This leaflet is to help you understand what para-ovarian-cysts are, what causes them, and the various treatments available to you.

What is a para-ovarian cyst?

A para-ovarian cyst is a fluid-filled sac found adjacent to ovaries and fallopian tubes. It might also be called a para-tubal cyst or a hydatid cyst of Morgagni.

What are the causes of para-ovarian cysts?

Para-ovarian cysts are usually caused by remnants of embryological structures in early fetal life. The Mullerian duct is one of these early structures that develops into the uterus, cervix, fallopian tubes, and vagina. 

What symptoms can these cysts cause?

These cysts usually don’t cause any symptoms and are often discovered incidentally during a pelvic scan or during pelvic surgery for other reasons. Symptoms of large para-ovarian cysts can include:

  • Pressure  
  • Abdominal pain that comes and goes
  • Feeling of heaviness or fullness in the abdomen
  • Constipation
  • Frequent urination

How are these cysts diagnosed?

The diagnosis is usually made by pelvic ultrasound although they can be found also on CT scan and MRI, when often performed for other indications. They need to be visualized as separate from the ovary for accurate diagnosis, otherwise, they can be confused with an ovarian cyst, especially if they are v very close in location to an ovary. They also can be discovered incidentally during laparoscopy or laparotomy for other indications.  A para-ovarian cyst is usually non-cancerous and can resolve on its own or remain stable. They can vary in size from 0.5 cm to 20 cm. 

What are the expected complications of para-ovarian cysts?

  • Torsion: This refers to a twisting of the cyst on its pedicle, which is the stalk-like structure that holds it in place. This can cause extreme, debilitating pain, as well as nausea and vomiting.  
  • Pressure symptoms: Although giant cysts are rare, these cysts can place pressure on your internal organs, including the uterus, kidney, bladder, and bowel. This pressure may result in hydro-nephrosis. This refers to kidney swelling caused by excess urine buildup. Large cysts may also cause uterine bleeding and painful intercourse.
  • Hemorrhage: If the cyst ruptures, it may cause internal bleeding.

How are para-ovarian cysts treated?

If the cyst is small and asymptomatic, follow-up with ultrasound scans is sufficient. Large ovarian cysts and para-ovarian cysts with suspicious contents such as solid or hyperechogenic internal components need to be removed via laparoscopy vs. laparotomy, depending on the size. Twisting (torsion) of the para-ovarian cyst is managed by emergency laparoscopy vs. emergency laparotomy to remove the cyst.


Last updated August 2023