Conservative Tx safe for many small ovarian cysts. (Asymptomatic Postmenopausal Women).

NEW YORK -- The development of high-resolution ultrasound in the past decade has improved ovarian imaging so well that many small, simple ovarian cysts that previously went unnoticed are now commonly detected in asymptomatic postmenopausal women.

Many of these ovarian cysts probably are getting managed too aggressively, Dr. Ivica Zalud observed during the 12th World Congress on Ultrasound in Obstetrics and Gynecology.

Between 5% and 17% of postmenopausal women develop simple ovarian cysts, which are small, unilocular, anechoic cysts with smooth walls, no papillary projections, and no solid components.

When physicians detect ovarian cysts--even simple ones in normal ovaries in low-risk patients--they feel compelled to do something, largely because little is known about the premalignant stages of ovarian cancer, said Dr. Zalud of the University of Hawaii at Manoa, Honolulu.

Surgical removal of incidentally detected cysts "has been practiced widely in the past 8 years, he said at the meeting.

A retrospective study in 2000 showed, however, that surgery for persistent ovarian cysts in 5,479 women did not affect the death rate from ovarian cancer (Lancet 355[9209]:1060-63, 2000).

Other data support more conservative management of some simple cysts in asympromatic women.