Management Of Simple Ovarian Cysts Research Articles

Management of Simple Ovarian Cysts

Dr. Chafitz is a Resident, Department of Obstetrics and Gynecology, Hackensack University Medical Center, Hackensack, NJ 07601, E-mail: [email protected]; Dr. Chemerinski is a Reproductive Endocrinology and Infertility Fellow, Rutgers-New Jersey Medical School, Newark, New Jersey; and Dr. McGovern is Associate Professor, Rutgers-New Jersey Medical School, Newark, New Jersey, and University Reproductive Associates, Hasbrouck Heights, New Jersey. All authors, faculty, and staff have no relevant financial relationships with any ineligible organizations regarding this educational activity. CME Accreditation Lippincott Continuing Medical Education Institute, Inc., is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. Lippincott Continuing Medical Education Institute, Inc., designates this enduring material for a maximum of 2.0 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. To earn CME credit, you must read the CME article and complete the quiz and evaluation on the enclosed answer form, answering at least seven of the 10 quiz questions correctly. Please visit http://cme.lww.com. This CME activity expires on June 29, 2025. NCPD Accreditation Lippincott Professional Development is accredited as a provider of nursing continuing professional development (NCPD) by the American Nurses Credentialing Center's Commission on Accreditation. Lippincott Professional Development will award 2.0 contact hours for this NCPD activity. This activity is also provider approved by the California Board of Registered Nursing, Provider Number CEP 11749 for 2.0 contact hours. Lippincott Professional Development is also an approved provider of continuing nursing education by the District of Columbia, Georgia, West Virginia, New Mexico, South Carolina, and Florida, CE Broker #50-1223. Your certificate is valid in all states. Instructions for earning ANCC contact hours are included on page 11 of the newsletter. This NCPD activity expires on June 5, 2026.

Management of Simple Ovarian Cysts

Topics in Obstetrics & Gynecology 43(9):p 6, June 30, 2023. | DOI: 10.1097/01.PGO.0000937008.79482.3a

Preliminary results: ethanol sclerotherapy after ultrasound-guided fine needle aspiration without anesthesia in the management of simple ovarian cysts.

To investigate the feasibility of ultrasound-guided, fine-needle aspiration and ethanol sclerotherapy of simple ovarian cysts in an office setting without anesthesia. We also describe the rate of cyst recurrence in patients treated with this technique and explore the associated risk factors. Prospective follow-up of patients after ethanol sclerotherapy of simple adnexal cysts in a single center trial (Canadian Task Force classification II-1). The study was conducted at Bellvitge Teaching Hospital in Barcelona, Spain. Ethanol sclerotherapy was performed on 60 simple adnexal cysts between 2009 and2012. Ultrasound-guided fine-needle aspiration and ethanol sclerotherapy. Patient demographics and cyst characteristics were collected for all patients. Potential risk factors for recurrence were analyzed by univariate and multivariate analyses. All the procedures, except 1, were performed without anesthesia. The only major complication was a case of self-limiting hem peritoneum that was managed expectantly. Moderate abdominal pain occurred in 26.7% of patients during the procedure. Fifty-five patients completed at least 6 months of follow-up and were included in the statistical recurrence analyses. Cyst recurrence was recorded in 9.1% of the patients and was managed in the usual manner in all the cases. Univariate analyses indicated that a larger cyst diameter and a higher estimated cyst volume were significantly associated with recurrence. In the multivariate analysis, recurrence was only significantly associated with estimated cyst volume. Ethanol sclerotherapy of simple ovarian cysts in an office setting without anesthesia is a feasible technique associated with a low rate of complications and recurrence, although larger randomized studies are necessary to assess the predictive factors for cyst recurrence.

Diagnosis and management of simple ovarian cysts

Adnexal masses are found in 6% of women of reproductive age. Ultrasonography can clearly identify the characteristics of ovarian cysts. Simple ovarian cysts in women of reproductive age have commonly been treated with oral contraceptives. However expectant management can also be effective. The present study evaluates the results of expectant management of simple ovarian cysts and compares these results with those of oral contraceptive treatment. This randomized controlled trial of a 24-months duration enrolled 141 premenopausal women younger than 50 years who had low serum cancer antigen (CA)-125 levels (< 65 U/mL) and an ovarian cyst detected by transvaginal Doppler ultrasonography within the first 5 days of their menstrual cycle. The women were assigned to expectant management (n = 74 group 1) or to receive daily hormonal treatment (n = 67 group 2). The treatment consisted of 20 µg of ethinyl estradiol and 150 µg of desogestrel (Myralon; Organon Ilac AS Istanbul Turkey). (excerpt)

Diagnosis and management of simple ovarian cysts: An audit

Simple ovarian cysts are common. The aim of clinical management is to optimize the treatment of malignant and premalignant cysts while minimizing intervention for cysts likely to resolve spontaneously. In this retrospective study, ovarian cysts over 30 mm in diameter were detected in 90 women. Of this population, 75 were premenopausal, 13 postmenopausal, and two had undergone a hysterectomy. Thirteen women presented acutely. Family history of breast, ovary or colon cancer was not ascertained in any of the women. None had CA125 levels performed. In 22 cases, the cyst was aspirated; only 10 of these had follow-up ultrasound. Laparotomy was performed in 25 premenopausal women, the two perimenopausal women and eight postmenopausal women. Average cyst size was 71 mm (range 40-80 mm) in the laparoscopy group, and 72 mm (range 36-180 mm) in the laparotomy group. After initial diagnosis at ultrasound, a follow-up scan was performed 4-16 weeks later. The final diagnosis was ovarian neoplasm in 13 and hydrosalpinx in two. None had a malignancy. Documentation at ultrasound was often inadequate, and management of the women with an ovarian cyst was haphazard. Guidelines on management of simple ovarian cysts are likely to improve clinical practice.

Management of non-neoplastic ovarian cysts with sclerotherapy

Objective: To evaluate sclerotherapy with alcohol and erythromycin in the management of simple ovarian cysts. Methods: Twenty-four simple ovarian cysts were subjected to sclerotherapy with alcohol and erythromycin. All procedures were performed under local anesthesia and in an outpatient setting. Cytological examination was carried out in all cases and two patients were excluded from the study because of suspicious cytological results. The patients were followed up monthly with color Doppler sonography for more than 12 months. Results: Cyst fluid was serous in 17 cases and dark-chocolate colored in seven cases. The volume of aspirated fluid ranged from 100 to 220 ml. The size of ovarian masses and cyst-wall thickness ranged from 5.5 to 8.5 cm and 1.5 to 5 mm, respectively. Cytological analysis of 15 cysts revealed acellular sediment, seven cysts were compatible with endometrioma, and two were reported as suspicious. During the 12-month follow-up, seven cyst recurrences were detected. Conclusion: Aspiration and sclerotherapy with alcohol and erythromycin are followed by a relatively high recurrence rate when the aspirate is bloody. However, patients with a simple cyst that is painful or liable to torsion could benefit from sclerotherapy. Such patients, who are at low risk for malignancy, are relieved with sclerotherapy while avoiding surgery.

Asymptomatic postmenopausal simple ovarian cyst.

High-resolution transvaginal ultrasound frequently reveals incidental, simple ovarian cysts in asymptomatic postmenopausal women. Traditionally oophorectomy has been recommended for these women. However, evidence is emerging that most postmenopausal simple ovarian cysts are benign, allowing conservative management. Furthermore, many of these cysts will resolve spontaneously. Cancer antigen 125 (CA-125) and color Doppler may help differentiate benign from malignant cysts. When oophorectomy is favored, the laparoscopic approach may be considered, depending on the clinical situation. Nonoperative management of simple ovarian cysts in asymptomatic women is reasonable; regular follow-up with sonography should be performed. Because sonography is an operator-dependent test, it is imperative that the sonographer have expertise in ovarian imaging. Monitoring of CA-125 levels may be useful. Indications for removal during follow-up are increasing size, development of solid components, abnormal Doppler flow, CA-125 elevation, patient desire for removal of the cyst, and noncompliance with sonographic follow-up. Obstetricians & Gynecologists, Family Physicians After completion of this article, the reader will be able to estimate the prevalence of benign simple ovarian cysts in a postmenopausal population of women, to describe the natural history of a simple ovarian cyst, and outline the features consistent with a benign ovarian cyst on ultrasound.

Aspiration and tetracycline sclerotherapy for management of simple ovarian cysts.

To evaluate the procedure of aspiration and tetracycline sclerotherapy in the management of simple ovarian cysts. Twenty-five cases of simple ovarian cysts were subjected to cyst fluid aspiration and 5% tetracycline injection under ultrasound guidance. Cytological examination of the aspirated fluid was carried out in 24 cases and the patients were followed for 6-36 months. Cytology revealed a cellular sediment in 18 cases (simple cysts), follicular cells in four cases (follicular cysts), and blood and hemosiderin-laden macrophages in two cases (endometriosis); subsequent surgery was required in only one case (endometriosis). The procedure of aspiration and tetracycline sclerotherapy was easy, safe and acceptable, with no recurrences. It appears to be a valid alternative to cyst aspiration in the management of simple ovarian cysts.

A Comparison of Ovarian Cyst Aspirate Cytology and Histology. The Case Against Aspiration of Cystic Pelvic Masses

Summary: The management of simple ovarian cysts by laparoscopically or sono‐graphically‐directed aspiration is widely practised. A study was undertaken to correlate the accuracy of cyst aspirate cytology with histology in 29 consecutive cystic pelvic masses managed in a gynaecological oncology unit. The results of a literature review are then presented to determine the role for aspiration of simple cysts. Aspiration cytology was found to correlate poorly with histology. On the basis of these results and literature evidence, the case against aspiration of ovarian cysts, as either a diagnostic or a therapeutic modality, is presented.