symptoms are present or not. The following methods can be used by the doctor-

  • Laparoscopic Cystectomy- A cystectomy is a procedure that removes a cyst from the body. A tiny incision in the abdominal area is required for this treatment. Both local and general anesthesia is acceptable for this surgery. As compared to laparotomy, the patient recovers earlier.

  • Laparotomy- This is an invasive open surgery that requires a huge abdominal incision. If there are complications from a paraovarian cyst or require emergency surgery, the doctor may do a laparotomy to examine more of the abdomen. This is a more invasive technique. The procedure is always done after the administration of general anesthesia.

• Before choosing one procedure over the other, the doctor will assess the cyst's condition, size, and placement. If the patient has not achieved menopause, the doctor may recommend an ovary or fallopian tube preservation procedure.

What Are the Complications of Paraovarian Cysts?

Paraovarian cysts can sometimes enlarge and cause additional health issues. Paraovarian cysts can cause a variety of problems which are as follows-

• Torsion- This refers to the twisting of the paraovarian cyst on its pedicle, the stalk-like structure that maintains it in place. Torsion can induce severe adverse effects such as-

  • Vomiting.

  • Fever.

  • Sudden and severe abdominal pain.

  • Cramps.

  • Pain radiating into the lower back.

Torsions are a severe medical condition. Because when the cyst is twisting, the fallopian tube is also twisting. This may result in blood loss in the affected area. In addition, the fallopian tubes may be permanently damaged due to this. Torsion of the paraovarian cyst is more likely to occur during pregnancy due to the rapid growth.

• Hemorrhage- The cyst can sometimes get ruptured. It results in uncontrollable bleeding and blood loss.

• Fallopian Tube Rupture- The fallopian tube can split open if the cyst grows too large or twists.

• Giant Cysts- Cysts can grow to be very large at times. Other organs, such as the colon, bladder, kidneys, or uterus, may be impacted. Giant cysts can cause constipation, kidney swelling (hydronephrosis), and frequent, painful urination.

• Cancer- The cells in the paraovarian cyst can sometimes alter and turn cancerous. This is rare.

What Is the Effect of Paraovarian Cyst on Fertility?

Small paratubal cysts are unlikely to affect fertility. However, if left untreated, huge, burst, or twisted cysts can cause difficulties. The ovary and fallopian tube can be preserved if cysts are removed as soon as possible. If the cyst is not removed promptly, it can result in the removal of the ovary (oophorectomy), fallopian tube (salpingectomy), or both. The majority of paraovarian cysts are unilateral, meaning they only affect one side of the body. Iif the ovary or tube of the affected side is removed, ovulation and pregnancy are still feasible.

Conclusion

The paraovarian cysts are usually not accompanied by symptoms. That is why they go undiagnosed and unnoticed. They may eventually disintegrate on their own. On the other hand, large cysts might cause pain and other issues. These cysts must be surgically removed, although the procedure usually has no long-term consequences for fertility. The outcomes are almost always good.