How are adnexal cysts formed?

There are many causes of adnexal cysts, the most important of which are the epithelial origin theory, metaplasia theory and implantation theory. It has certain transmission routes, such as retrograde menstruation, iatrogenic implantation, lymphatic transmission, or vascular dissemination, etc., and of course there is the immunological theory. When cysts appear in the adnexal area, it often causes dysmenorrhea in women, causes pain during sexual intercourse, and leads to infertility in women.

How are adnexal cysts formed?

There are three main theories about the occurrence of endometriosis: implantation theory, metaplasia theory and epithelial origin theory. The implantation theory is the most popular theory in the study of ovarian endometriomas. Implantation theory: Sampsan first proposed this theory in 1921. This theory holds that ectopic endometrium originates from endometrial tissue that migrates to sites outside the uterine cavity, implants, and grows. Common transmission routes include retrograde menstruation, iatrogenic implantation, lymphatic spread and vascular dissemination. There is also the immunology theory.

1. Dysmenorrhea Dysmenorrhea is the most obvious symptom of endometriosis, but it is the most easily ignored precursor and often progressively worsens. 2. Pain during sexual intercourse is also an obvious signal, which may be accompanied by punctate bleeding. The symptoms of ovarian chocolate cyst are not very obvious. 3. Infertility and menstrual disorders Among infertile women, infertility caused by endometriosis accounts for a high proportion.

Inspection method

1. The medical history should focus on menstrual history, pregnancy and delivery history, family history and surgical history. Pay special attention to the relationship between the occurrence and development of pain or dysmenorrhea and menstruation and surgeries such as cesarean section, abortion, and fallopian tube insufflation. 2. In addition to bimanual examination, gynecological examination should emphasize the necessity of triple examination. In patients with ovarian endometriosis, a cystic mass adhered to the uterus, broad ligament, and pelvic wall can be felt in the adnexal area. It has poor mobility and is often mildly tender. The cyst is generally less than 10 cm in diameter. 3. Laparoscopic examination Laparoscopic examination is currently the most effective method for clinically diagnosing ovarian chocolate cysts. It mainly involves observing the pelvic cavity with the assistance of a laparoscope. It can accurately find the location and cause of endometriosis and make an accurate diagnosis of it. 4. Other auxiliary examinations (1) Imaging examinations Vaginal and abdominal B-type ultrasound examinations are the simplest and most convenient diagnostic methods. It is an important means to identify ovarian endometriomas, with a diagnostic sensitivity and specificity of over 96%, but it is difficult to detect cysts with a diameter less than 1 cm. Type B ultrasound examination can determine the location, size, shape and contents of ovarian endometriotic cysts, whether there are papillae in the cysts, whether it is cystic or solid, and its relationship with surrounding organs, especially the uterus. Ultrasound images generally show that the cyst is oval or round. The cyst can be single-chambered or multi-chambered, and is adhered to the surrounding tissues, especially the uterus. The cyst wall is thick and rough, and there are small, dot-like, flocculent light spots inside the cyst. The size of the cyst may change with the menstrual cycle. Since the echo image of the cyst is non-specific, the diagnosis cannot be made based solely on ultrasound images. The diagnostic value of pelvic CT and MRI for pelvic endometriosis is equivalent to that of B-ultrasound, but the cost is more expensive. MRI is useful in the diagnosis and evaluation of ovarian endometriomas.