A cyst is an encapsulated liquid or semisolid fluid filled sac.
There are ovarian cysts that are "functional cysts," which are involved in normal reproduction and the organization of the menstrual cycle. Functional ovarian cysts generally resolve spontaneously within 1-3 months. Other nonfunctional or pathological cysts may persist within the pelvis and cause pelvic pain. Most pathological cysts of the ovary are benign however physicians have a high level of concern for early diagnosis of a possible ovarian malignancy. Therefore, nonfunctional ovarian cysts are usually removed if they persist for more than 3-4 months or if they have certain complex features on ultrasound examination that increases the suspicion of malignancy.
Other pelvic cysts can include peritoneal cysts (blisters or blebs that result in response to local irritation), para-tubal cysts of Morgagni (remnants of the Wolffian duct system are commonly found in the female reproductive tract, the Wolffian ducts develop into male reproductive organs in the event that the fetus becomes a boy and are resorbed more or less completely in the event of a girl), degenerating uterine fibroids (when the smooth muscle tissue begins to degenerate and the central core of the fibroid becomes filled with liquid), twisting or torsion of the fallopian tubes (the distal portion may twist especially after tubal ligation) which can entrap fluid within the tube, and sometimes bladder or bowel related cysts.
Symptoms associated with pelvic cysts include a persistent dull ache localized within the pelvis, a constant feeling of bloating or fullness, pain during intercourse, pain with increased motion or exercise, urinary frequency or constipation (if the cyst is large and pushing on surrounding organ systems), and fatigue.
If a persistent adnexal cyst is thought to be the cause of pain, then surgical removal is generally performed since hormonal treatment is often ineffective. This can usually be done through laparoscopy, assuming that the cyst can be completely freed from the surrounding pelvic structures prior to removal.