ROLE OF PUNCTURE AND ASPIRATION IN EXPECTANT MANAGEMENT OF SIMPLE OVARIAN CYSTS - A RANDOMIZED STUDY

Objectives-To assess the potential of expectant management for simple ovarian cysts diagnosed by transabdominal or transvaginal ultrasonogra phy. To compare the results of needle aspiration with those achieved w ith simple observation. Design-Randomised trial. Setting-Hospital depa rtment of obstetrics and gynaecology. Subjects-278 women with simple c ysts randomly allocated to simple observation (143) or ultrasound guid ed fine needle aspiration (135) between 1990 and 1944.Main outcome mea sures-Resolution of cyst or development of malignancy. Results-After s ix months 269 were available for follow up. The rate of resolution was 46% (59/128) with aspiration and 44.6% (63/141) with observation. Onl y the diameter of the cyst (P<0.0001) was a significant independent pr ognostic factor for resolution in a multivariate analysis. Age and tre atment had no significant effect. One woman was subsequently found to have borderline malignant changes on histopathological examination. He r cyst was detected by transabdominal ultrasonography. Conclusions-Exp ectant management for up to six months does not cause risks for the pa tients and allows spontaneous resolution in over a third of cases, avo iding the costs and risks of unnecessary surgery. Aspiration does not provide better results than simple observation.