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How safe is it for septated, para ovarian cyst that causes occasional discomfort on Left Lower Quadrant?

Mar 2013
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How safe is it to take a "wait and see" approach on the existence of a septated, paraovarian cyst (1.8 x 1.4 x 0.9 cm.) that causes occasional discomfort on LLQ?
Additional information: I have a lengthy history of non-malignant ovarian cysts and uterine fibroids.
Posted Wed, 10 Jul 2013 in Women's Health
Answered by Dr. Aarti Abraham 1 hour later
Thanks for your query.
A paraovarian cyst is a closed, fluid-filled sac that grows beside or near the ovary and fallopian tube, but is never attached to them. It is usually located on the broad connection (ligament) between the uterus and the ovary, and is often found on only one side (unilateral) of the uterus.
Paraovarian cysts are usually very small (ranging in size from 2 to 20 cm). These cysts have little clinical significance, occurring asymptomatically as incidental findings during other pelvic examinations and surgeries.

Although known for their small size, paraovarian cysts can sometimes grow larger, especially during pregnancies. Unlike the small cysts, the larger cysts are usually symptomatic. Depending on their size and location, large paraovarian cysts can put pressure on the bladder or bowel, and cause pelvic pain or pain during sexual intercourse (dyspareunia).

Most paraovarian cysts that remain small and asymptomatic do not require treatment; sometimes they disappear on their own.

However, if the cyst is larger than 4 inches (10 cm), is complex, increasing in size, persists after several months, is solid, dense, and irregularly shaped, or is infected, bleeding or ruptured, more invasive surgery (cystectomy) may be required. Such cysts pose a problem if they put pressure on pelvic structures, thus risking damage to them, and cause pelvic pain or pain during sexual intercourse (dyspareunia).

For a small sized septated cyst, follow up with ultrasound is absolutely fine, and there is no indication for removal at present.

Take care.
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