Is an adnexal cyst an ovarian cyst?

Written by Liu Jian Wei

Obstetrics and Gynecology

Updated on September 16, 2024

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In clinical terms, the adnexa include the fallopian tubes and ovaries, so an adnexal cyst is not solely an ovarian cyst; rather, ovarian cysts are just one type of adnexal cyst. Adnexal cysts can also include fallopian tube cysts, but in clinical practice, most adnexal cysts are manifestations of ovarian cysts. Therefore, when patients hear the term "adnexal cyst," they should further inquire whether it is an ovarian cyst, instead of simply assuming it to be one.

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Symptoms of benign ovarian cysts

When women develop benign ovarian cysts, the clinical symptoms are somewhat related to the number and size of the cysts. For example, when the cysts are relatively small in diameter, they usually exhibit no clinical manifestations and are often only discovered during routine gynecological exams or ultrasound screenings. As the cysts grow in size, some women may experience heaviness and pain on one side of the lower abdomen, along with a sore back. These abdominal symptoms can worsen with excessive fatigue, staying up late, or during intercourse. Some women may also experience abnormalities in their menstrual cycle, such as changes in the amount of menstrual bleeding, duration of menstruation, or irregular vaginal bleeding.

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Can ovarian cysts cause infertility?

Women with ovarian chocolate cysts may experience effects on their reproductive function. When the cysts are small, they typically do not significantly impact fertility. However, as the cysts grow in size, they can compress the normal ovarian tissue, causing ovulatory disorders and leading to infertility. Additionally, certain types of ovarian cysts, such as chocolate cysts, can cause adhesions in the female pelvic area. For instance, they may result in abnormal fallopian tube function, leading to infertility due to tubal factors. These cysts may also alter the pelvic environment, making conception difficult. If the ovarian cysts are malignant or capable of secreting hormones, they can also affect normal ovulation, leading to infertility.

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Symptoms of ovarian cyst carcinogenesis

The main symptom of malignant transformation of ovarian cysts is increased abdominal pain, which generally occurs on one side, including either the left or right side, since the ovaries are present on both sides. If the cyst is unilateral, rapid growth can cause lower abdominal distension and pain. Therefore, when such symptoms aggravate, timely examination is necessary. Initially, a gynecological examination is recommended to assess the boundaries of the ovarian cyst and to palpate its nature and texture. These are essential evaluations. If there is a potential for malignancy, sometimes nodular changes, which may be metastases, can be detected in the posterior cul-de-sac. Subsequently, an ultrasound should be performed, with vaginal ultrasound generally providing greater accuracy.

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Do ovarian cysts require the removal of the ovary?

When women discover ovarian cysts, it is not necessarily required to remove the entire ovary. For example, in women of childbearing age, the ovary can continue to ovulate, aiding in normal conception and secreting hormones to maintain normal endocrine function. In such cases, surgery to remove the ovarian cyst while preserving the healthy ovarian tissue can be performed. However, if a woman is nearing menopause or has already undergone menopause and discovers a large ovarian cyst, the function of the ovaries may have gradually declined or already ceased. If surgery is performed to remove the ovarian cyst, there is a possibility of recurrence, and the function of the ovary may already be lost. In this case, it might be appropriate to proceed with the removal of the ovary.

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Causes of ovarian cysts

There are several common causes of ovarian cysts. The first is during the ovulation process where the follicle fails to release an egg, resulting in the formation of follicular cysts. The ultrasound typically shows these as simple cysts containing follicular fluid. Another situation is the corpus luteum cyst, which occurs after ovulation when the ovary forms a wound surface and a corpus luteum. Cysts can also develop during the growth of the corpus luteum. These two types of cysts generally disappear after the next menstrual period and are considered physiological cysts that usually require no treatment. However, some cysts result from pathological changes in ovarian cells, or even from tumors. On an ultrasound, these appear differently, often as mixed composition masses, in which case surgical treatment is recommended.