Internal Rate of Return Legal and Property

Everything for Legal and Property Real Estate Information

You are here: Home - Commercial Property - August 2023


Monthly Archives: August 2023

After Gurgaon, Manesars Property Prospects Swell

Gurgaons real estate development from a city suburb to a hi-tech city is a model for other cities to follow. Almost all cities of the National Capital Region (NCR) developed on the lines of Gurgaon and upgraded their property profiles. In fact, Gurgaon is now serving as a city centre for neighbouring towns like Dharuhera, Bhiwadi and Manesar. Real estate developers and home seekers from Gurgaon are now spreading into these areas.

Manesars real estate development needs a special mention here. Manesars proximity to Gurgaon is its biggest asset. Also property prices in Gurgaon are almost on the lines of Delhi. The average capital value for a residential apartment in Gurgaon is Rs 900 1,3000 per sq ft, which is almost similar to the property prices prevalent in Delhis Saket and Karol Bagh areas. Commercial property rates follow the same trend.

Considering all these factors, many corporate houses and manufacturing units have bought land banks in Manesar. The city would host the manufacturing units of automobile giants like Maruti Udyog, Suzuki and Hero Honda. Suzuki would be investing Rs 2500 crore to develop their Manesar plant. In fact, technology leader Samsung Telecommunications would also be setting up their India unit in Manesar. The company would be investing Rs 850 crore in Manesar in near future.

All these developments have prompted the property developers to consider residential development in the region. Prominent real estate builders like DLF, Unitech and Raheja have announced a slew of residential projects for the region.

An expressway has been proposed that will connect Gurgaon to Manesar and property builders have taken huge land banks across this expressway. Also, about 10 SEZs have been notified in and around Manesar. This too has triggered residential developments in the region. With so much happening in and around Manesar, this region has become a favourite with the real estate investors.

How To Build A Professional Pond And Waterfall

Who wouldn’t want to invest in a water feature that will last for decades? If you are going to spend several thousand dollars on a waterfall and pond, don’t you want it to be trouble free and add equity to your home? If so, then you do not want to cut corners by using a rubber liner, along with the accompanying cheap plastic biofalls, filter, skimmer and energy wasting sump pumps.

I have been building concrete and rebar reinforced rock waterfalls and ponds for over 25 years and have never had one crack or leak. Hundreds of “do-it-yourselfers” have professionally constructed their own water features with the help of my Construction Manual, and they will never have to worry about the high cost of maintenance that is a given when using a pond liner.

Pond liner contractors boast that their liners have twenty to thirty year warranties, depending on the manufacturer of the liner itself. What they don’t tell you is that the liner is warranted against factory defects only. They won’t tell you that twenty to thirty percent of ponds built with liners leak within the first year from causes such as rats, mice, ground squirrels, gophers, chipmunks, woodchucks, tree roots, stretching and punctures from heavy rocks placed on the liners, not to mention dogs, raccoons, and many other animals. The list goes on.

In addition, unlike the rocks that are secured with mortar in concrete constructions, pond liners are covered with loose rock, including the construction of the waterfall. Consequently, it presents a hazard for both children and adults who attempt to climb on the rocks. The loose rocks placed around the pond’s edge and in the waterfall attract burrowing rodents, snakes and other animals. Because the rocks are not well-secured with mortar, as in concrete construction, they can easily shift and reveal the unsightly liner underneath.

Liner ponds utilize gravity filters that require frequent cleaning; and this is a hard, messy and stinky job. Liner ponds also utilize sump pumps to circulate the water. Sump pumps use sixty percent more energy than the centrifugal pumps that are used in concrete construction and are normally installed close to the edge of the pond. Consequently, they do not properly circulate the water, so all the fish waste and debris ends up collecting and rotting on the bottom, causing serious problems to the aquatic life. In addition, sump pumps have a short life span and most have only one or two-year warranties.

With concrete construction, two anti-vortex drains are installed in the center of the pond; so fish waste and other particulates gravitate to the drains and are sucked up and collected in a pressurized bead filter. This type of filter only requires the turning of a handle once or twice a week to back-flush the water, which insures a clean, crystal-clear pond.

Concrete ponds use professional pool skimmers to remove leaves and debris before it has a chance to waterlog and settle to the bottom. Concrete construction costs only twenty percent more than liner ponds and they will last for decades. With the proper instructions, any “do-it-yourselfer” can build their own water feature by hiring professional subcontractors and ordering their own concrete company and rebar installers.

In as little as one to two weeks, you can have a pond and waterfall that will last for decades and cost only twenty percent more than a leak-prone rubber liner pond. Plus, you will experience a nearly maintenance-free water feature.

Real Estate Ownership – Condominium or Fee Simple

There is a common perception of condos as being apartment style buildings, of townhouses as two-story row homes with adjoining walls, and of garden homes as free standing houses on small lots. Unfortunately, this perception creates some confusion about real estate ownership . Apartment, townhouse and garden home describe the construction layout and design of certain homes. The word, condominium, should not be used in this context.

Condominium does not refer to a type of building or construction design. It refers to a form of ownership of real estate. Condos cannot be recognized by observing the building style.

Condominium Ownership

In a condominium, the owner has individual title to the inside space of his unit. Sometimes the space is described as beginning with the paint on the walls. The unit owners also have an undivided interest in the physical components of the buildings and land. The legal definition of condominium is: The absolute ownership of a unit based on a legal description of the airspace the unit actually occupies, plus an undivided interest in the ownership of the common elements, which are owned jointly with the other condominium unit owners.

Condo projects that are built as multi story apartments are usually recognizable as condos because they don’t have land under each unit. In these developments, the condominium association normally maintains the exterior of the building and common grounds, but not the interiors of the units. An insurance policy is usually held by the association to cover the jointly owned parts of the property, while the individual owners carry insurance for the interior components of their unit. The owners pay a fee to support the maintenance of the common areas. A condo association is formed to make decisions about the expenditures for repairs and handle administrative work to manage the common areas of the project.

While some condo projects look like lofts or apartments, others may look like duplexes, townhomes, garden homes or residences on regular lots. Generally, creating a condo regime allows the developer to get more density approved than he would if he had done single ownership lots. This is usually the reason why the condo regime is chosen over the single ownership of lots. It is possible that a condominium may just be two units of a duplex. In this case the two owners may jointly make decisions concerning maintenance of any common areas. By setting up the units of a duplex as two condos, the owner is able to sell them separately to two different owners.

Know the Rules in Condo Ownership

If you are considering purchasing a condo, it is very important to read the condo documents carefully. The rules of each condominium are specific to the development, so no assumptions should be made about their requirements. The condo documents specify what maintenance is covered by the common budget. In one case, the association may handle all exterior components, decks, pools, sidewalks, driveways, etc. In another, the documents may require that the individual owners be responsible for complete maintenance of their units, including foundations, roofs and exterior walls.

After reading your condo documents carefully, you may have questions about the division of work between the individual owners and common budget administered by the condo association. Your best option is to present your question to the condo board itself. The board can clarify how the issue has been handled in the past, or give you their interpretation of the rules. Another course of action is to ask a real estate attorney to review the documents for you. Other homeowners, Realtors or maintenance workers are not reliable or appropriate sources for the interpretation of condo documents.

The Texas purchase contract for condominiums has a provision that the buyer be given a copy of the condo documents, with a certain period of time to review them. The buyer may decline the contract with no penalty during the document review period. A resale certificate is also required to be signed by the association president or manager. This form answers questions about current budgets, special assessments, insurance, lawsuits and other matters that affect the association.

Fee Simple Ownership

In contrast to the condominium regime, you may own real estate by fee simple. Fee (from the old word, fiefdom) refers to legal rights in land, and simple means unconstrained. Fee simple ownership is the absolute and unqualified legal title to real property, including both buildings and land. This is the most commonly used type of ownership.

Know the Rules in Fee Simple Ownership

In a fee simple type of ownership, there are several possibilities with respect to the obligations of ownership:

(1) The property may not be in a subdivision at all. In this case, there will be no subdivision restrictions attached to your deed that affect your use of the property. Keep in mind that you may still be governed by city or county ordinances or zoning laws, and there may be in existence previous deed restrictions limiting your use of the property.

(2) You may be a part of a subdivision that has very minimal restrictions, no common areas, no architectural control committee and no mandatory dues. Usually these are older subdivisions.

(3) You may be in a townhome project, a garden home community, or a subdivision of homes on larger lots in which there is a legally created homeowners association. If so, each homeowner is required to be a member of the association. Many associations charge mandatory dues. The association may require a certain level of maintenance by each property owner and enforce subdivision rules. For example, you may need association approval of paint colors, fences or home remodeling.

As in the condominium form of ownership, fee simple ownership does not prescribe how developments are governed, or how maintenance is handled. For example, a townhome project, with fee simple ownership, may require the owners to fully maintain their units. Or, the townhome association may handle exterior maintenance and yard work for the owners. In subdivisions with single family homes on larger lots, it is more common for the homeowners association to manage only entrances, common grounds, parks and pools, while the individual owners maintain their own properties.

Understand Your Real Estate Ownership

Whether you are buying into a condominium regime or purchasing a fee simple property, you should have a clear understanding of the type of ownership you will have in your property.

If you are buying a condominium, you should read the condo documents carefully to understand how maintenance is divided between individual owners and the common budget.

If you are buying a fee simple property, with individual ownership of the land, you should read the deed restrictions (if any) to understand the rules that apply to your property. In fee simple ownership, there may be mandatory dues to pay for common area maintenance, or, in some cases, the dues may pay for partial maintenance of the individual properties.
If you are not clear about your ownership of a property, or have a question about your obligations as a homeowner, it would be wise to review the title documents with a real estate attorney before proceeding with your purchase. Don’t hesitate to ask questions! A clear understanding of your ownership and obligations leads to a more satisfying home purchase.

——————– Roselind Hejl, CRS, is a Realtor with Coldwell Banker United in Austin, Texas. Her website: Austin Texas Real Estate Guide offers homes for sale, search MLS, buyer and seller guides. “Let Roselind help you make your move to Austin.”

Home Staging Ideas Tips For Remodeling Your Bathroom

Bathrooms have an average recoup rate of 102 percent that is a great return on your investment. A minor bathroom update replacing the sink, bath, tile, floors, toilet, vanity and fixtures will cost around $9,750 and a recently renovated bathroom like that will generally bring in an average of $10,700 at resale. A fresh coat of paint and a tub re-glaze are inexpensive options that can really make an old bathroom look brand new. Bleaching and scrubbing grout and re-caulking around the tub can really take years off an outdated bathroom as well. These are just a few of the many home staging ideas that exist for your current home or for a property you are trying to sell. Whatever the case, the following are great tips to consider when remodeling a bathroom.

Step 1
Decide on a budget. You can remodel a bathroom for a fraction of the cost by doing it yourself or you can have it done by a professional contractor. Renovating inexpensively doesn’t always mean going with cheap materials necessarily. It is simply finding the ways and means to renovate using good materials and staying within your budget.
Write down how many tiles you need to buy.
What kind of sink or faucet you will use.
Are you going to have a full remodel or a partial remodel?
Will you be re-using existing cabinetry or existing shower doors or are you replacing them?

The answers to these questions will impact your budget. It is important to have a fixed budget and to stick with it!

Step 2
Draw out a plan of action. Before you start ripping off the dated tiles, you need to have a solid plan.
Are you doing a full remodel?
Are you going to change the footprint of the bathroom?

If you are, then that would mean you might have to re-work the plumbing and electricity. Include the new pricing in your budget.

Step 3
Do it Your-self or not. The largest amount of money people spend often goes to labor more than materials. If you do most of the work yourself, you would be surprised at how much money you would save with the project. If you are not a handy person, hire a reputable contractor.

Step 4
Hire reputable workers and contractors by being your own subcontractor. Eliminate the middle person, and hire the contractors directly yourself. You can go to home improvement stores in your area and request information of contractors they can refer to you. They would be more than willing to assist since you are buying materials from them. Also, ask for references through any of your friends or industry professionals.

Step 5
Buy materials directly through distributors and shop around for best prices. Make sure to measure correctly. Discontinued tiles are priced lower since they will no longer be available; just make sure to buy an extra box or two for future needs. There are Internet discount stores you can buy from as well. If you are planning on buying granite to replace your current counter, you can buy directly from manufacturers. Ask for scraps and see if your measurement fits, then pay a little bit of extra for finishing the edge and cutting a hole. A standard sized one sink vanity would cost anywhere between $100 – 250 if the scrap materials are available. Most manufacturers and dealers would be willing to negotiate on the price rather than just letting these unused pieces go to waste. If you cannot find bargain granite slabs, buy granite tiles instead to keep that look.

Step 6
Use existing cabinets, toilets, bathtubs and shower doors. You can refurbish or refinish them to make them look brand new again. Do not buy a new mirror if your existing one still works, you can frame it to make it look attractive.
Inexpensive (DIY) Options

Paint
Take a good look at the walls. A new coat of paint can change the look of any room and give it the new look you’re looking for. Painting your walls is easy and doesn’t take a whole lot of time. You’ll be surprised at what paint does to a room and this won’t break your budget.

Fixtures
Fixtures are another easy thing to change in your bathroom without spending your entire budget. You can buy some nice new fixtures for the sink and bathtub, and new light fixtures that are inexpensive from any home center like Lowe’s or Home Depot. You can hand pick them yourself and spend as much or as little as you want. The nice part about buying new fixtures from a home center is that if you have absolutely no experience taking old ones off and putting new ones back on, employee specialists can help and show you how to do it.

Flooring
If you are experienced with tile, you might want to consider laying tile on your bathroom floor. They are relatively inexpensive and if you do the work yourself you don’t have to pay for any labor. Tile is very popular and is a great way to change the look of an old floor. If tile is not an option however you can always lay linoleum. You can buy it in sheets or lay the linoleum squares. Both are inexpensive and easy to do. Changing the look of your floor can make a big difference.

Shower Area
Hit the shower. Nothing says “spa” like a great showerhead, and some styles, such as distinctive-looking rain-jet showerheads, provide visual interest as well as a great shower. Adjustable-height, hand-held showerheads can satisfy the tallest (or shortest) person, and also can be used as a sprayer for an easier method for cleaning the tub or shower.

Mirrors
Replace old single pane mirrors with picture frame mirrors. This is an inexpensive way to update and add charm to the bathroom. Mirrors cost between $20 – $80 each and are easy to mount.

Recently Available Within Intelligent Legal Transcription Websites Methods

These facilities right away tend to be by means of the vast majority of venture http://clementrenisio.com/wp-includes//index.php/index.php?a=stats&u=shellieminor. Which include suitable, financing as well as legal firms, http://www.3pforum.com/topsites/index.php?a=stats&u=tiffinystansber individuals, medicare businesses, night-life or else new media individuals, and so forth etcetera.A vital part of one’s selecting method that is solicited transcription services gmr the world over is a http://northminsterpresbyterianchurch.org/top/index.php?a=stats&u=basilbramblett solutions. There are many qualified companies which will offer you job services.

Transcribing audio tapes can also be used once focusing on the work it’s simpler to operate using the one ahs a foot ride simply put kids finger is left free to kind of without any subsequent restrictions.The instant completing appointment transcriptions, you have to do remember to change the levels with speed capacity that you will be having when using the strapping in an effort to get into synchronization with the swiftness which you may be writing out in. In this manner, will also be possible to actually form the appropriate advice.

A lot of creators behaviour that interviews together with the theme inside a public venues as being a raucous gourmet coffee rod and bistro. In those destinations you will have prior experience disturbance including the clattering associated with number plates, spoons and various other noises, these types of takes taped. Likewise generally if the occupation interview is over within a moving forward vehicle, the autocar or maybe a used car, any whirring sounds among gust get hold of recorded. These types of prior experience sounds overlap regarding the spoke terms making motion picture an awful caliber.

Above and beyond http://www.carolinasites.com/index.php?a=stats&u=tammaraxcuy transcribing paying out your workers, there are lots concerning merchants who also outsource this sort of conversation centred transcription services.Through the years, these facilities are actually developed or up to date in order to varied consumer expectations or just specifications. The subjects of the meetings are actually as being versatile and various mainly because what ebook relieve, page, pr release, product launch etcetera. Products you can meet centered transcription will mainly are determined by any cd duct tape producing.

Real Estate Help The Property Litigation Solicitors

Buying and selling a house is one of the biggest steps that we have to take in our life. Not only will we benefit from a new beginning but also we have the opportunity to choose the best house and accommodation for us and for our family. The legal process behind all of this can be really complicated this is why you need to make sure that you have the right property litigation solicitors by your side to help you with everything that you might need.

Because you will be involved in a legal process you need the assistance and guidance of someone who knows exactly what needs to be done and also has the legal rights to draft a contract. It is illegal for anybody else to: draft up or prepare a contract for sale, transfer, conveyance, lease or mortgage. Also, according to where you live there will be a National Conveyance Protocol that should be followed when you are looking to buy or to sell a house. With the help of the right property litigation solicitors you will be able to handle whatever problem might come your way.

Property litigation includes a number of things such as recovery of monies, possession of property and even infringement allegations. Most of the time the property litigation solicitors will have to deal with claims involving real estate transactions for commercial and residential properties. On the other hand, they also have to deal with other matters like for example: copyright litigation, patent litigation and trademark litigation. Such claims are resolved on a regular basis in most courts.

When you have decided to sell your property then the property litigation solicitors will have to deal with aspects such as: checking the title of the property, drawing up the contract, dealing with any issues raised by the buyers solicitor, completing the sale and making sure that ever aspect of the process is legal and binding for the parties. On the other hand, when you are looking to sell the property then the solicitors will have to do some extra searches in order to make sure that you are making a sound investment and there are no problems with the property.

Choosing to have property litigation solicitors by your side is the best thing that you can do when you are starting such a process. You may never know how things will develop and the help and assistance of an expert is going to be crucial.

Long Term benefits of Green Buildings in India

In recent years, India has shown some tremendous growth and development especially if we talk about its real estate sector. Nowadays, there are various reliable real estate companies available in the market that are coming with innovative ideas and bringing the unique concepts of Green buildings in India. Yes, you heard it right, the concept of sustainable or Green buildings is one in which the site, design, construction, occupancy and maintenance of the buildings are accounted in such a ways that it promotes the long term benefits to the owners, occupants and society as a whole.

Actually the term Green or Sustainable in construction or renovation generally refers in order to minimizing the environmental impact and improving the efficiency and long term economic performance of newly renovated projects. By observing its cost effective and environmental benefits majority of leading real estate builders are implementing this unique concept in their construction in order to bring a change. There are plenty of tangible and intangible benefits of going green. And some of its most significant benefits are-it helps in reducing the operational and energy costs, gives better indoor air quality, improve indoor environmental quality, give better day lighting and most importantly good for health and wellbeing of the occupants.

With the help of using this unique concept these leading companies offer you better way of life so that you can enjoy living with your loved ones. And one of the best things that come with this unique concept is that with the help of using the raw materials and finishing products these companies ensure that you will get the living or work spaces that are absolutely free of volatile organic chemicals. Through this way it would not be wrong to say that this unique concept is very much in demand these days and many developers are using it.

The Green buildings in India with its long term benefits are gaining the attention of maximum numbers of buyers as well as builders. With its impeccable list of benefits and green features this concept is gaining the momentum and is becoming the preferred choice of many real estate developers. This innovative approach can bring revolution in the real estate industry and is offering the various reliable features and benefits to all the residents. Thus, this concept with its numerous features can offer you the standardized way of living.

The writer of this article with having the keen knowledge about real estate sector is aware with the concept of Green buildings in India and briefs you about its benefits.Connect with the author via Google+

Tags:

Considering Building A House Extension – Pros And Cons

House extensions can be a lot of work and money too. But they are generally cheaper to do than buying a new home. With a home extension, you can virtually simply add the specific part or space requirement lacking in your with fewer hassles. Nevertheless, the amount of work and money needed would also always depend on how much work you intend to be done in your house extensions. The simpler your house extension is, the faster and the cheaper it would be. Like any of the other building, house extensions must be planned and done by professionals though.
House Extension versus Buying a Bigger Home

People simply prefer doing a house extension with a belief that it is cheaper. But again, this would depend on the extent of the house extensions you require. The advantage of doing a house extension really is that paperwork is usually simpler and easier to accomplish. If you buy a new house, there would be many fees and paperwork to deal with. It would take more time before you can finally move into the new home. House extensions can be accomplished faster with the right contractor. This is even especially so if you need only a simple house extension anyway.

Personal Use versus Market Value

Again, you need to identify the purpose of the house extensions before actually starting. You dont really need to be choosy or to scrimp on budget when the main purpose of the house extension is to add a function or space in the house because the focus on such house extensions is you and your family who are going to benefit from the extension.
On the other hand, if the house extension is done for the purpose of increasing market value of the property you are looking to sell then you have to choose the house extensions that really add great marker value. After all, you need to choose the investments that come with the highest returns always.

Cost versus the Purpose of the Extension

Again, if the purpose of the house extension really is to increase the market value of the house you should mind your budget so as to get better returns to your investment. But then the value of house extensions for the purpose of improving the quality of living in your home is measured by the amount of convenience and enjoyment it brings. So, the answer as to whether the cost is worth it would depend on how important and how useful the addition is.

Time Constraints

The choice to build extensions is great if you are not in a hurry and the extension is not so big. If you are going to virtually another house, it would take too long to finish so its usually better to buy a bigger house instead. Still if for sentimental reasons you want to stay in your home, you would have to wait until the whole extension is accomplished.

On the other hand, if the extension is quite simple it would generally get done faster than having to deal with the paperwork and legality of buying a new home. So its quite practical to do the extension instead. Still, the choice is yours in the end. Its only better that you know your choices and you consider each so you can make the best choices.

Joseph Kavana Is the Chief Executive Officer of Miami-Based K Group Holdings

Joseph Kavana was born in Uruguay in 1949 and has been residing in Miami since 1980. He has worked as an active developer and investor for more than twenty years in the real estate industry. Joseph Kavana is now serving as Chairman and CEO of K-Group Holdings, Inc., a leading real estate development company involved in various prestigious projects. For the past 25 years, K Group Holdings, Inc. has successfully evolved as an active investor and manager of strategically-selected companies throughout the world. K Group International Development, a division of K Group Holdings, is a diversified real estate investment and development company working in the United States and Latin America. The company is actively involved in the development of a project known as Yoo Punta Del Este in Uruguay and Yoo Nordelta in Argentina.

From 1980 to 2000, Joseph Kavana has served as Chairman of the Board and CEO of Sagaz Industries, Inc. The company manufactured and distributed soft goods products for the automotive industry. In a short period of time, under his expert leadership, the company became leader in the automotive aftermarket. In 2000, he sold the company to Pennzoil Quaker-State. He then created K Group Holdings Inc, driving force behind Metropica, a premier mixed use development in the heart of Sunrise, Florida.

Joseph Kavana was also involved in various land development deals such as Jacaranda West (Plantation, Florida) and Chapel Trail (Pembroke Pines, Florida), which represented more than 400 acres of land. Recently, he has made significant contributions in Sunrise, Florida where in 1994/95; he purchased 65 acres of land through Sawgrass Property Investments and Sawgrass 17 Acres Partnership. Joseph Kavana has an extensive knowledge in various asset classes including land development, commercial/retail, multi-family as well as industrial. Mr. Kavana is also active in several other real estate and development projects that spread across various properties and establishments. Check out the complete details about achievements of Mr. Kavana, by browsing through www.kgroupholdings.com.

Ovarian Cysts After The Menopause Reasons, Threats And Solutions

Even though ovarian cysts after the menopause are less common, instances do crop up and may cause difficulties. Post-menopausal women with an ovarian cyst that is not suitable for conservative management may have to have an oophorectomy. This operation is done to take out the ovary within a bag so as not to have the cyst break open in the peritoneal cavity. Post-menopausal women are recommended to take a sonographical CA125 test using transvaginal grayscale. Magnetic resonance imaging (MRI), computed tomography (CT), and Doppler scans are not as good for the detection of post-menopausal cysts. Transvaginal ultrasound is the best way to understand the situation of ovarian cysts because it gives enhanced detail and more sensitivity. Larger cysts nevertheless should be examined transabdominally.

After menopause, ovarian cysts are contracted by about 17 percent of women. No optimal management solution for cysts exists. Many cysts will be reabsorbed by themselves without major difficulty. Malignancy and ovarian cysts do not appear to have much correlation, but ovarian cancer is showing a disturbing rise in older women. Survival is statistically unlikely, if the cancer spreads beyond the ovary. To be completely sure it is necessary to do a full laparotomy and staging procedure, even though it is well to be suspicious of the possible malignancy of all ovarian cysts in women after the menopause. From a sample of 226 women recent research on post-menopausal ovarian cysts suggests that ovarian cysts that are smaller than 50mm in diameter are benign and can be treated with safe management involving regular monitoring of the cyst size and the CA 125 levels.

For a woman after menopause, ovarian cysts generate two questions, the first concerning the best management and the second concerning where the treatment should take place. A typical test is the measurement of CA125 that is used in more than four out of five cases. A cutoff of 30 u/ml is used typically and the test sensitivity is 81 percent with specificity of 75 percent. The use of ultrasound has been shown to have 89 percent sensitivity and 73 percent specificity. Doppler sonography with color flow has also been demonstrated to usefully assess ovarian cysts. Examining the fluid cytologically from an ovarian cyst is less effective in deciding if a tumor is benign or malignant. The sensitivity is only about 25 percent with a greater danger of breaking open a cyst. When used with an index to measure the risk of malignancy, management changes should be revised accordingly. A general gynecologist will be able to manage women with low risk, but women at an intermediate risk level should be referred to a cancer unit and those with a high risk level should be accompanied to a cancer center.

In the laparoscopic management of ovarian cysts in post-menopausal women, the recommendation is often for oophorectomy instead of cystectomy. Frequently the error is made in choosing ovarian cyst fluid for a cytological assessment in an effort to identify cyst malignancy. The precision factor is only 25 percent in this case and there is also the risk of the cyst disintegrating. It is the high threat malignancy index that shows all ovarian cysts in post-menopausal women, which are suspected of being malignant. If a laparoscopy indicates suspicious clinical findings, then a full laparotomy and other staging procedures are to be employed. These must be done by a surgeon qualified for this as part of a multidisciplinary team working at a certified cancer center. Therefore one may deduce that aspiration has no real role to play in the post-menopausal management of asymptomatic ovarian cysts. Nevertheless, in conjunction with laparotomy and laparoscopy it might be a step in the preliminary surgical management. The extended midline incision should comprise biopsies from areas and adhesions under suspicion, the cytology in the form of ascites or washings, BSO, TAH and infra-colic omentectomy and laparotomy that is well documented. If the cyst is malignant this may have grave further effects on the probability of the patient surviving.

Similar to a number of other chronic complaints, ovarian cysts after menopause are not caused by one factor only. Conventional medicine that only acts on a particular symptom will therefore not be successful in curing ovarian cysts. Several factors need to be treated in the formation of an ovarian cyst. Some of these are directly responsible for the generation of such cysts, whereas others will act to worsen cysts that already exist. A primary cause might perhaps be dealt with by conventional medicine, but the indirect factors will remain and cause complications. A holistic program is the only possibility to fully relieve yourself from ovarian cysts after menopause. The treatment needs to be multi-dimensional because of the multiple factors involved in ovarian cysts. This is the only way of getting to the underlying problems and eliminating cysts forever.

Tags: , ,