What Are Adnexal Cysts?
The adnexa are made up of the fallopian tubes and ovaries. Cysts are fluid-filled structures that can develop in the adnexa.
What Causes Adnexal Cysts?
Fluid-filled cysts on the ovaries are usually caused by hormonal stimulation or bleeding at the time of ovulation (hemorrhagic ovarian cysts). Cysts associated with the fallopian tubes (paraovarian or paratubal cysts) are less likely to resolve on their own and more likely to require surgical intervention if they are causing symptoms.
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What Are the Signs and Symptoms of Adnexal Cysts?
Depending on the size, type and location, cysts can be completely symptom-free or cause symptoms like pain, fullness and bloating.
How Are Adnexal Cysts Diagnosed?
Adnexal cysts are diagnosed (and monitored) with pelvic ultrasound. If there is uncertainty about the nature of the cyst, rarely pelvic MRI may be needed.
How Are Adnexal Cysts Treated?
The majority of ovarian cysts (both fluid-filled and hemorrhagic) resolve spontaneously and require no intervention. Pelvic ultrasound is often repeated after 1-2 menstrual cycles to check for ovarian cyst resolution. Hormonal contraceptives are sometimes recommended because they prevent new cysts from forming.
Fallopian tube cysts are less likely to resolve on their own. If they are small and asymptomatic, they can be monitored with pelvic ultrasound. Larger or symptomatic paraovarian or paratubal cysts require surgical removal, with care to avoid damage to the fallopian tube.
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A hymenectomy is a procedure that is done to remove extra tissue from the hymen that partly or totally covers a female’s vaginal opening.
Pelvic masses may be caused by adnexal cysts, ovarian masses and tumors and uterine abnormalities. The most common reason the uterus would become enlarged in a girl or young woman is due to build-up of menstrual blood, also known as an outflow tract obstruction.
Ovarian Masses and Tumors
Ovaries can become enlarged due to cysts, masses or neoplasms. The vast majority of ovarian neoplasms in girls and young women are not cancerous. Most ovarian cysts do not cause significant symptoms and resolve spontaneously.