Published online Nov 10, 2015. doi: 10.5317/wjog.v4.i4.108
Peer-review started: May 9, 2015
First decision: July 10, 2015
Revised: September 9, 2015
Accepted: October 12, 2015
Article in press: October 13, 2015
Published online: November 10, 2015
AIM: To answer some questions related to the problem of ovarian simple cysts in asymptomatic postmenopausal women.
METHODS: A literature search and systematic review using MEDLINE (PubMed) database from 1980 to 2014 was performed using the following terms: “simple cyst”, “postmenopause”, “postmenopausal”, “ultrasound”, “ovary”, “ovarian”, “asymptomatic”. Papers not related to the topic, reviews, letters to editor, opinion letter, commentaries and studies published in non-English language were excluded. Two authors then reviewed the full paper of all the studies initially selected. This review does not claim to be a meta-analysis. Therefore, meta-analysis statistics were not applied and PRISMA guidelines were not strictly followed. Simple descriptive statistics were used providing absolute numbers and corresponding percentages as well as range.
RESULTS: Nine papers were ultimately included in this review, accounting for 98899 postmenopausal women. We have found that ovarian simple cysts are relatively common in asymptomatic postmenopausal women (prevalence: 8.7%). The risk of malignancy is very low (0.19%). More than 90% of these cysts were smaller than 5 cm. Bilaterality rate ranged from 3.7% to 15%. Histologically, most cysts are serous cystadenomas (61%). When managed conservatively, a significant number resolve spontaneously (46.1%) or remain unchanged (39%).
CONCLUSION: According to these data, conservative management should be the first option to offer to these women.
Core tip: The problem of ovarian simple cysts in asymptomatic postmenopausal women remains a controversial issue in gynecological practice. We have performed a literature review about this topic. We have found that ovarian simple cysts are relatively common in asymptomatic postmenopausal women. The risk of malignancy is very low. Histologically, most cysts are serous cystadenomas. When managed conservatively, a significant number resolve spontaneously or remain unchanged.