The management of ovarian cysts in premenopausal women

Prakash, Anjali; Li, Tin‐Chiu; Ledger, William

doi:10.1576/toag.6.1.12.26966

Cited by 7 publications

(7 citation statements)

References 26 publications

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“…The incidence of malignant ovarian cyst in this group is reported as being between 0.4-8.9/100,000 women. It increases to 60/100,000 women at age 60-80 years [3]. The majority of serous neoplasms of the ovary are benign (70%).…”

Section: Discussionmentioning

confidence: 99%

“…The risk of malignancy index in a young woman of reproductive age with ovarian cyst is low (<3%) if the cyst appears simple in nature on ultra-sonographic assessment (e.g., no solid areas, no evidence of metastasis or bilateral lesion) and CA125 is within the normal limits [3]. Midline laparotomy is the standard surgical management for excision of large ovarian cysts.…”

Section: Discussionmentioning

confidence: 99%

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Laparoscopic excision of a large ovarian cyst

Rabbani¹,

Wynn²,

Hickling³

2007

Gynecol Surg

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Keywords Large ovarian cyst . Laparoscopic management and ovarian cyst Case reportWe present a case of laparoscopic drainage and excision of a large ovarian cyst. A 22-year-old, nulliparous woman presented to a general practitioner with occasional rightsided upper abdominal pain. An abdominal ultrasound was arranged to assess the biliary system. However, the scan identified a huge ovarian cyst filling the entire abdominal cavity from the epigastrium to the pouch of Douglas. An urgent review was arranged at the gynaecology clinic. There was generalized distension of the abdomen, but the margins of the cyst were not palpable. A repeat pelvic ultrasound scan was arranged in the gynaecological ultrasound department to examine the cyst in detail. It appeared simple in nature, with a unilocular fluid-filled cavity. The approximate size was 50×30×13 cm. No solid elements, ascites or renal system dilatation was noted on ultrasound. CA-125(15 iu/ml), CEA (2 ng/ml) and HCG (<5 iu/l) were all normal. After detailed discussion with the patient about the management options, a decision was made to perform laparoscopic drainage and excision of the cyst. The patient was aware of the possibility of oophrectomy and laparotomy if complications arose during the procedure or if it proved impossible to excise the cyst laparoscpically.The procedure was performed under general anaesthetic in the lithotomy position. A Veres needle was inserted through the umbilicus into the cyst as for routine laparoscopy and 5,800 ml of straw-coloured fluid was drained through the suction apparatus till the fluid stopped draining. The Veres needle was than removed and reinserted at the same point and CO2 in-sufflation was performed as per routine. A 10-mm trocar was then inserted with ease into the peritoneal cavity. The cyst had completely collapsed and the detailed inspection revealed origin from the right adnexa possibly ovarian in nature, but the right ovary appeared healthy and well preserved. The left ovary also appeared normal. The cyst had expanded in the mesosalpinx and broad ligament and had involved the right tube. Ureters were identified separately on both sides. Two further 5-mm ports were inserted in the suprapubic area on either side of the midline. Right partial salpingectomy and excision of the base of the cyst were performed with bipolar diathermy and laparoscpic scissors. Hemostasis was secured using bipolar diathermy. The cyst was then grasped with lockable laparoscpic forceps inserted through a suprapubic port on the left. The portal entry incision was enlarged by a further 1 cm as the port, forceps and cyst were being removed under direct vision. The cyst was removed piecemeal and both ovaries were preserved. The patient made an uneventful post-operative recovery with minimal use of oral analgesics only and was discharged the next day.The histology showed a unilocilar thin-walled cyst. The cyst wall was composed of fibrous tissue and was lined by tubal-type cuboidal epithelium. No background ovarian tissue was seen. Attached to the...

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Laparoscopic excision of a large ovarian cyst

Rabbani¹,

Wynn²,

Hickling³

2007

Gynecol Surg

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“…In Denmark, the national guidelines that were drawn up in 2002 for the management of ovarian cysts recommend that the sonographic features used to evaluate ovarian cysts in non-pregnant women can also be used for pregnant women (Knudsen et al 2004). The sono-morphological features suggestive of ovarian malignancy include increased size, presence of septations, papillary formation, echogenic solid areas, and free fluid in the pouch of Douglas (Prakash et al 2004). In the last decade, the use of the high-frequency transvaginal probe has advanced the accurate definition of cystic masses, but its use during pregnancy for this purpose is probably restricted to the first trimester.…”

Section: Role Of Ultrasound In Diagnosismentioning

confidence: 99%

“…Levels of the serum tumour marker CA-125 are usually elevated in cases of epithelial ovarian cancer, although this is not specific since CA-125 may be also raised in benign conditions such as endometriosis (Edmonds 1999;Prakash et al 2004). One of the additional difficulties encountered during the management of ovarian cysts is the limited role that tumour markers can have in the differentiation between benign and malignant lesions during pregnancy.…”

Section: Role Of Ca-125mentioning

confidence: 99%

Ovarian cysts during pregnancy: Dilemmas in diagnosis and management

El-Shawarby

Henderson

Mossa

2005

Journal of Obstetrics and Gynaecology

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With routine obstetric ultrasound examinations, ovarian cysts are now more commonly diagnosed during pregnancy and their management is still a challenging clinical issue among obstetricians. The aim of this paper is to review the different management options of ovarian cysts detected during pregnancy, and it highlights the emergence of laparoscopic technique as a valuable therapeutic tool in these conditions. The review shows that conservative management and ultrasound follow-up is sufficient for the majority of cases of ovarian cysts during pregnancy. It also discusses the limitations of tumour markers during pregnancy, and the controversy around ultrasound-guided aspiration procedures. Emerging evidence suggests that if surgery is necessary, then it is preferable to perform an elective laparoscopic procedure at 16 - 23 weeks' gestation. It is time to consider establishing a UK registry to monitor the treatment offered to those women and to develop national guidelines to help in the management of this controversial issue.

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“…6 Sonography is the modality of choice in the evaluation of these cysts either through abdominal or transvaginal approach. 7 Doppler Us is helpful for more details about the vascularity of the cyst and a risk of being malignant; because it shows clearly the vascularity of the cysts. In malignant ovarian cyst then will be abnormal vessels with a lower impedance of blood flow.…”

Section: Introductionmentioning

confidence: 99%

The role of ultrasound in detection of ovarian cysts confirmed by histopathology

Agha¹

2018

Ann Coll Med Mosul

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Objective:The aim is to diagnose the ovarian cyst by ultrasound modality and confirmed this by histopathologic results. Methods: Aprospective study on one hundred and fifty female patients in the period of one year (2009) in gyne-and obstetrical out patent clink. Results: The patients examined and (150), ninty of these patient (60%) have ovarian cysts. (48) patient 53%. Their cyst resolved completely while (42) patient 47% are not respond to medical treatment and need surgical interference and these cyst are exposed to the histopathological assessment. Conclusion: Sonography of the pelvic organs to detect ovarian cyst is a good imaging modality, quick and safe procedure, need no much preparation and easily predict the nature and type of the cyst and very easy methods to follow these patients.

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The management of ovarian cysts in premenopausal women

Cited by 7 publications

References 26 publications

Laparoscopic excision of a large ovarian cyst

Laparoscopic excision of a large ovarian cyst

Ovarian cysts during pregnancy: Dilemmas in diagnosis and management

The role of ultrasound in detection of ovarian cysts confirmed by histopathology

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