Click here for an explanation of these scores
Answer Rating key
|
search
|
|
strong
|
|
appraisal
|
|
weak
|
|
confidence
|
|
moderate
|
Question answered:28/04/08
We found no specific guidance on premenopausal women (our assumption is that she is premenopausal).
Mentor have published a review of Benign Ovarian Tumours [1] reports:
“Management
- Any cyst not positively identified as non-neoplastic should be removed, as seemingly benign tumours may be malignant.
- In younger women cystectomy may be preferable to oophorectomy.
- In post-menopausal women, if one ovary is pathological then both are removed.
Expectant management
- With periodic reassessment by ultrasound for a maximum of 3 months.
- Appropriate for asymptomatic cysts unremarkable by ultrasound.
- Many tumours resolve spontaneously within two to three cycles.
Oral contraceptives
- For asymptomatic cysts unremarkable by ultrasound for a maximum of three cycles.
- Very effective in preventing formation of functional tumours but their use in shrinking or resolving cystic tumours has not been proven.”
They also discuss surgical management (see URL below for further details).
The American eMedicine has a chapter on Ovarian Cysts [2] reports the following ‘medical care’:
“Many patients with simple ovarian cysts based on ultrasonography findings do not require treatment.
In a postmenopausal patient, a persistent simple cyst smaller than 5 cm in dimension in the presence of a normal CA125 value may be monitored with serial ultrasonography examinations. Some evidence suggests that cysts up to 10 cm can be safely followed in this way.
Premenopausal women with asymptomatic simple cysts smaller than 8 cm on sonograms in whom the CA125 value is within the reference range may be monitored with a repeat ultrasonographic examination in 8-12 weeks. Hormone therapy is not helpful for suppressing ovarian stimulation by gonadotropins.”
You may also be interested in two chapters in GP Notebook: benign ovarian tumours [3] and non-neoplastic functional cysts [4]
References
1) http://www.patient.co.uk/showdoc/40000074
2) http://www.emedicine.com/med/topic1699.htm
3) http://www.gpnotebook.co.uk/simplepage.cfm?ID=1228210213&linkID=25456&cook=yes
4) http://www.gpnotebook.co.uk/simplepage.cfm?ID=711655451&linkID=25455&cook=yes
DISCLAIMER: TRIPanswers is a collection of clinical questions and answers. Each provider will have their own methodology in answering questions and these are likely not to be as rigorous as systematic review. If you have any doubt as to the implications of this contact the Q&A Service Provider for further information. This document is presented for information purposes only. This document cannot and should not be used as a basis of diagnosis or choice of treatment, and is in no way intended to replace professional medical care or attention by a qualified practitioner. TRIPanswers and TRIP Database Ltd are not responsible or liable for, directly or indirectly, ANY form of damage whatsoever resulting from the use/misuse of information contained in or implied by this document. Also, ensure you have read the terms and conditions for using the site.