Many ovarian cysts do well without surgery

Many ovarian cysts do well without surgery

The G.O. Institute and Dr. Steven Vasilev MD encourage you to be careful when you are told you have ovarian cysts.  Depending upon what type of cyst it is and how old you are, surgery may or may not be your best choice.  There is a danger of overtreatment for simple “physiologic” cysts, as well as the danger of undertreatment when the cyst is a tumor, especially a cancerous tumor. This information may help you decide if you need a second opinion or not.

“Non-suspicious adnexal masses had a low risk of malignancy, and many of the lesions resolved spontaneously, according to a large prospective conservative treatment study.

During a median follow-up of 27 months, less than 1% of 1,919 patients had an invasive malignancy or a borderline tumor at surgery. Torsion and cyst rupture also occurred in less than 1% of the cases.

Spontaneous resolution within 2 years occurred in 20.2% of cases, Dirk Timmerman, MD, of KU Leuven in Belgium, and co-authors reported online in the Lancet Oncology.

Timmerman found that surgical removal of adnexal masses in women aged 50 to 74 years has a 3 to 15% risk of complications. In a statement, he said, “Despite these low surgical risks, if the women in this age group in our study had surgery, then we could speculate that 29 to 123 of them might have had serious surgical complications.”

Instead, fewer than 100 patients were operated on in the study. The results suggest that most women with ovarian cysts can be safely observed.

The main remaining results were as follows:

  • Invasive malignancy during surgery: 0.4%

“Our results suggest that the risk of malignancy and acute complications is low when adnexal masses with benign ultrasound morphology are treated conservatively,” the authors concluded. “This information could lead to a reduction in the number of women who have surgery for benign adnexal pathology.”

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“I help and guide women to beat endometriosis and gynecologic cancers that are associated with endo, like ovarian cancer, using a unique combination of minimally invasive robotic surgery, precision medicine therapies and complementary holistic natural support towards thriving in survivorship." Dr. Vasilev is the only physician triple board certified in Ob-Gyn, Gynecologic Oncology and Integrative & Holistic Medicine in the United States. He is an accomplished advanced robotic master surgeon, and is internationally vetted by iCareBetter ( He serves as Professor at the world-renowned Saint John's Cancer Institute in Santa Monica, California and is Clinical Professor at Loma Linda University School of Medicine. He is former faculty and professor at UC Irvine, UCLA, USC and City of Hope and was the founding Medical Director of Integrative Medicine at Providence Saint John's Health Center. He is an active member of multiple medical societies and has been nationally listed in "Best Doctors" for over 20 years.