Role of puncture and aspiration in expectant management of simple ovarian cysts: a randomised study

Abstract

Objectives-To assess the potential of expectant management for simple ovarian cysts diagnosed by transabdominal or transvaginal ultrasonography. To compare the results of needle aspiration with those achieved with simple observation.Design-Randomised trial. Setting-Hospital department of obstetrics and gynaecology.Subjects-278 women with simple cysts randomly allocated to simple observation (143) or ultrasound guided fine needle aspiration (135) between 1990 and 1994.Main outcome measures-Resolution of cyst or development of malignancy.Results-After six months 269 were available for follow up. The rate of resolution was 46% (59/128) with aspiration and 44.6% (63/141) with observation. Only the diameter of the cyst (P<0.0001) was a significant independent prognostic factor for resolution in a multivariate analysis. Age and treatment had no significant effect. One woman was subsequently found to have borderline malignant changes on histopathological examination. Her cyst was detected by transabdominal ultrasonography.Conclusions-Expectant management for up to six months does not cause risks for the patients and allows spontaneous resolution in over a third of cases, avoiding the costs and risks of unnecessary surgery. Aspiration does not provide better results than simple observation IntroductionA large study performed in 1989 by Campbell et al on more than 5000 healthy women found that roughly 6% had adnexal masses, 90% of which were cystic tumours.' Grimes and Hughes reported that ovarian

Aspiration Cytology of 147 Adnexal Cysts with Histologic Correlation

“…5,7,10,12,14,20,21,30 This rapid and well-tolerated procedure has been used for aspiration of cysts in pregnant women 11,14 and prenatally, 3,27 but, like any other invasive techniques, it is not absolutely risk free. 9,16,19 Consequently, its therapeutic indications 34 and diagnostic value are subject to ongoing debate, especially because of the low sensitivity 4,6,24 and occasional false positive result, 25,28,29 even when carried out by expert cytopathologists.…”

Isosexual Pseudoprecocious Puberty in a 2½-Year-Old Girl Presenting with Intense Skin Pigmentation

“…In addition, the likelihood of recurrence increased significantly with increasing diameter (O7cm, recurrence rate O70%). 14 This is a rare case of a 2½ year old girl with pseudoprecocious puberty due to a large ovarian follicular cyst presenting with intense pigmentation of breast areola and labia minora. The above symptomatology should alert a general gynecologist and refer the patient to a pediatric and adolescent unit, where a thorough evaluation should be done in order to reveal the source of estrogen production and assess the differential diagnosis.…”

One-Trocar, Video-Assisted Stripping Technique for Use in the Treatment of Large Ovarian Cysts in Infants

“…12 Moreover, there is a direct correlation between cyst diameter and higher rate of recurrence. 11 On the other hand, laparoscopic excision of cysts shows a very low rate of recurrence (4%; statistically significant P ! .0001).…”