Talat Naz, Zubaida Akhter, Tanvir Jamal.
Oral contraceptives versus expectant treatment in the management of functional ovarian cysts.
J Med Sci Jan ;19(4):185-8.

Objectives: To describe the presentation of spontaneously occurring functional ovarian cysts and compare the effectiveness of oral contraceptive pills with expectant management in the treatment of these cysts. Material and Methods: This study was carried out in the outpatient gynaecological clinic of Hayatabad Medical Complex and Khyber Teaching Hospital, Peshawar from January 2009 to December 2010. Patients with functional ovarian cysts diagnosed on ultrasound were included. Ovarian tumours, malignancies, premenarche and post menopausal cysts were excluded. Patients were offered oral contraceptives or expectant management for 2 months. A repeat ultrasound was performed for cyst resolution. Results: Forty seven patients with functional ovarian cysts aged between 16-35 years (mean age 22.9 years + 3.5 years) were included. Nineteen patients (40.42%) were nulliparous while 14 (29.7%) were unmarried. In 13 (27.65%) it was incidentally diagnosed while other presentations were, pelvic pain 7 (14.89%), dysmenorrhea 7 (14.89%), menstrual irregularity 6 (12.76%) and infertility 6 (12.76%). The cyst size ranged between 2-3cm in 23 (48.93%), 3-4cm in 17 (36.17%) and 4-5cm in 7 (14.89%). Twenty two (46.80%) counseled for expectant management (Group A) and Oral contraceptives (Group B) were given in 25 (53.19%). Cyst resolution at 2 months by ultrasound was 72.72% in Group A and 80.0% in Group B. There were 2 persistent Cyst in Group A and 3 (12.0%) in Group B. Five patients were lost to follow-up, 3 in A and 2 in Group B. There was no statistically significant difference in Cyst resolution in the two groups. Conclusion: Functional ovarian cysts are common in women of reproductive age and are often asymptomatic. Expectant management achieves similar cyst resolution rates to oral contraceptives, and is a better alternative.

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