Paraovarian Cyst

Paraovarian cysts are sacs that develop beside your ovaries or fallopian tubes. Most are filled with fluid, but some contain both fluid and tissue. Most are harmless and don’t cause symptoms.

Unlike ovarian cysts, they don’t grow on or inside your ovaries. Instead, they form in nearby tissue. They’re sometimes called paratubal cysts when they’re close to your fallopian tubes.

It’s hard to know how common paraovarian cysts are since they usually don’t cause symptoms. But providers consider them common.

Symptoms of paraovarian cysts

Paraovarian cysts typically don’t cause symptoms. When they do, it’s often because they’ve grown large enough to press on nearby organs. This pressure may cause a dull ache or sharp pain. It can also give you a feeling of fullness.

Paraovarian cyst causes

Paraovarian cysts form in a layer of tissue around your ovaries and fallopian tubes called the broad ligament. A cyst can develop when fluid collects in this tissue.

Many paraovarian cysts may form out of small pieces of tissue left behind during fetal development. These tissues come from structures called Müllerian ducts. Before birth, the Müllerian ducts help form the fallopian tubes, uterus, cervix and upper part of the vagina. Sometimes, leftover tissue from these ducts can form a cyst.

Risk factors

Paraovarian cysts are most often found between the ages of 20 and 40. Because they may develop from tissue present before birth, there’s no known way to prevent them.

Complications of this condition

Paraovarian cysts don’t cause symptoms or need treatment unless you have a complication. Complications include:

• Enlargement: Most paraovarian cysts are 1 to 8 centimeters in diameter. When they’re small, they usually don’t cause symptoms. In rare cases, they can grow up to 20 centimeters (nearly 8 inches). A large cyst can press on nearby organs and cause pelvic pain, constipation or peeing more often. Large cysts can also twist or break open and bleed.
• Torsion: Large cysts are at risk of twisting, known as torsion. Torsion causes symptoms like abdominal pain, low back pain, fever and vomiting. Sometimes, torsion can also cause a fallopian tube to twist. This can cut off blood flow and damage tissue. You need emergency treatment if you have torsion.
• Rupture: Cysts can break open and cause bleeding.
• Cancer: Although it’s extremely rare, these cysts can become cancerous. There are very few reported cases of this happening.

How doctors diagnose paraovarian cysts

Many people learn they have a paraovarian cyst when their healthcare providers feel it during a pelvic exam. Your provider may also notice one during an ultrasound you have done for another reason.

If you have symptoms, your provider may perform a transvaginal ultrasound. This test can show the cyst’s size and location. Providers can diagnose most paraovarian cysts this way. In some cases, your provider may recommend removing the cyst so they can examine what’s inside.

How is it treated?

Most paraovarian cysts are harmless and don’t need treatment. Your provider may recommend removing a cyst if it’s growing large or could be cancerous.

Treatment options include:

• Expectant management: This means you don’t need follow-up care. The cyst is harmless, has no symptoms and isn’t likely to cause problems. This is the most common treatment.
• Surveillance: The cyst is likely harmless, but it could grow or cause problems. You may need more imaging tests or blood tests to check for changes.
• Surgery: Removing the cyst is an option if it’s causing symptoms or puts you at risk of complications. A surgeon removes the cyst through tiny cuts in your abdomen.

When should I see my healthcare provider?

Don’t skip yearly visits with your gynecologist once you’re 15 or become sexually active. Paraovarian cysts usually aren’t a concern, but your provider can make sure they’re not causing problems.

A twisted cyst (torsion) is a medical emergency. You should get help right away. Signs include:

• Sudden, sharp pain in your abdomen
• Pain radiating from your lower back
• Intense pain that makes you feel sick to your stomach or causes you to vomit

What can I expect if I have a paraovarian cyst?

These cysts may go away on their own without causing issues.

Your provider will let you know if you need follow-up care or more tests. Rarely, cysts can grow very large or twist. In this case, your provider can remove them.

Can I get pregnant with a paraovarian cyst?

Yes. These cysts usually don’t disrupt ovulation or your ability to get pregnant. But a very large cyst may press on a fallopian tube. Talk with your provider if you’re trying to get pregnant.