Adnexal cyst is common in many women. The pelvic cavity of a woman contains many organs such as the uterus, ovaries, fallopian tube, the ligaments attached to uterus, blood vessels etc. Adnexa is referred as an area of anatomical structures that is connected to the uterus. This includes ovaries, fallopian tube, ligaments etc. Any type of lump or mass in this area is abnormal and it is referred as adnexal mass. This mass usually originates from ovary or fallopian tube or from adjacent structures.
The mass can be benign or cancerous. It can be cystic or solid.Cystic mass is sac like structure which contains liquid or semi solid material. The solid mass is fully made up of cells of the structure. Most of the time adnexal cyst is benign condition while solid lesion has cancerous changes. Any women can develop adnexal cyst, and it may be detected from the symptoms that it produces on radiological studies or while examination. Adnexal cyst can develop due to variety of reasons.
Causes And Symptoms Of Adnexal Cyst
There are varieties of causes of adnexal cyst. It can be a physiological cyst or a cyst having some pathology involved.
- Follicular cyst: Normally every month the ovary releases an egg for fertilization to take place. The egg is released in the fallopian tube. Sometimes the egg remains in the ovary. It is not released. This may later on become a cyst in the ovary. It can enlarge in size to develop as an ovarian mass. Follicular cyst is a physiological cyst or a functional cyst.
- Polycystic ovaries: There are many cysts in the ovaries. It occurs when the egg instead of being released stays in the ovary. This leads to formation of cyst. Woman with polycystic ovarian disease has multiple tiny cysts in ovary, irregular menses, and increased amount of male hormones.
- Endometrioma: It is also referred as chocolate cysts of ovary. This cyst of ovary is lined by endometrial tissue of the uterus. It contains old blood in the cyst. Usually chocolate cyst develops as a result of endometriosis.
- Tubo ovarian abscess: It is an abscess formed in the fallopian tube or the ovary. It is caused by infection, mainly bacterial infection that spreads from vagina into the fallopian tube. Tubo-ovarian abscess results in other symptoms such as fever, pain in lower abdomen, abnormal vaginal discharge. Tubo ovarian abscess is sexually transmitted disease mainly the culprit is gonorrhea. The disease can cause infertility in woman.
Treatment Options For Adnexal Cyst
Once the adnexal mass is detected as a cyst, there are several management options available. This include medical and surgical. The treatment will depend on the age of patient, clinical findings, any accompanied pathology, medical history, radiological and blood tests.
For example functional cysts needs only proper monitoring from time to time with the help of sonogram. If the cyst becomes enlarged and if there is risk of torsion, then it is removed surgically. In many cases only birth control pills is used to prevent ovulation and formation of repeated cyst.
In case of polycystic ovarian syndrome, the treatment of choice is weight loss and use of hormonal pills to regulate menstrual cycle.
Endometrioma usually do require surgical removal as they do not subside easily with medicines. Dermoid cyst also requires to be removed surgically.