Fallopian Tube

Pelvic Adhesions/ Pelvic Inflammatory Disease (PID)

Ovaries

Endometriosis

Uterus

Endometrial Polyps

Cervix

Appendix

Uterosacral Nerve Ablation

OB Images

The ovaries are normally walnut-sized organs located on either side of the uterus. They have a number of functions, including making eggs each month, and making hormones. The ovaries respond to hormones that come from the brain, called gonadotropins. These hormones lead to release of an egg each month, usually in-between menstrual periods. It is surprising to many to learn that the ovary produces a cyst every month! These cysts form as an egg is released and can normally be the size of a golf ball. The ovaries also produce their own set of hormones. These include estrogen, progesterone, and androstenedione (a type of "male" hormone).

There are a number of gynecologic conditions that can affect the ovaries. These include cysts, cancer, scar tissue, and twisting of the ovary around it's blood supply (called torsion). Fortunately, almost all cysts that form on the ovary are non-cancerous. However, because ovarian cancer can strike 1:70 women, and because it can be deadly, gynecologists worry about ovarian cysts. The diagnosis of these cysts usually requires a good pelvic exam and perhaps a pelvic ultrasound (also called a sonogram). If necessary, surgery is sometimes required to take a better look at the ovaries. The photos below were all taken during surgery.

Click on the hyperlink below to view the larger JPG images

Normal Ovaries and Uterus
This is an operative photgraph of the uterus and ovaries.
The uterus is at the top of the picture. You can only see the
bottom part of the uterus. The ovaries are white and are about the
shape of a walnut. You can see the left fallopian tube hanging down to
the side of the left ovary.

Normal Ovary- Closeup View
This is a closeup view of a normal ovary. The fallopian tube
is long and red, and is hanging over the right side of the ovary.
The ovary is white, has a convluted appearance, and is about the
size of a walnut. It is somewhat spongy when you touch it.

Ruptured Endometriosis Cyst
This is a photo taken during laparoscopy of an endometriosis cyst. These
cysts are called "endometriomas" and develop as endometriosis implants slowly bleed into the ovary over many months. This patient complained of worsening left-sided pain, and was found to have a small rupture. There was a small amount of blood in her abdomen. The cyst was removed and the normal ovarian tissue was saved.

Corpus Luteum Cyst-Unruptured
This is a photo taken during laparoscopy of a corpus luteum cyst.
This is a normal, physiologic cyst found each month in women in their
"reproductive years" (the time between puberty and menopause). These
cysts develop when an egg is released (you can see the actual area the egg came from in this photo- it's the "bump"pointing at you). After the egg is released, a corpus luteum cyst forms, and begins making progesterone. If the egg is fertilized, the cyst makes enough progesterone to help the egg and sperm "hold on" when implanted into the uterine wall. If the egg is not fertilized, the cyst slowly shrinks, and the whole cycle begins again next month. These cysts are generally about 2-5 cm in size (a tennis ball is
about 6 cm). Thus, they can usually be felt during a pelvic exam. In general, it's best to have your annual exam right after your period is finished. If you have it 3-4 weeks after your last period, the corpus luteum cyst may make the exam more painful. Please note that women on the birth control pill usually do not form these cysts. In fact, preventing these cysts is one way the pill works.

Ovarian Torsion
This is a photo taken during laparoscopy of an ovarian torsion. Torsion
occurs when an ovarian cyst causes the ovary to twist on it's blood supply.
This usually causes tremendous pain that brings patients to the emergency room. If the ovary is not untwisted soon, it can "die off" which is called necrosis in medical terminology. Treatment is usually detorsion by laparoscopy. In this photo, we see an ovary that is literally black and blue from edema and blood. The black color suggests that necrosis has set in, and that the ovary cannot be saved. You can see the ovary at the top of the photo, and a large cyst just below it. Notice the healthy, pink color of
the surrounding tissue. This ovary had to be removed, which is seen in the bottom photo. The bottom photo shows the ovary, which has been cut away, being put in a sterile bag. The bag is then pulled through a small opening, the cyst is drained, and it is removed from the body. This patient went home the same day as her laparoscopic surgery.

Ovarian Cancer
This is a close-up view of ovarian cancer. The ovary is the white organ at the top of the photo. The irregular area growing from the ovary is the cancer, which has broken through the ovary and is growing on the outside.
Fortunately, this cancer was found very early, and treated by removal of the uterus and ovaries (total abdominal hysterectomy with bilateral salpingooophorectomy). Her chance at survival is excellent.

Dermoid Cyst
This is a photo of a dermoid cyst of the ovary, taken after the cyst was removed from the body. I have opened the ovary and placed it on a sterile towel for photography. Dermoid cysts begin developing while the woman
was a fetus. A cell becomes "confused" and tries to form many different body tissues. These cysts can contain hair, teeth, bone fragments, skin, thyroid tissue, sweat glands, and even nerve tissue. This dermoid contains a lot of hair and sweat (the sticky yellow material). If they rupture, the material can stick to the intestines, causing severe pain. Treatment is
by removal of the cyst while leaving the ovary behind (as was done here), or removal of the entire ovary. The cyst you see here was about the size of a grapefruit.