From the Guidelines
Ovarian cysts should be managed based on their type, size, and symptoms, with watchful waiting and hormonal contraceptives being initial options for asymptomatic, small, simple cysts, as recommended by the most recent guidelines 1. The treatment approach for ovarian cysts depends on several factors, including the type of cyst, its size, and the presence of symptoms.
- For asymptomatic, small (less than 10 cm), simple cysts, watchful waiting is often recommended with follow-up ultrasounds to monitor for changes.
- Hormonal contraceptives like combined oral contraceptive pills may be prescribed to prevent new cyst formation, typically taken daily for 3-6 months.
- For painful cysts, over-the-counter pain relievers such as ibuprofen (400-600 mg every 6 hours) or naproxen (500 mg twice daily) can help manage discomfort. Surgical intervention becomes necessary for cysts that are large (greater than 10 cm), complex, persistent beyond 2-3 menstrual cycles, or causing severe symptoms.
- Laparoscopic cystectomy (removal of just the cyst) or oophorectomy (removal of the entire ovary) may be performed depending on the situation, as outlined in guidelines for ovarian cancer management 1. Emergency surgery is required if a cyst ruptures causing severe pain or bleeding, or if ovarian torsion occurs. The treatment approach balances the risk of complications against the likelihood of spontaneous resolution, which occurs in approximately 70% of functional cysts within 2-3 menstrual cycles, and factors associated with a reduced risk of ovarian cancer include the use of oral contraceptives, pregnancy and breastfeeding, bilateral tubal ligation, and removal of the ovaries 1.
From the Research
Tratamento de Cistos Ovarianos
Os cistos ovarianos são comuns e podem ser encontrados em exames de imagem realizados por outras razões 2. Existem várias opções de tratamento para cistos ovarianos, dependendo do tipo e tamanho do cisto, bem como da idade e condição de saúde da mulher.
Opções de Tratamento
- Observação: cistos simples podem ser seguidos sem intervenção, mesmo em mulheres pós-menopáusicas 3.
- Cirurgia: laparoscopia é o tratamento de primeira linha para cistos patológicos, como endometriomas e dermoides, se sintomáticos 4.
- Investigação e gerenciamento: abordagem sistemática para uma massa ovariana, incluindo exames de ultrassom transvaginal e transabdominal, e considerações de risco de câncer de ovário e encaminhamento 5.