| Even though ovarian cysts after the menopause are | | | | has in addition been found to correctly assess ovarian |
| less common, instances do crop up and may cause | | | | cysts. Examining the fluid cytologically from an ovarian |
| difficulties. Post-menopausal women with an ovarian | | | | cyst gives less precise results in order to find out if a |
| cyst that is not suitable for conservative management | | | | tumor is benign or not. The sensitivity is only |
| may have to have an oophorectomy. This operation is | | | | approximately 25 percent with a greater menace of |
| done to take out the ovary within a bag so as not to | | | | the cyst rupturing. |
| have the cyst break open in the peritoneal cavity. | | | | In the laparoscopic management of ovarian cysts in |
| Post-menopausal women are recommended to take a | | | | post-menopausal women, the recommendation is |
| sonographical CA125 test using transvaginal grayscale. | | | | often for oophorectomy instead of cystectomy. |
| Magnetic resonance imaging (MRI), computed | | | | Frequently the error is made in choosing ovarian cyst |
| tomography (CT), and Doppler scans are not as good | | | | fluid for a cytological assessment in an effort to |
| for the detection of post-menopausal cysts. | | | | identify cyst malignancy. The precision factor is only 25 |
| Transvaginal ultrasound is the best way to understand | | | | percent in this case and there is also the risk of the |
| the situation of ovarian cysts because it gives | | | | cyst disintegrating. It is the high threat malignancy index |
| enhanced detail and more sensitivity. Larger cysts | | | | that shows all ovarian cysts in post-menopausal |
| nevertheless should be examined transabdominally. | | | | women, which are suspected of being malignant. If a |
| Some seventeen percent of post-menopausal women | | | | laparoscopy indicates suspicious clinical findings, then a |
| contract ovarian cysts. There is no optimal solution for | | | | full laparotomy and other staging procedures are to be |
| cyst management. Most of them will disappear | | | | employed. These must be done by a surgeon qualified |
| spontaneously without any major impact. Ovarian | | | | for this as part of a multidisciplinary team working at a |
| cysts and malignancy do not seem to be correlated, | | | | certified cancer center. Therefore one may deduce |
| but there is a concerning rise in ovarian cancer in older | | | | that aspiration has no real role to play in the |
| women. If the cancer invades beyond the ovary then | | | | post-menopausal management of asymptomatic |
| survival is probably unlikely. Although it may be | | | | ovarian cysts. Nevertheless, in conjunction with |
| recommended to suspect all ovarian cysts of | | | | laparotomy and laparoscopy it might be a step in the |
| malignancy in a woman following the menopause, to | | | | preliminary surgical management. The extended midline |
| be entirely certain means a full laparotomy and staging | | | | incision should comprise biopsies from areas and |
| procedure. Studies done recently on post-menopausal | | | | adhesions under suspicion, the cytology in the form of |
| ovarian cysts from a group of 226 women indicates | | | | ascites or washings, BSO, TAH and infra-colic |
| that ovarian cysts that are smaller than 50 mm in | | | | omentectomy and laparotomy that is well documented. |
| diameter are benign and can be handled using safe | | | | If the cyst is malignant this may have grave further |
| management using regular examination of the | | | | effects on the probability of the patient surviving. |
| dimensions of the cyst and the concentration of | | | | Post-menopausal ovarian cysts in common with many |
| CA125. | | | | other chronic health ailments have no simple cause. |
| For a post-menopausal woman, ovarian cysts spark | | | | For this reason, classical medicine that only focuses on |
| two questions, the first about the best management | | | | a specific symptom will not be successful in remedying |
| and the second on where the treatment should be | | | | ovarian cysts. Several factors will in fact trigger the |
| done. A general gynecologist will be able to handle | | | | formation of an ovarian cyst. Some of these factors |
| women with low risk, but for women at an | | | | are directly responsible for ovarian cysts forming, and |
| intermediate risk level referral should be made to a | | | | others act indirectly to play a secondary part to |
| cancer unit and if the level of risk is high, they should | | | | worsen existing cysts. Although classical medicine may |
| be accompanied to a cancer center. When used with | | | | be of use in handling a primary cause, these indirect |
| an index to register the risk of malignancy, the revision | | | | factors will stay around and be the root of further |
| of management changes should be done accordingly. | | | | complications. A holistic program is the only way to |
| A typical test is the check on CA125 that is practiced | | | | free yourself from a complaint of post-menopausal |
| in over four out of five cases. A cutoff of 30 u/ml is | | | | ovarian cysts. Because multiple factors are at the root |
| used most often and the test sensitivity is 81 percent | | | | of ovarian cysts, the treatment needs to integrate |
| with specificity of 75 percent. The use of ultrasound | | | | multiple dimensions. This is the only way for getting to |
| has been registered at 89 percent sensitivity and 73 | | | | the real, underlying problems and removing cysts |
| percent specificity. Doppler sonography with color flow | | | | forever. |