Systematic Reviews
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Obstet Gynecol. Nov 10, 2015; 4(4): 108-112
Published online Nov 10, 2015. doi: 10.5317/wjog.v4.i4.108
Ovarian simple cysts in asymptomatic postmenopausal women detected at transvaginal ultrasound: A review of literature
Juan Luis Alcazar, Naroa Martinez, Leire Juez, Maria Caparros, Ana Salas, Tania Errasti
Juan Luis Alcazar, Leire Juez, Maria Caparros, Ana Salas, Tania Errasti, Department of Obstetrics and Gynecology, Clínica Universidad de Navarra, School of Medicine, University of Navarra, 31008 Pamplona, Spain
Naroa Martinez, Department of Obstetrics and Gynecology, Hospital Universitario Cruces, 48903 Bilbao, Spain
Author contributions: Alcazar JL contributed to literature search, study design, analysis of data, and writting draft; Martinez N contributed to analysis of data and draft approval; Juez L and Errasti T contributed to study design and draft approval; Caparros M and Salas A contributed to draft approval.
Conflict-of-interest statement: All authors declare having no conflict of interest.
Data sharing statement: I agree with this.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Juan Luis Alcazar, MD, PhD, Department of Obstetrics and Gynecology, Clínica Universidad de Navarra, School of Medicine, University of Navarra, Avenida Pío XII 36, 31008 Pamplona, Spain. jlalcazar@unav.es
Telephone: +34-948-296234 Fax: +34-948-296500
Received: May 8, 2015
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
Processing time: 185 Days and 12.4 Hours
Abstract

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.

Keywords: Ovary; Simple cyst; Diagnosis; Cancer; Management

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.