Ovarian cyst/pelvic mass

This condition is treated in the Gynaecology clinic.

Emergency Referral Criteria

Criteria for Emergency include: 

• Ruptured haemorrhagic ovarian cyst with uncontrolled pain and/or haemodynamic compromise
• Ectopic pregnancy 
• Ovarian torsion 
• Acute/severe pelvic pain 
• Significant or uncontrolled vaginal bleeding 
• Severe infection 
• Abscess intra pelvis or PID 
• Bartholin's abscess/acute painful enlargement of a Bartholin's gland/cyst 
• Acute trauma including vulva/vaginal lacerations, haematoma and/or penetrating injuries 
• Post-operative complications within 6 weeks including wound infection, wound breakdown, vaginal bleeding/discharge, retained products of conception post-op, abdominal pain 
• Urinary retention 
• Acute urinary obstruction 
• Any molar pregnancy 
• Inevitable and/or incomplete miscarriage 
• Hyperemesis gravidarum 
• Ascites, secondary to known underlying gynaecological oncology 

If you, or someone else, are experiencing a serious and life-threatening injury or illness call triple zero (000) immediately or go to the nearest Emergency Department.

Learn more about when to access emergency care and non-emergency care options if the injury or illness is not serious or life-threatening.

Statewide Referral Criteria (SRC)

Criteria for referral to public hospital specialist clinic services

Red flags are clinical indicators of possible serious underlying conditions requiring further medical intervention. They may or may not indicate an emergency.

Urgent (Category 1)

• Suspicious of malignancy or high-risk features
  • USS findings such as solid areas, papillary projections, septations, abnormal blood flow, bilaterally or ascites 
  • ovarian cyst greater than 8cm 
  • elevated Cancer Antigen 125 and cyst greater than 5cm in premenopausal patients or any size cyst in post-menopausal patient 
• Significant pain and/or due to risk of torsion 
• Pre-pubertal patient 

Semi-urgent (Category 2)

• Persistent ovarian cyst greater than 5cm on 2 pelvic USS 6 weeks apart 
• Complex cyst (haemorrhagic, endometriotic or dermoid) 
• Persistent pelvic pain 

Routine (Category 3)

• Hydrosalpinx 

Information to be included in the referral

(Referral may be returned without this)

Essential supporting information

Pathology

• FBC
• Cancer antigen 125

Imaging

• Pelvic Ultrasound  
• Transvaginal pelvic USS should be done when indicated

Note: If delay obtaining a USS may impact critical care this should be clearly indicated in the referral, however the scan should still be booked. Phone discussion on a case-by-case basis may be needed. 

Investigations/other

• Any relevant

Additional information

• History including pain and other symptoms
• Dates and results of pelvic ultrasounds

Interim/GP management

To refer a patient with this condition, please see the Gynaecology clinic page for the full referral process and templates.

For simple (non-suspicious) cysts under 4cm - repeat ultrasound after menstrual period if applicable.

For more information please see the HealthPathways Tasmania website.

Additional resources

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