The incidence of paratubal cysts and their association with polycystic ovarian syndrome and hyperandrogenism

Abstract

OBJECTIVE: Paratubal cysts are remnants of paramesonephric or mesonephric ducts. The aim of this study is to determine the incidence of paratubal cysts at our institution and any association with hyperandrogenism and/or polycystic ovarian syndrome (PCOS).DESIGN: A retrospective chart review at Texas Children's Hospital, Houston, Texas was done from June 1998- November 2008. Females with benign adnexal masses presenting to Texas Children's Hospital during the specified time period, determined to have paramesonephric or mesonephric duct remnants were included in the study.MATERIALS AND METHODS: Information on maternal graphics including race, age, height, weight and BMI were collected. In addition, all charts were then reviewed for age of menarche, menarchal status at diagnosis, gynecologic year of diagnosis, type of procedure, type of surgeon, surgical findings, presence of torsion, reason for surgery, preoperative diagnosis based on imaging, size of the cyst and laterality of the cyst. The presence of irregular menses, PCOS, acne, hirsutism, clitoromegaly, insulin resistance, or other signs of hyperandrogenism were reviewed as well. Statistical analysis was done using chi square analysis and simple student t test. Pearson correlation coefficients were also assessed.RESULTS: The incidence of paratubal cyst was 7.3%. 14 patients were premenarchal (12.6%). The average age of menarche was 11.7 ±1.34 years. The average age of diagnosis was 13.7±2.82 years. Patients with hyperandrogenism characteristics on average had a higher BMI, 35.5 vs. 26.3, p-value <. 0001, and had larger cysts 8.96 vs. 5.47, p-value -.005. Cyst size was affected by race with average cyst sizes of 7.9cm, 3.7cm and 6.4cm in Hispanics, African-Americans, and Caucasians respectively.CONCLUSIONS: This study shows an association between paratubal cysts and hyperandrogenism as well as obesity. In addition hyperandrogenism is associated with larger paratubal cysts. This is the first study to demonstrate paratubal cyst occurrence in the premenarchal female. OBJECTIVE: Paratubal cysts are remnants of paramesonephric or mesonephric ducts. The aim of this study is to determine the incidence of paratubal cysts at our institution and any association with hyperandrogenism and/or polycystic ovarian syndrome (PCOS). DESIGN: A retrospective chart review at Texas Children's Hospital, Houston, Texas was done from June 1998- November 2008. Females with benign adnexal masses presenting to Texas Children's Hospital during the specified time period, determined to have paramesonephric or mesonephric duct remnants were included in the study. MATERIALS AND METHODS: Information on maternal graphics including race, age, height, weight and BMI were collected. In addition, all charts were then reviewed for age of menarche, menarchal status at diagnosis, gynecologic year of diagnosis, type of procedure, type of surgeon, surgical findings, presence of torsion, reason for surgery, preoperative diagnosis based on imaging, size of the cyst and laterality of the cyst. The presence of irregular menses, PCOS, acne, hirsutism, clitoromegaly, insulin resistance, or other signs of hyperandrogenism were reviewed as well. Statistical analysis was done using chi square analysis and simple student t test. Pearson correlation coefficients were also assessed. RESULTS: The incidence of paratubal cyst was 7.3%. 14 patients were premenarchal (12.6%). The average age of menarche was 11.7 ±1.34 years. The average age of diagnosis was 13.7±2.82 years. Patients with hyperandrogenism characteristics on average had a higher BMI, 35.5 vs. 26.3, p-value <. 0001, and had larger cysts 8.96 vs. 5.47, p-value -.005. Cyst size was affected by race with average cyst sizes of 7.9cm, 3.7cm and 6.4cm in Hispanics, African-Americans, and Caucasians respectively. CONCLUSIONS: This study shows an association between paratubal cysts and hyperandrogenism as well as obesity. In addition hyperandrogenism is associated with larger paratubal cysts. This is the first study to demonstrate paratubal cyst occurrence in the premenarchal female.