Ovarian cyst surgery often unnecessary, say researchers

Many women may be undergoing needless and risky surgery to remove ovarian cysts, new research suggests.

Scientists found that non-malignant cysts only very rarely turned cancerous or caused harmful effects such as rupturing or ovary twisting.

They recommended a “watchful waiting” alternative to surgery that involves regular monitoring with ultrasound scans.

Ovarian cysts are fluid-filled sacs that develop in a woman’s ovary.

They are very common and usually cause no symptoms, but in some cases can trigger pelvic pain and bloating.

Some ovarian cysts turn out to be cancerous tumours and have to be surgically removed.

But many women with benign cysts are also asked to undergo precautionary surgery, which always carries the risk of complications.

To address this issue, an international team of researchers monitored the progress of 1,919 women diagnosed with non-cancerous ovarian cysts over two years.

A fifth of the women, from 10 different countries including the UK, had cysts that disappeared naturally, and 16% underwent surgery.

Overall, in 80% of cases cysts either resolved themselves or required no intervention.

Only 12 women from the group ended up being diagnosed with ovarian cancer.

According to the study, reported in The Lancet Oncology journal, the risk of getting cancer from non-malignant ovarian cysts was just 0.4%.

This may have been due to initial misdiagnosis rather than benign cysts turning cancerous, said the authors.

The likelihood of experiencing ovarian twisting was also 0.4% and of cyst rupture 0.2%.

Against this background, women undergoing surgery faced a 3% to 15% risk of complications such as bowel perforation.

Lead researcher Professor Tom Bourne, from Imperial College London, said: “Our results may lead to a paradigm shift resulting in less surgery for non-cancerous ovarian cysts – on condition that trained ultrasound examiners reliably exclude cancer.”

Marie-Claire Platt, head of campaigns at the charity Ovarian Cancer Action, said: “These research findings could save women with benign ovarian cysts from unnecessary major surgery, avoiding the risk of short and long-term surgical complications.

“However, we need to ensure these women receive appropriate and regular surveillance, in case a cyst is misdiagnosed and is in fact ovarian cancer.

“Both benign cysts and ovarian cancer can present in the same way, with symptoms such as bloating and pelvic pain. If you are persistently experiencing these symptoms, visit your GP immediately.”