Ovarian cysts

Definition/Description

  • Ultrasound scan is initial investigation of choice – transabdominal and possibly transvaginal
  • Radiology will give guidance on further management but assess the patient clinically and continue to investigate if concerned
  • Radiology department at YHFT has a complicated algorithm (depending on size and features of cyst) and will offer guidance about management. If a referral to Gynaecology is recommended, then a CA125 should be considered

Red Flag Symptoms

  • Abdominal/vaginal mass, thought to be ovarian, will need urgent USS and CA125 or 2WW referral
  • Raised CA125

Guidelines on Management

Will be guided by radiology report of USS or CT/MRI
 

Indications for referral

  • As guided by scan report
  • Consider admission for a woman presenting with any ovarian torsion symptoms with a known ovarian cyst via Gynae registrar on-call
     

Examination Findings

Abdominal and vaginal examination – good clinical practice
 

Investigations prior to referral 

  • SS and CA125

Referral Criteria/Information

Information to include in referral letter

  • Symptoms and timescale
  • Current contraception / hormone therapy
  • Abdominal/vaginal findings
  • Smear history
  • USS result
  • CA125
  • Relevant past medical / surgical history
  • Current regular medication
  • BMI
  • Smoking status

Additional Resources & Reference

Patient information

Ovarian cysts before the menopause
 

References:

  1. Levine D et al. Management of Asymptomatic Ovarian and other Adnexal Cysts imaged at US; Society of Radiologist in Ultrasound Consensus Conference Statement. Radiology 2010; 256; 943-954
     
  2. Sauders B et al. Risk of malignancy in sonographically confirmed septated cystic ovarian tumours. Gynaecologic Oncology 2010 – 118; 278-282
     
  3. Greenlee R et al. Prevalence, incidence and natural history of simple ovarian cysts among women >55yrs old in a large cancer screen trial. American Journal of Obstetrics and Gynaecology 2010 ; 202-373 e 1-9
     
  4. Ovarian cysts in Postmenopausal Women. Royal College of Obstetricians and Gynaecologists 2003 Guideline No 34
     
  5. Ovarian masses in premenopausal women RCOG 20011 Green top Guideline 62

Associated Policies

There are no associated policies.

Specialties

Gynaecology York

Places covered by

  • vale-of-york

Hospital Trusts

  • york-and-scarborough-teaching-hospitals
Author: Responsible GP – Dr Omnia Hefni, SRCCG / Responsible Consultant – Ms Louise Hayes, YTHFT / Responsible Pharmacist – Ms Rachel Ainger, SRCCG Medicines Mngt
Date created: 13/08/2025, 10:12
Last modified: 13/08/2025, 10:12
Date of review: 30/9/24