Ovarian Cysts Questions & Answers

Updated: Dec 20, 2018
  • Author: Shannon M Grabosch, MD; Chief Editor: Nicole W Karjane, MD  more...
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Questions & Answers

Overview

What are ovarian cysts?

What are the signs and symptoms of ovarian cysts?

Which physical findings suggest ovarian cysts?

What are ACOG guidelines for use of imaging in the diagnosis of ovarian cysts?

How are ovarian cysts diagnosed?

What is the role of lab studies in the diagnosis of ovarian cysts?

Which patients with ovarian cysts do not require treatment?

What is the role of oral contraceptives in the treatment of ovarian cysts?

When is surgery indicated in the treatment of ovarian cysts?

When is bilateral oophorectomy indicated in the treatment of ovarian cysts?

What are the ACOG guidelines for referral of patients with ovarian cysts to a gynecologic oncologist?

What are ovarian cysts?

At what age are ovarian cysts most likely to develop?

When is surgery indicated in the treatment of ovarian cysts?

What is the goal of emergency response to suspected ovarian cysts?

What education should patients with ovarian cysts receive?

What is the pathophysiology of theca-lutein ovarian cysts?

What is the pathophysiology of neoplastic ovarian cysts?

What is cystic teratoma of the ovary?

What is the physiology of a menstrual cycle in a normally functioning ovary?

What is the pathophysiology of follicular ovarian cysts?

What is the pathophysiology of corpus luteal ovarian cysts?

What is the pathophysiology of a luteoma of pregnancy?

What is an ovarian endometrioma?

What are the risk factors for ovarian cyst formation?

What are the risk factors for ovarian cystadenocarcinoma?

How common are ovarian cysts in the US?

Does the incidence of ovarian cysts vary among races and ethnicities?

Does the incidence of ovarian cysts vary among age groups?

What is the prognosis of ovarian cysts?

What is the risk of malignancy in ovarian cysts?

What is the mortality rate for malignant ovarian carcinoma?

Which types of ovarian cysts increase the risk of malignancy?

What are the potential outcomes of ovarian cysts?

How do ovarian cysts cause torsion?

How common is torsion in patients with ovarian cysts and what are the risk factors?

How common is malignancy in ovarian torsion?

How is torsion in ovarian cysts diagnosed?

How is the outcome of ovarian cyst rupture evaluated?

What is the presentation of ovarian cyst rupture?

Which ultrasonographic findings suggest ovarian cyst rupture and how is it treated?

What is the morbidity of ovarian cysts?

What factors increase the risk of ovarian cyst rupture?

What are the possible complications of torsion due to ovarian cysts?

What is the morbidity of malignant ovarian cystic tumors?

What are the possible effects of cystic granulosa cell tumors?

How can ovarian cysts complicate pregnancy?

Presentation

How are the majority of ovarian cysts discovered?

What are the possible causes and presentations of pain in patients with ovarian cysts?

What are the symptoms of ovarian cysts?

What are the symptoms of theca-lutein ovarian cysts?

Which findings upon palpation suggest ovarian cysts?

Which conditions can result from hemorrhage caused by rupture of an ovarian cyst?

Which conditions may result from complications of ovarian cysts?

Which findings may suggest hemorrhage or peritonitis caused by ovarian cysts?

Which physical findings may suggest advanced malignant ovarian cysts?

DDX

Which high morbidity conditions should be ruled out prior to a diagnosis of ovarian cyst in the emergency department (ED)?

Which conditions should be included in the differential diagnosis of ovarian cysts?

What are the differential diagnoses for Ovarian Cysts?

Workup

When performing the workup for ovarian cysts, what findings should trigger further evaluation for ovarian cancer?

How is the definitive diagnosis of an ovarian cyst made?

What is the role of culdocentesis in the workup of ovarian cysts?

What is the role of laparoscopy in the workup of ovarian cysts?

What is the role of lab testing in the workup of ovarian cysts?

What is the role of cancer antigen 125 (CA125) testing in the workup of ovarian cysts?

How are cancer antigen 125 (CA125) values interpreted in the workup of ovarian cysts?

How is the finding of an elevated cancer antigen 125 (CA125) level used in the workup of ovarian cysts?

Which ovarian cancer biomarkers may be included in the workup of ovarian cysts?

What is the role of immunoassay in the workup of ovarian cysts?

Which experimental biomarkers for ovarian cancer have been identified?

What is the role of ultrasonography in the workup of ovarian cysts?

What is the appearance of a normal ovary on a sonogram?

What is the appearance of simple ovarian cysts on a sonogram?

What is the appearance of complex ovarian cysts on a sonogram?

What may be differentiated on a sonogram of ovarian cysts?

What is the appearance of a corpus luteal ovarian cyst on a sonogram?

What is the appearance of ovarian torsion on a sonogram?

What is the role of endovaginal ultrasonography in the workup of ovarian cysts?

What is the role of transabdominal ultrasonography in the workup of ovarian cysts?

What is the role of 3-D ultrasonography in the workup of ovarian cysts?

What is the role of Doppler ultrasound (flow study) in the workup of ovarian cysts?

What is the role of combined ultrasonography and serum cancer antigen 125 (CA125) testing in the workup of ovarian cysts?

What is the role of CT scanning in the workup of ovarian cysts?

What is the role of MRI in the workup of ovarian cysts?

What is the appearance of ovarian cysts on MRI?

Treatment

What is the role of oral contraceptive pills (OCPs) in the treatment of ovarian cysts?

What monitoring is required for patients with ovarian cysts who do not require treatment?

What is the incidence of ovarian cysts in female newborns?

What causes fetal ovarian cysts?

When are fetal ovarian cysts usually diagnosed?

What should be included in the differential diagnoses for fetal and neonatal ovarian cysts?

Which complications are associated with aspiration of fetal ovarian cysts?

What testing should be performed once a diagnosis of fetal ovarian cysts is made?

How are fetal ovarian cysts managed?

What is the role of the corpus luteum during pregnancy?

What is the rate of spontaneous resolution of pregnancy-associated cysts?

How are corpus luteal ovarian cysts differentiated from follicular ovarian cysts during pregnancy?

How are ovarian cysts that do not resolve in pregnancy treated?

What are the treatment options for suspected malignant ovarian cysts in pregnancy?

Which ovarian conditions are unique to pregnancy?

What is the prevalence of simple ovarian cysts in postmenopausal women and what is the risk for malignancy?

What is the risk of malignancy for an ovarian neoplastic cyst in postmenopausal women?

What is the role of bilateral oophorectomy in the treatment of ovarian cysts?

When is transfer from the emergency department (ED) to another facility indicated in the treatment of ovarian cysts?

Which ovarian cysts should be considered for removal?

What are the surgical options for treatment of ovarian cysts and what are the goals?

What are the advantages of a laparoscopy in the treatment of ovarian cysts?

What are the contraindications to laparoscopy in the treatment of ovarian cysts?

What are the contraindications to the use of laparoscopy in the treatment of benign ovarian cysts?

How are malignant ovarian cysts treated?

What is the surgical approach for very large, benign-appearing ovarian cysts?

When is ovarian-sparing surgery indicated in the treatment of ovarian cysts?

When is removal of both ovaries indicated in the treatment of benign ovarian cysts?

When are consultations with a gynecologic oncologist considered in patients with ovarian cysts?

Which factors may protect against the development of functional ovarian cysts?

What is the role of an annual gynecologic exam in the prevention of ovarian cysts?

How should women at high risk for ovarian cystadenocarcinoma be managed?

Which specialist consultations may be needed in the treatment of ovarian cysts?

What is the treatment for hemodynamically unstable patients with ovarian cysts?

What should be considered prior to outpatient care for ovarian cysts?

What follow-up is required for patients with small benign-appearing ovarian cysts?

What follow-up is required if an ovarian cyst is larger than 5-6 cm or is multicystic?

Which ovarian cysts are more likely to require surgical intervention?

When is it most advantageous to perform surgery in the treatment of ovarian cysts during pregnancy?

What should be considered prior to selection of treatment for ovarian cysts in postpartum patients?

How quickly do ovarian cysts resolve in premenopausal patients?

Medications

Which medications are used for pain relief in patients with ovarian cysts?

Which medication may protect against the development of functional ovarian cysts?

Which medications in the drug class Analgesic Nonsteroidal Anti-inflammatory Drugs (NSAIDs) are used in the treatment of Ovarian Cysts?

Which medications in the drug class Opioid Analgesics are used in the treatment of Ovarian Cysts?