Management of ovarian cysts

BMJ 1996; 313 doi: https://doi.org/10.1136/bmj.313.7065.1098 (Published 02 November 1996) Cite this as: BMJ 1996;313:1098
  1. J Salat-Baroux,
  2. Ph Merviel,
  3. F Kuttenn
  1. Professor Chef de clinique Department of Gynaecology and Obstetrics, Hopital Tenon, 75020 Paris, France
  2. Professor Department of Endocrinology and Reproductive Medicine, Hopital Necker, 75015 Paris

    Depends on age, menopausal status, and the size and structure of the cyst

    Ovarian cysts are present in 6% of asymptomatic postmenopausal women. Most of these cysts are benign or functional, and the physician's role is largely to exclude cancer, which has a prevalence of 61 per 100 000 in women aged 68 years.1 Needle aspiration of ovarian cysts has been proposed as an alternative to laparoscopic and conventional surgical excision, especially when the cyst is believed on clinical grounds to be benign. Needle aspiration has the important advantage over surgical excision that it can be performed under local anaesthetic and does not require admission to hospital. Nevertheless, there are several important questions concerning needle aspiration of ovarian cysts.

    Firstly, how easy is it to predict whether a cyst is benign or malignant? Clinical examination, ultrasonography, and serum concentrations of CA 125 are the main approaches available. Clinical examination is often disappointing, with 30–65% of ovarian tumours (in particular those less then 40–50 mm in diameter) being overlooked. Vaginal …

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