Article Text
Abstract
Introduction/Background*Ovarian cysts frequently resolve on their own, but little information on resolution is available for use in clinical practice. The objective of this study was to characterize the resolution of incident ovarian cysts in relation to cyst diameter, structure, age, body habitus, and menopausal status. These categorizations are important for decisions on whether to continue monitoring the cyst or intervene surgically.
Methodology A total of 2,638 women with incident cysts were selected who had undergone 51,356 transvaginal ultrasound examinations in the University of Kentucky Ovarian Cancer Screening Program and were negative for ovarian malignancy. Prevalent cysts were excluded as they would be examined with an undefined course of first appearance when defining resolution time. Other exclusions included women with concurrent ovarian malignancies, cysts with solid components, and cases where surgery interrupted the natural history of measured cysts. The descriptor reported here is cyst diameter used to relate findings to physicians discovering these structures by bimanual examination. The variables collected in this study were: age, BMI, cyst diameter, cyst structure (loculation/septation), family history of ovarian cancer, and use of hormone replacement therapy. All images were reviewed by a physician. Methods of analysis include t-tests, chi-square, and Cox regression analysis of cyst resolution times.
Result(s)*Women with a history of 1 or more cysts were included so that 2,465 unilocular and 1,420 septated cysts were available for analysis. Septated cysts (mean ± SEM, 3.8±0.03) had a larger diameter than unilocular cysts (3.4±0.03), P<0.05. The resolution of incident septated cysts was faster than unilocular cysts. Unilocular cysts, but not septated cysts, resolved the quickest in women 70+ years of age, and resolution was the most prolonged in women <40 years. No difference in resolution was observed between pre- and post-menopausal status nor BMI in the resolution of unilocular or septated cysts.
Conclusion*While septated cysts tended to have a larger diameter than unilocular cysts, they were observed to resolve more rapidly. Menopausal status and body mass index were not seen to have an influence on the time to resolution of unilocular and septated cysts. For the clinician, this study establishes expectations for cyst resolution based on a primary estimation of cyst diameter in a population where no malignancy was observed.