Cysts In Postmenopausal Women Research Articles

Management of ovarian cysts in postmenopausal women

Management of ovarian cysts in postmenopausal women

Natural history and malignant potential of simple ovarian cysts in postmenopausal women: a systematic review and meta-analysis.

Postmenopausal ovarian masses are not uncommon, and the incidence of ovarian cancer rises sharply after menopause. We conducted a systematic review and meta-analysis to investigate the natural history and malignant potential of postmenopausal simple ovarian cysts. PubMed, MEDLINE, EMBASE, CENTRAL (Cochrane Central Register of Controlled Trials), ClinicalTrials.gov , and ISRCTN (International Standard Randomized Controlled Trial Number Register) were searched from inception to January 31, 2022. Meta-analyses were conducted using R software. Twelve cohort studies with 1,672 participants and 1,513 ovarian cysts were included. The rates of simple cysts remaining unchanged (38.90%; 95% CI, 19.79%-59.85%; P < 0.01) or disappearing (34.17%; 95% CI, 19.13%-50.93%; P < 0.01) were the highest during conservative observation. The surgery rate for the simple cyst was 19.04% (95% CI, 8.19%-32.92%; P < 0.01). The malignancy rate (including borderline tumors) was very low, approximately 1/10,000 (95% CI, 0% to 0.23%; P = 0.79). Simple ovarian cysts in postmenopausal women were most likely to remain unchanged or disappear during follow-up. The malignancy rate was approximately 1 in 10,000. Personal preference is the most common reason for surgery.

Intracystic Injection of Methotrexate in Postmenopausal Female Suffering from Simple Ovarian Cyst with Low Malignancy Index

Although ovarian cysts are more prevalent in premenopausal women, but ovarian cysts in postmenopausal women are common also, this attributed to the advances in the use of ultrasound in the screening and diagnosis of different lesions [1]. Before the era of use of ultrasound, most gynecologists were depending on palpable postmenopausal ovaries in their management, and it was considered as an indication for surgery [2].

When Less is Not More: Population-level Perspective on Adnexal Cyst Surveillance for Post-Menopausal Women.

Ovarian simple cysts are found with high frequency in older women, and at least a third eventually regress in a year. Multiple large studies, including the sample from the Prostate, Lung, Colorectal, and Ovarian Cancer Screening trial, have found no direct association with ovarian cancer incidence, corroborating earlier, smaller studies [ 1 Hartge P. Hayes R. Reding D. et al. Complex ovarian cysts in postmenopausal women are not associated with ovarian cancer risk factors: preliminary data from the prostate, lung, colon, and ovarian cancer screening trial. Am J Obstet Gynecol. 2000; 183: 1232-1237 Abstract Full Text Full Text PDF PubMed Scopus (33) Google Scholar , 2 Menon U. Gentry-Maharaj A. Hallett R. et al. Sensitivity and specificity of multimodal and ultrasound screening for ovarian cancer, and stage distribution of detected cancers: results of the prevalence screen of the UK Collaborative Trial of Ovarian Cancer Screening (UKCTOCS). Lancet Oncol. 2009; 10: 327-340 Abstract Full Text Full Text PDF PubMed Scopus (631) Google Scholar ]. The current practice of safely following, rather than resecting, asymptomatic ovarian cystic lesions accompanied a rejection of an older, simple biologic model of ovarian cystic lesions as cancer precursors or markers of subsequent cancer onset in either ovary. Instead, it is now widely accepted that aggressive or high-grade ovarian neoplasms arise via a solid tumor pathway from serous tubal intraepithelial carcinoma [ 3 Erickson B.K. Conner M.G. Landen Jr., C.N. The role of the fallopian tube in the origin of ovarian cancer. Am J Obstet Gynecol. 2013; 209: 409-414 Abstract Full Text Full Text PDF PubMed Scopus (179) Google Scholar ]. In this decision-analytic modeling study by Pandharipande et al, the question of managing ovarian cystic lesions in postmenopausal women is revisited within the practical and highly informative context of overall health status and wide-ranging life expectancy [ 4 Seguin C.L. Lietz A.P. Wright J.D. et al. Surveillance in older women with incidental ovarian cysts: Maximal projected benefits by age and comorbidity level. J Am Coll Radiol. 2020; 18: 10-18 Abstract Full Text Full Text PDF PubMed Scopus (2) Google Scholar ]. Surveillance in Older Women With Incidental Ovarian Cysts: Maximal Projected Benefits by Age and Comorbidity LevelJournal of the American College of RadiologyVol. 18Issue 1PreviewThe aim of this study was to estimate effects on life expectancy (LE) of imaging-based ovarian surveillance after detection of incidental postmenopausal ovarian cysts, under different assumptions of patient age, comorbidity level, and cancer risk and detection. Full-Text PDF

Conservative management of unilateral and unilocolor ovarian cysts ≥ 10 cm in diameter in postmenopausal women

Objective: To evaluate and follow up the native behaviour of large ovarian cysts in postmenopausal women and establish the best approach based on advanced imaging technology. Study Design: The number of patients that were evaluated from January 2015 to September 2019 were 417. At the end of this study period, 375 patients were considered for this prospective evaluation. The patients with an ultrasound diagnosis of unilateral and unilocular ovarian cysts with regular septa ≥ 10 cm in diameter at menopause were enrolled in this study. During the follow-ups, the patients who developed irregular or thick septa, papillary formation or solid areas, exhibited any suspicious sign of malignancy in magnetic resonance imaging (MRI) results or displayed an augmentation in CA-125 levels were excluded from the study. In this study cancer antigen-125 (CA-125) values &gt; 65 IU/mL were considered abnormal. The patients who met these criteria were followed with periodical ultrasounds and yearly MRI. Results: The 42 patients who were excluded from the study had significant morphological changes. These patients were showing an increase in CA-125 levels along with abnormal MRI findings during the follow-ups and in addition, they had surgical removal of cysts. All the significant morphological changes were detected by transvaginal ultrasounds. Postoperative histopathological diagnosis of these ovarian cysts revealed no abnormality. From 375 patient’s cysts samples one hundred and twenty-five (33.3%) cysts had significantly decrease in size, one hundred and eleven (29.6%) of the cysts had spontaneous resolution and one hundred thirty-nine (37%) cysts persistently remained unchanged during the follow up period. The diameter of the cysts ranged from 10.4 to 18.4 cm. The cysts were categorized into three groups corresponding to a range of diameters i.e., 10–12.9 cm (62%), 13–15.9 cm (24.1%) and ≥ 16 cm (13.8%) respectively. The patients who showed spontaneous resolution were discontinued with the follow-ups while the rest of the patients were continued with their regular follow up examinations. Conclusion: The cysts should be monitored conservatively as long as possible before proceeding to a surgical treatment regardless of the size of the unilateral and unilocular ovarian cysts at postmenopausal period with limited oncogenic potential and without significant morphological changes.

Size threshold for follow-up of postmenopausal adnexal cysts: 1cm versus 3cm.

To assess 3cm size threshold for follow-up of simple cysts in postmenopausal women. Radiology information system was retrospectively queried for "US pelvis complete" over 8years in women > 50years, with keywords ovarian cyst, adnexal cyst, ovarian mass, cystic mass, cystic neoplasm, ovarian neoplasm, and ovarian mass. Premenopausal women were excluded. Cysts, were classified as ≤ 1cm, 1-3cm, 3-5cm, and ≥ 7cm. Largest cysts on each ovary was recorded. EMR and imaging archives were reviewed for assessing size, stability duration, and surgical records. Descriptive statistics and confidence interval were performed. 4388 patients met the initial search criteria. 919 cysts in 896 women (age: 50-91years, mean: 61.5years) were identified. We found 162 cysts ≤ 1cm, 352 1-3cm, 296 3-7cm , and 51 ≥ 7cm cysts. 127 patients with 1-3cm cysts had no follow-up. Final analysis of 225 1-3cm cysts included 203 ovarian and 22 paraovarian cysts (average size = 1.95cm (1.1-3.0cm)). 103 ovarian cysts had less than 2years, and 100 cysts had more than 2years follow-up. All except one ovarian cyst were stable for the entire duration of their follow-up (Mean duration of follow-up 5.4years) (0.3%, 95% CI 0.0-0.05). 40 cysts resolved. One simple cyst increased in size (followed over 3.25years) without suspicious imaging features and benign on surgery. 1-3cm cysts represented the most common size range (> 40%) in postmenopausal women, majority of which are stable over follow-up with benign outcome. 3cm size threshold is appropriate for simple cyst follow-up in postmenopausal women.

Abbreviated MRI Protocols for the Abdomen.

Technical advances in MRI have improved image quality and have led to expanding clinical indications for its use. However, long examination and interpretation times, as well as higher costs, still represent barriers to use of MRI. Abbreviated MRI protocols have emerged as an alternative to standard MRI protocols. These abbreviated MRI protocols seek to reduce longer MRI protocols by eliminating unnecessary or redundant sequences that negatively affect cost, MRI table time, patient comfort, image quality, and image interpretation time. However, the diagnostic information is generally not compromised. Abbreviated MRI protocols have already been used successfully for hepatocellular carcinoma screening, for prostate cancer detection, and for screening for nonalcoholic fatty liver disease as well as monitoring patients with this disease. It has been reported that image acquisition time and costs can be considerably reduced with abbreviated MRI protocols, compared with standard MRI protocols, while maintaining a similar sensitivity and accuracy. Nevertheless, multiple applications still need to be explored in the abdomen and pelvis (eg, surveillance of metastases to the liver; follow-up of cystic pancreatic lesions, adrenal incidentalomas, and small renal masses; evaluation of ovarian cysts in postmenopausal women; staging of cervical and uterine corpus neoplasms; evaluation of müllerian duct anomalies). This article describes some successful applications of abbreviated MRI protocols, demonstrates how they can help in improving the MRI workflow, and explores potential future directions. ©RSNA, 2019.

Asymptomatic Complicated Cysts in Postmenopausal Women: Is Tissue Sampling Unnecessarily High?

To determine the malignancy rate of complicated cysts in postmenopausal women and to discuss appropriate (Breast Imaging Reporting and Data System assessment and recommendation. This study was approved by our institutional review board and informed consent was waived. One hundred fourteen postmenopausal patients with 183 complicated cysts as defined by the newest Breast Imaging Reporting and Data System edition were identified retrospectively between January 2013 and December 2015 (to allow for 2 years follow-up period). One hundred eight complicated cysts were assessed as probably benign and 75 as suspicious. Prospective review of all images and pathology was performed and patient's age, breast density, risk factors, use of hormone replacement therapy, and family history of breast cancer were recorded. A total of 30 symptomatic patients and lesions not meeting criteria for complicated cysts were excluded from our cohort. Benignity was determined by aspiration, biopsy, resolution, recategorization to a simple cyst, or adequate follow-up. None of our complicated cysts proved malignant. Fifteen of 108 probably benign complicated cysts were aspirated yielding benign fluid in 10 and 5 were biopsied yielding benign pathology (only 2 with atypical cells). Twenty-nine of 75 complicated cysts categorized as suspicious were aspirated and fluid was discarded in 25 and 4 sent for cytology yielding benign pathology. The other 41 complicated cysts thought to be suspicious were biopsied with benign pathology (only 1 atypical). This study supports the use of a probably benign assessment of asymptomatic complicated cysts irrespective of age. The sensitivity for malignancy was 100% in our cohort.

Reliability of IOTA score and ADNEX model in the screening of ovarian malignancy in postmenopausal women

BackgroundThe IOTA (International Ovarian Tumor Analysis) group has developed the ADNEX (Assessment of Different NEoplasias in the adneXa) model to predict the risk that an ovarian mass is benign, borderline or malignant. This study aimed to test reliability of these risks prediction models to improve the performance of pelvic ultrasound and discriminate between benign and malignant cysts. Material and methodsPostmenopausal women with an adnexal mass (including ovarian, para-ovarian and tubal) and who underwent a standardized ultrasound examination before surgery were included. Prospectively and retrospectively collected data and ultrasound appearances of the tumors were described using the terms and definitions of the IOTA group and tested in accordance with the ADNEX model and were compared to the final histological diagnosis. ResultsOf the 107 menopausal patients recruited between 2011 and 2016, 14 were excluded (incomplete inclusion criteria). Thus, 93 patients constituted a cohort in whom 89 had benign cysts (83 ovarian and 6 tubal or para-ovarian cysts), 1 had border line tumor and 3 had invasive ovarian cancers (1 at first stage, 1 at advanced stage and 1 metastatic tumor in the ovary). The overall prevalence of malignancy was 4.3%. Every benign ovarian cyst was classified as probably benign by IOTA score which showed also a high specificity with the totality of probably malignant lesion proved malignant by histological exam. The limit of this score was the important rate of not classified or undetermined cysts. However, the malignancy risks calculated by ADNEX model allowed identifying the totality of malignancy. Thus, the combination of the two methods of analysis showed a sensitivity and specificity rates of respectively 100% and 98%. Evaluation of malignancy risks by these 2 tests highlighted a negative predictive value of 100% (there was no case of false negative) and a positive predictive value of 80%. Discussion and conclusionOn the basis of our findings, the IOTA classification and the ADNEX multimodal algorithm used as risks prediction models can improve the performance of pelvic ultrasound and discriminate between benign and malignant cysts in postmenopausal women, especially for undetermined lesions.

Surgical management of ovarian cysts in postmenopausal women

Many ovary cysts are asymptomatic especially in postmenopausal women. In the case of large cysts, the risk of malignancy becomes increase and if conservatively treated could remain unchanged. Although the laparoscopy still represents the main abort pathway, in the cases when cysts present the signs of malignancy or even extraovarian dissemination, the treatment should involved laparotomy. Anyway, the technique which should be applied in ovarian cysts should take into consideration the patient will and the surgeon’s experience in which the staging can be performed when indicated. The present review systematizes the pathology, ovarian masses evaluation, laparoscopy vs. laparotomy techniques, the role of CA125 marker and surgical management of the cysts in postmenopausal women.

Ovarian cysts in post-menopausal women

Abstract not availableBangladesh J Obstet Gynaecol, 2016; Vol. 31(1) : 1-2

Management of unilocular or multilocular cysts more than 5 centimeters in postmenopausal women

ObjectiveTo evaluate the malignancy potential of large unilocular and multilocular ovarian cysts in postmenopausal women and to discuss their appropriate management. Study designThis retrospective study included 204 postmenopausal patients who underwent surgery for simple adnexal cysts or cysts with isolated septal structures at the Gynecology and Obstetrics Clinic of Bakirkoy Dr Sadi Konuk Training and Research Hospital. Data obtained from patient and computer records included patient age, follow-up period, ultrasonography reports, surgery information, histopathological evaluation results, and cancer antigen-125 (CA-125) levels at diagnosis and during follow-up. The Kruskal–Wallis test was used to compare three or more groups. The Chi-square test or Fisher's exact test was used to compare qualitative parameters, while relationships between parameters were analyzed by using Spearman's correlation analysis. ResultsA total of 236 cysts were identified in 204 postmenopausal women who underwent surgery. The cysts were categorized as having unilocular cyst morphology or complex structures without morphological abnormalities other than septa in 182 (77.1%) and 54 cases (22.9%), respectively. The mean cyst diameter was 6.6±3.1cm (range, 2.7–30cm) with diameters ≥5cm in 176 cysts (75%). The median cyst volume was 88.5 cm3 (range, 10–2636; interquartile range: 81) and the mean morphology index was 1.2 (range, 1–6), with 16 cysts (6.8%) ≥5. No malignancy or borderline histology was observed in any patient. ConclusionsAmong postmenopausal women, cysts that are unilocular or contain isolated septa, have a low-risk of malignancy even when they are larger than 5cm. Rather than undergoing emergency surgery, these patients may be followed up conservatively with intermittent transvaginal ultrasonography.

Ovarian cysts in postmenopausal women. Surgery and surgical approach

Ovarian cysts in postmenopausal women. Surgery and surgical approach

Current diagnosis and management of ovarian cysts

The epidemiology of ovarian cysts is unclear due to the lack of consistent reporting and a high likelihood of spontaneous resolution. In the USA, postmenopausal women have an ovarian cyst incidence of 18% over a 15-year period. Worldwide, about 7% of women have an ovarian cyst at some point in their lives. In Europe, a large screening trial revealed a 21.2% incidence of ovarian cysts among healthy postmenopausal women. The American College of Obstetricians and Gynecologists (ACOG) stated that simple cysts found on ultrasound may be safely followed without intervention, even in postmenopausal women. These cysts are not likely cancer precursors, nor markers of increased risk, and can be managed conservatively. Simple ovarian cysts appear to be stable or resolve by the next annual examination. These findings support recent recommendations to follow unilocular simple cysts in postmenopausal women without intervention. For those patients, ovarian cancer screening and follow up include a CA-125 blood test and transvaginal ultrasonography (TVU) at baseline, an annual TVU for three additional years, and annual CA-125 tests for five years beyond baseline. The TVU screening examination is considered positive (abnormal and suspicious for ovarian cancer) when findings included: 1) ovarian volume greater than 10 cubic cm; 2) cyst volume greater than ten cubic cm; 3) any solid area or papillary projection extending into the cavity of a cystic ovarian tumor of any size; or, 4) any mixed (solid/cystic) component within a cystic ovarian tumor. Women with positive screening examinations are referred to gynecologic oncology unit for follow-up investigation. Diagnostic consideration and surgical management of ovarian cysts are discussed.

Nonvisualization of the ovaries on pelvic ultrasound: does MRI add anything?

The purpose of our study is to assess the utility of pelvic magnetic resonance imaging (MRI) in the event that either one or both ovaries are not visualized by pelvic ultrasound. This HIPAA-compliant retrospective study was approved by our local institutional review board and informed consent waived. 1926 pelvic MRI examinations between March 2007 and December 2011 were reviewed and included if a combined transabdominal and endovaginal pelvic ultrasound had been performed in the preceding 6months with at least one ovary nonvisualized. Ovaries not visualized on pelvic ultrasound were assumed to be normal and compared with the pelvic MRI findings. MRI findings were categorized as concordant or discordant. Discordant findings were divided into malignant, non-malignant physiologic or non-malignant non-physiologic. The modified Wald, the "rule of thirds", and the binomial distribution probability tests were performed. 255 pelvic ultrasounds met inclusion criteria with 364 ovaries not visualized. 0 malignancies were detected on MRI. 6.9% (25/364) of nonvisualized ovaries had non-malignant discordant findings on MRI: 5.2% (19/364) physiologic, 1.6% (6/364) non-physiologic. Physiologic findings included: 16 functional cysts and 3 hemorrhagic cysts. Non-physiologic findings included: 3 cysts in post-menopausal women, 1 hydrosalpinx, and 2 broad ligament fibroids. The theoretical risk of detecting an ovarian carcinoma on pelvic MRI when an ovary is not visualized on ultrasound ranges from 0 to 1.3%. If an ovary is not visualized on pelvic ultrasound, it can be assumed to be without carcinoma and MRI rarely adds additional information.

Asymptomatic Simple Ovarian Cyst in Postmenopausal Women: Syndrome of ‘Visible Ovary’

ABSTRACT Simple cysts of the ovary are quite common, with a prevalence of 5 to 17%. Advances in the technology of ultrasound and the increasing frequency of use of TVS has made it all the more important to have knowledge of the natural history of simple asymptomatic postmenopausal cysts. Previously, due to the paucity of data, postmenopausal women with asymptomatic simple cysts were managed much too aggressively. Current available data suggest a more conservative approach with serial ultrasounds, Doppler evaluation and CA-125 levels. Further studies are needed in order to have definitive guidelines for the gynecologic practitioner. How to cite this article Zalud I, Busse R, Kurjak BF. Asymptomatic Simple Ovarian Cyst in Postmenopausal Women: Syndrome of ‘Visible Ovary’. Donald School J Ultrasound Obstet Gynecol 2013;7(2):182-186.

A Huge Dermoid Cyst in Postmenopausal Women with Third Degree Uterine Prolapse

ABSTRACTGerm cell tumors are derived from primordial germ cells of the ovary. Approximately 25 to 30% of all ovarian tumors are of germ cell origin and of these, 95% are benign and only 3 to 4% are malignant. They are seen mostly in women in their second and third decades of life and very rarely in postmenopausal women. There are many reported cases of ovarian tumor in postmenopausal women but a huge dermoid cyst in postmenopausal women causing prolapse uterus is very rare. Here, we are presenting a rare case of large dermoid cyst in a 58-year-old postmenopausal multiparous woman with third degree uterine prolapse.How to cite this articleKakani A, Bannerjee I, Shrivastava D. A Huge Dermoid Cyst in Postmenopausal Women with Third Degree Uterine Prolapse. J South Asian Feder Menopause Soc 2013;1(1):43-44.

Jednostronne cysty proste przydatków u kobiet w wieku menopauzalnym – problem diagnostyczno-terapeutyczny

ENWEndNote BIBJabRef, Mendeley RISPapers, Reference Manager, RefWorks, Zotero AMA Fuchs T, Grobelak K, Pomorski M, Woytoń R, Tomiałowicz M, Zimmer M. Unilateral and unilocular adnexal cysts in postmenopausal women: a diagnostic and therapeutic problem. Menopause Review/Przegląd Menopauzalny. 2013;12(2):115-119. doi:10.5114/pm.2013.35066. APA Fuchs, T., Grobelak, K., Pomorski, M., Woytoń, R., Tomiałowicz, M., & Zimmer, M. (2013). Unilateral and unilocular adnexal cysts in postmenopausal women: a diagnostic and therapeutic problem. Menopause Review/Przegląd Menopauzalny, 12(2), 115-119. https://doi.org/10.5114/pm.2013.35066 Chicago Fuchs, Tomasz, Krzysztof Grobelak, Michał Pomorski, Robert Woytoń, Marek Tomiałowicz, and Mariusz Zimmer. 2013. "Unilateral and unilocular adnexal cysts in postmenopausal women: a diagnostic and therapeutic problem". Menopause Review/Przegląd Menopauzalny 12 (2): 115-119. doi:10.5114/pm.2013.35066. Harvard Fuchs, T., Grobelak, K., Pomorski, M., Woytoń, R., Tomiałowicz, M., and Zimmer, M. (2013). Unilateral and unilocular adnexal cysts in postmenopausal women: a diagnostic and therapeutic problem. Menopause Review/Przegląd Menopauzalny, 12(2), pp.115-119. https://doi.org/10.5114/pm.2013.35066 MLA Fuchs, Tomasz et al. "Unilateral and unilocular adnexal cysts in postmenopausal women: a diagnostic and therapeutic problem." Menopause Review/Przegląd Menopauzalny, vol. 12, no. 2, 2013, pp. 115-119. doi:10.5114/pm.2013.35066. Vancouver Fuchs T, Grobelak K, Pomorski M, Woytoń R, Tomiałowicz M, Zimmer M. Unilateral and unilocular adnexal cysts in postmenopausal women: a diagnostic and therapeutic problem. Menopause Review/Przegląd Menopauzalny. 2013;12(2):115-119. doi:10.5114/pm.2013.35066.

OP29.09: Accuracy and reproducibility of ultrasonography for the diagnosis of ovarian cancer in operators with different degrees of experience

according to the IOTA protocol. A proper counselling on a low ovarian cancer risk was given and an adequate informed consent was obtained. Sonographic follow-up was proposed at 3 and 9 months, than yearly. Surgery was proposed in case of changes of ovarian cyst volume (>50%) and/or sonographic parameters at TVS-CD. Demographic, medical, sonographic and pathologic data were recorded. Results: 98 post-menopausal patients with 106 ovarian cysts were enrolled. Median age (IR) was 69 years (59–74). Median years after menopause (IR) were 18 (8–24). Median BMI (IR) was 26 kg/m2 (24–29). Mean parity (±sd) was 2 ± 1.8 women reported bilateral cysts. 53 cysts were unilocular, 53 multilocular. Median cyst diameter (IR) of unilocular and multilocular ovarian cysts was 50 mm (34–56). At a median follow-up period of 36 months, surgery was performed in 28 cases: 14 patients required immediate removal, 5 drop-out, 9 volume changes. One successfully managed cardiac arrest occurred during laparoscopic procedure. No malignant lesions were reported at histology. Conclusions: Sonographic follow-up might be a useful option in the clinical management of incidental unilocular >5 cm and multilocular <7 cm ovarian cysts in post-menopausal women. Larger and longer multicentres studies with strict sonographic parameters are needed to support this potentially safe conservative management.

Simple ovarian cysts in postmenopausal women: scope of conservative management

This study was done to evaluate/investigate the natural history of simple ovarian cysts in postmenopausal women and to determine the risk for malignant transformation of these cysts. Ultrasound reports of all the postmenopausal women who attended St. Francis Hospital and Medical Center, Hartford, USA from January 1997 to April 2010 with an ultrasound diagnosis of simple cysts of ovary were reviewed retrospectively. A total of 619 patients with 743 simple ovarian cysts were evaluated. It was found that 305 out of 619 patients (49.27%) were lost in follow-up. Therefore, 314 patients (50.73%) with 378 cysts could be followed further by ultrasound study. One hundred and seventy-five (46.30%) of the 378 cysts that could be followed further had spontaneous resolution and 166 cysts (43.91%) persisted unchanged over the follow-up period. Thirty cysts (7.94%) turned into complex cysts and four cysts (1.06%) significantly increased in size. One cyst significantly decreased in size, though it did not resolve. Only one patient developed papillary serous carcinoma (high grade) of the ovary. This occurred three years after her last ultrasound for simple cyst surveillance. Simple ovarian cysts during the menopause can be followed conservatively because their risk for malignant transformation is low. The majority of these cysts either resolve spontaneously or persist unaltered on follow-up.