Pelvic Pain

Question 1

Management of premenopausal women with suspected ovarian mass

Answer 1

Asymptomatic/ incidental finding:

• 5cm in size- no follow up, clears in 3 cycles
• 5-7cm
  — annual follow up with USS
  — if persistent or increasing in size- offer surgery as unlikely to be functional
• > 7cm
  — consider MRI or surgery due to difficulty assessing entire cyst with USS

Question 2

Management of haemorrhagic cysts

Answer 2

Conservative with analgesia and observation.
Repeat scan in 12 weeks to confirm resolution

Question 3

Management of recurrent cyst rupture/ haemorrhage

Answer 3

Can be prevented by suppression of ovulation:
- COCP
- cerazette
- Depo Provera