Paraovarial Cysts

What are Paraovarial Cysts?

Paraovarial cysts are located between the leaves of the wide ligament of the uterus. Paraovarial cysts arise from the rudiments of the mesonephral duct, oophoron, as well as from the coelomic epithelium. Paraovarial cysts make up from 8 to 16.4% of all ovarian formations. Paraovarial cysts are diagnosed mainly at the age of 20 to 40 years, but can occur in girls and girls of puberty age. In childhood and adolescence, paraovarian cysts have papillary growths on the inner surface. Cysts can be either small or giant, occupying the entire abdominal cavity.

Pathogenesis during Paraovarial Cysts

Macroscopically, the paraovarial cyst has a round or oval shape, a tight elastic consistency, the formation is usually single-chamber, located mainly on the side or above the uterus. The wall of the paraovarial cyst is thin (1-2 mm), transparent, with a vasculature consisting of vessels of the mesentery of the fallopian tube and the wall of the cyst. On the upper pole of education, as a rule, there is an elongated, deformed fallopian tube. The ovary is located at the posterior lower pole of the cyst, sometimes along its lower surface. The contents of the cyst are mostly homogeneous, clear, watery fluid. The inner layer consists of connective tissue and muscle bundles, inside the cyst is lined with cylindrical ciliated, cubic and flat single-row or multi-row epithelium.

A small paraovarial cyst at first does not have a leg, but when it grows, one of the leaves of the wide ligament of the uterus protrudes and a cyst leg forms. The structure of such a leg includes the fallopian tube, and sometimes its own ovarian ligament.

Symptoms of Paraovarial Cysts

Clinically, paraovarial cysts often do not show anything. As the cysts grow, patients complain of pain in the lower abdomen, an increase in the abdomen. Menstrual irregularities and infertility are rare.

A complication of the paraovarial cyst is the torsion of its legs with the development of the “acute abdomen” clinic, as a result of compression of the main vascular and nerve trunks of the ovarian ligament and the fallopian tube.

Diagnosis of Paraovarial Cysts

Diagnosis of a paraovarial cyst is carried out on the basis of clinical examination and ultrasound, it presents significant difficulties. A two-handed gynecological examination on the side or above the uterus determines the formation of a diameter of 5 to 15 cm, an elastic consistency, limited mobility, painless, with a smooth, even surface.

The main and almost the only ultrasonic sign of paraovarial cysts is the visualization of a separately located ovary. The paraovarial cyst is round or oval, the wall is thin (about 1 mm). Education is always single-chamber. The contents of the cysts are mostly homogeneous and anechoic; in some cases, fine suspension can be determined. In isolated cases, parietal growths are visualized on the inner surface of the cyst wall. With CDC, paraovarial cysts are avascular.

Treatment of Paraovarial Cysts

Since paraovarial cysts are observed in young patients, surgical laparoscopy is preferable to prevent adhesions. With an uncomplicated cyst, the operation is reduced to its enucleation with dissection of the leaf of the wide ligament of the uterus (preferably in front) from the intraligamentary space. In this case, the ovary and fallopian tube are preserved. Despite the significant deformation and extension of the fallopian tube, due to the good retraction ability, the fallopian tube contracts and restores its former shape.

Relapse is not observed.

The forecast is favorable.