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Ovarian Cysts in Postmenopausal Women (Green-top Guideline No. 34)

Published: 19/07/2016

This is the second edition of this guideline, which was previously published in 2003, and reviewed in 2010, under the title ‘Ovarian Cysts in Postmenopausal Women’.

Update February 2017: Following a review of all guidelines in December 2016, some minor editorial changes have been made to this guideline since the original publication. The version available here is the most up to date. The date on the guideline has not been changed since no amendments were made to the content.

Ovarian cysts are diagnosed with increasing frequency in postmenopausal women as more patients are undergoing imaging in connection with medical care. An ovarian cyst inevitably raises the question of its relevance to the woman’s symptoms and concerns for the possibility of ovarian cancer. The understandable fear of malignancy has driven many patients and their care providers to pursue further testing and surgical investigation.

This guideline aims to clarify when ovarian masses can be managed within a general gynaecological service or when referral to a specialist gynaecological oncology service is appropriate. This should help in determining whether surgical or expectant management is more appropriate, and help to avoid unnecessary surgery or invasive or costly testing in the vast majority of patients in whom simple cysts are benign.

A useful clinical algorithm for the management of postmenopausal women with ovarian cysts can be found on page 6 of this guideline.

The management of confirmed ovarian malignancy is outside the remit of this guideline. Further information can be sought from the National Institute for Health and Care Excellence and the Scottish Intercollegiate Guidelines Network.

Declaration of interests (guideline developers)

Dr MK Mehasseb MRCOG, Glasgow, Scotland: Dr Mehasseb has received payment for lectures at the University of Leicester for the RCOG Membership examination, and is a member of the Advisory Board for Ethicon Endo-Surgery.

Dr NA Siddiqui FRCOG, Glasgow, Scotland: None declared.

Dr F Bryden FRCR, Glasgow, Scotland : None declared.