How are ovarian cysts treated?

Objectives:

To investigate the management of women with asymptomatic ovarian masses, to determine the appropriate duration of follow up, and to identify diagnostic indicators of growing cysts.

Design:

Review of women's hospital records.

Setting:

Tokyo Metropolitan Cancer Detection Center, Japan.

Population:

Two hundred and twenty-five pre- and postmenopausal women with a diagnosis of ovarian cyst< 6 cm in diameter and normal serum level of CA125, diagnosed between 1 October 1990 and 25 December 1991.

Main Outcome Measure:

Change in size of cyst as shown by ultrasound.

Results:

Seventy-five months after initial diagnosis, 29 (13%) of the masses had progressed, 31 (14%) had persisted, and 165 (73%) had regressed. One hundred and nine masses (48%) had regressed within six months of the initial diagnosis. In univariate analysis transvaginal ultrasonographic assessment of morphology findings, cyst diameter, carcinoembyronic antigen (CEA) and CA19-9 were associated with the prognosis of the cyst. Multivariate regression analysis demonstrated that only the initial serum CA19-9 level and serum CEA level were significant predictors of ovarian masses that regressed (P for trend = 0.004 and 0.02, respectively).

Conclusion:

Simple ovarian cysts in patients with a normal level of CA125 have a low risk for ovarian cancer. Vaginal ultrasound at six months will identify regression of most simple cysts. CA19-9 and CEA at the initial diagnosis are useful parameters to predict future regression of ovarian cysts.

Please click on the required question.

• 1 Pelvic Pain. Is this a common problem?
• 2 What are the common causes of pelvic pain in women?
• 3 What are the more common gynaecological causes of pelvic pain?
• 4 What are the more common non-gynaecological causes of pelvic pain?
• 5 What are primary and secondary dysmenorrhoea - painful periods?
• 6 What is retrograde menstruation?
• 7 How can dysmenorrhoea - painful periods be treated?
• 8 What are ovarian cysts?
• 9 How do ovarian cysts cause pain?
• 10 How are ovarian cysts diagnosed?
• 11 How are ovarian cysts treated?
• 12 I think I may be pregnant and I have some pelvic pain. What should I do?
• 13 What is pelvic inflammatory disease and how can it be treated?
• Mittelschmertz

FIBROIDS

•  What are fibroids?
•  I have fibroids. What difficulties might they cause for me?
•  How are fibroids diagnosed?
•  How could my fibroids be treated?

  ENDOMETRIOSIS

•  What is endometriosis?
•  How prevalent is endometriosis?
•  What causes endometriosis?
•  How can my endometriosis be treated?
•  How can my doctor determine the cause of my pelvic pain?
•  What investigations might be recommended by my gynaecologist to investigate my pelvic pain?
•  What is laparoscopy?
•  What are pelvic adhesions?
•  I have chronic pelvic pain. Could this be related to adhesions?
•  What is uterine retroversion (retroverted uterus)
•   Does a retroverted uterus (backward tilted uterus) cause symptoms?
•  How is a retroverted uterus - backward tilted uterus - treated?
•  What is pelvic congestion?
•  What causes pain associated with sexual intercourse (dyspareunia)
•  How can painful sexual intercourse (dyspareunia) be treated?
•  What is a pelvic mass?

  IRRITABLE BOWEL SYNDROME - IBS

•  What is irritable bowel syndrome?
•  How can we find out if I have irritable bowel syndrome?
•  Is irritable bowel syndrome (IBS) a common condition?
•  What causes IBS?
•  What is the pain associated with IBS like?
•  Can IBS be mistaken for gynaecological problems?
•  How can my IBS be treated?
•  What other treatments are available for IBS?
•  What can be done to reduce the amount of bowel gas(flatus)
•  What is constipation?
•  What causes constipation?
•   How can constipation be treated?
•  How could we summarise the treatments that are available for my pelvic pain?
•  Where can I obtain more information?
•  Pelvic Pain Support Groups.
•  Endometriosis Support Groups.
•  IBS Support Groups.




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This is the personal website of David A Viniker MD FRCOG, Consultant Obstetrician and Gynaecologist at Whipps Cross University Hospital, London - Specialist Interests - Reproductive Medicine including Infertility, PCOS, PMS, Menopause and HRT.

I do hope that you find the answers to your women's health questions in the patient information and medical advice provided.