الفهرس 
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Abstract
Ovarian cysts are small fluid-filled sacs that develop in a woman’s ovaries. Most cysts are harmless, but some may cause problems such as rupturing, bleeding, or pain; and surgery may be required to remove the cyst(s). It is important to understand the function of the ovaries and how these cysts may form. The number of diagnoses of ovarian cysts has increased with the widespread implementation of regular physical examinations and ultrasound technology. The finding of an ovarian cyst causes considerable anxiety for women because of the fear of malignancy, but the vast majority of ovarian cysts are benign. (Clement, 2002).
The most common types of ovarian cysts are the following: Functional cysts (follicular cysts, corpus luteum cysts and hemorrhagic cysts), Endometriotic cysts (endometriomas) and benign epithelial cysts (serous cysts, mucinous cysts and dermoid cysts) (American Cancer Society, 2009).
Functional ovarian cysts (follicular and corpus luteum) are a common gynecological problem among women of reproductive age worldwide. Hospital-based studies in the U.K. and U.S. have provided a range of reported incidences. In England and Wales from 1983 to 1985, the annual hospital discharge rate for women with a main diagnosis of ovarian cyst was 67 per 100.000 women (Westhoff and Clark, 1992).
The appropriate management of functional ovarian cysts is one of the most controversial problems facing the gynecologist today despite the different treatment modalities that are available (Crawford et al., 1995).
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Functional ovarian cysts typically disappear within 60 days without any treatment. Oral contraceptive pills may be prescribed to help establish normal menstrual cycle and decrease the development of functional ovarian cysts. (Skiadas et al., 2004).
The theoretical advantages of ultrasound- guided cyst aspiration are that surgery is avoided and cyst accidents are reduced. However, the role of this technique remains controversial (Balat et al., 1996).
The aim of the present study was to compare the different modalities of functional ovarian cyst management i.e expectant management and combined oral contraceptive pills (C.O.P). Persistent functional ovarian cyst will be managed by transvaginal ultrasound guided cyst aspiration.
Eighty patients with a probably functional ovarian cyst based on ultrasound criteria (unilateral, unilocular, no papilla or excrescences, 2.5-6 cm in diameter were randomly allocated into two groups after giving informed consent: Group A: women who will be managed expectantly. Group B: women who will be given combined oral contraceptive pills.
Women managed by either of the two modalities (Group A and Group B) will be followed up by transvaginal ultrasound monthly for three successive months to evaluate the size, and location of the functional ovarian cyst.
After three months, persistent functional ovarian cysts from two groups will be managed by transvaginal ultrasound guided needle cyst
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aspiration. Statical analysis was performed to evaluate the effectiveness of each procedure.
At the beginning of the study, the two groups were comparable with respect to age and ultrasound criteria of their functional ovarian cyst we found after 3 months remission in 31 (77.5%) women in group (A) and 34 (85.0%) women in group (B).persistent functional ovarian cyst undergo trans vaginal guided ultrasound needle aspiration we found after three months recurrence in five (55.6%) women in group (A) and three (50.0%) women in group (B).
Transvaginal guided ultrasound needle aspiration in such patient with persistent functional ovarian cyst was safe, effective with less morbidity, short hospital stay and early recovery.