Hemorrhagic ovarian cysts: Clinical and sonographic correlation with the management options

Background: Hemorrhagic ovarian cysts (HOCs) are commonly seen in clinical practice. Most of them disappear spontaneously with follow-up except in minority of cases in which surgical intervention is stated. Our aim in this study was to review the cases diagnosed as having HOCs in our hospital and clarify the clinical and sonographic features of both surgically and conservatively managed patients. Materials and methods: Forty-eight patients who had been diagnosed as having HOCs were enrolled in this retrospective study divided into 2 groups: the first was surgically managed after hospitalization and the other managed conservatively with follow-up. Clinical and sonographic features with management options of both groups were reviewed. Results: Out of 48 patients, 16 patients (33.3%) underwent a surgical procedure, and 32 (66.7%) managed conservatively. The two groups were comparable regarding clinical features. The sonographic features revealed that the mean volume of HOCs was 65.7 ml and the mean length of their greatest diameters was 4.8 cm. There was significant difference between both groups, as the values in surgical group were significantly greater than those in the conservative group (P < 0.05). According to the sonographic morphological pattern of HOCs, 8 cases (16.7%) showed a diffuse dense echo pattern mimicking a solid mass, 25 cases (52.1%) showed a sponge like pattern and 15 cases (31.2%) displayed a mixed cystic–solid pattern. Conclusion: Clinical, laboratory and ultrasound features of patients with HOCs can guide the gynecologists to the optimum management of such cases avoiding unnecessary surgery.