Ovarian cysts removal or observation

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Woman Front Stomach Painful Sign Of endometriosis gas endo belly

Women do not always have to have surgery for non-cancerous ovarian cysts. Being careful and not over-operating can avoid possible surgical complications.

The two-year study tracked 1919 women from 10 different countries including the UK, Belgium, Sweden and Italy who were diagnosed with non-cancerous ovarian cysts.

All cysts that were felt to be malignant or cancerous were removed.  This was based on ultrasound and other factors.

An alternative to surgery for those cysts that do not look obviously malignant, however, is what is known as “watchful waiting”, in which doctors do not remove the cysts, but instead monitor their size and appearance with regular ultrasound examinations. This is because many cysts shrink and go, or don’t change over time.

Of the 1,919 women in the study, one in five (20 percent) had cysts that went away on their own, and 16 percent had surgery. Overall, in 80 percent of the cases, the cyst either resolved or did not require intervention. The mean age of the women in the study was 48 years and the mean size of the cyst was 4 cm.

Only 12 women were later diagnosed with ovarian cancer, increasing the cancer risk to 0.4 percent. However, the researchers warn that this could be because the tumors were initially mistakenly diagnosed as non-cancerous rather than a benign cyst that becomes cancerous on the first ultrasound scan.

The rate of other complications such as ovarian twisting or cyst rupture was 0.4% and 0.2%, respectively.

The research team says these risks need to be assessed along with the risks of surgical removal. The risk of complications such as bowel perforation from surgical removal of cysts in women aged 50 to 74 years is between 3 and 15 percent.

So a discussion with your surgeon about risks and benefits before surgery is very important.  There is a risk of over or undertreating ovarian masses and cysts.  Consult with your trusted surgeon.

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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 (https://icarebetter.com/doctor/dr-steven-vasilev/). 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.