Management of Suspected Ovarian Masses in Premenopausal Women
Royal College of Obstetricians and Gynaecologists Guidelines for the “Management of Suspected Ovarian Masses in Premenopausal Women”
Mr Kaloo is the primary author of this National Guideline produced by the Royal College of Obstetricians and Gynaecologists.
Implications for practice:
The underlying management rationale is to minimise patient morbidity by:
- conservative management where possible
- use of laparoscopic techniques where appropriate, thus avoiding laparotomy where possible
- referral to a gynaecological oncologist where appropriate.
Laparoscopic management of presumed benign ovarian cysts should be undertaken by a surgeon with suitable experience and appropriate equipment, whenever local facilities permit.
If surgery is indicated, a laparoscopic approach is generally considered to be the gold standard for the management of benign ovarian masses. Laparoscopic management is also cost-effective because of the associated earlier discharge from hospital and less pain.
Women who are symptom free with small (less than 50 mm diameter) simple ovarian cysts generally do not require follow-up as these cysts are very likely to be physiological and almost always resolve within 3 menstrual cycles. Women with simple ovarian cysts of 50–70 mm in diameter should have yearly ultrasound follow-up and those with larger simple cysts should be considered for either further imaging (MRI) or surgical intervention.