Ovarian Cyst Removal

What Is Ovarian Cyst Removal Surgery?

Ovarian cyst removal (ovarian cystectomy) is a surgical procedure done to remove an ovarian cyst. Whether to operate or not depends on the age and general health of the candidate, symptoms, and ultrasound findings of cyst position and size. Your gynaecologist may perform the ovarian cyst removal in any of the following conditions:

• Older cysts that persist for several menstrual cycles
• Large, rapidly growing cysts
• Persistent pelvic pain or discomfort
• Appears suspicious on ultrasound imaging
• Twists the ovary, causing ovarian torsion, a medical emergency
• Cysts that rupture and cause severe symptoms
• Those that interfere with fertility treatment
• Imposes pressure on nearby organs such as the bladder or bowel

What Symptoms Indicate a Problematic Ovarian Cyst?

Many ovarian cysts are symptomless and do not cause any problematic issues. Surgical removal is for larger and complicated cysts that cause:

• Persistent lower abdominal pain
• Pain during sexual intercourse
• Bloating or a feeling of fullness in the abdomen
• Frequent urination
• Irregular menstrual cycles
• Difficulty emptying the bladder
• Sudden severe pelvic pain (a medical emergency)
• Nausea or vomiting associated with severe pain (in ovarian torsion)

Types of Ovarian Cysts

Below are different types of ovarian cysts:

• Functional cysts: These are the most common type of cyst among premenopausal women. They are benign and happen when the process of releasing eggs in the ovaries is just a little bit off. The common types are follicular cysts and corpus luteum cysts.
• Pathological cysts: These cysts form outside of the menstrual cycle and may require observation by a doctor or surgery. Dermoid cysts, cystadenomas, and endometriomas are the three common types of pathological cysts.
• Cyst-related conditions: The most common cyst-related ovarian condition is the PMOS, formerly known as the polycystic ovary syndrome. This is associated with the formation of multiple, harmless cysts on the outer edge of the ovaries.

What are The Benefits of Laparoscopic Ovarian Cyst Removal?

Below, we listed the benefits of laparoscopic ovarian cyst removal:

• Smaller incisions, so less scarring
• Less postoperative pain
• Minimal blood loss
• Lower risk of infection
• Shorter hospital stay and faster recovery

How Do You Prepare For Ovarian Cyst Removal Surgery?

Before the ovarian cyst removal surgery, your gynaecologist will carry out a complete medical examination. This includes a blood and urine test, a pelvic examination, and an ultrasound scan. This is to confirm the fitness of the patient and to eliminate any chance of complications. You will also receive instructions on fasting, medications, and recovery planning prior to the procedure. At your first assessment, tell your doctor about any medicines you are taking and any serious medical conditions.

How Is Ovarian Cyst Removal Surgery Performed?

A gynaecologist surgeon will perform the ovarian cyst removal surgery under general anesthesia. It is performed either laparoscopically (small incision) or laparotomically (large open incision).

• Laparoscopy: This procedure is done most commonly by a gynaec-laparoscopic surgeon. It takes anywhere between 30 minutes and 2 hours, depending on the size and complexity of the cyst. The procedure involves making small incisions in the abdomen. A thin camera (called a laparoscope) is inserted to give a clear view of the pelvic organs. Specialized instruments are used to carefully separate and remove the cyst. Healthy ovarian tissue is preserved to whatever extent possible. The incisions are closed with dissolvable sutures.
• Laparotomy: This method is preferred for large solid ovarian cysts and those with cancerous suspicion. The gynecological surgeon will make a large incision on the abdomen to gain direct access to the ovaries, cyst, and its surrounding tissue.

In either of the methods, the removed ovarian cyst is sent for laboratory testing to check for cancerous cells.

How is Recovery After Ovarian Cyst Removal?

Recovery generally depends on the cyst size and surgical complexity. Most laparoscopic cyst removal procedures require a short recovery of 1-3 weeks. The incision wounds heal within a week, and you can walk slowly a few hours after the procedure. Mild discomfort with pain and soreness around incisions is common for a few days. It’s recommended to avoid strenuous physical exercises, heavy lifting, and sexual intercourse until complete recovery.

Are there any Risks and Complications?

While serious complications are rare, some less severe risks include: 

• Infection at the incision site
• Bleeding
• Accidental injury of surrounding organs
• Recurrence of ovarian cysts
• Formation of adhesions
• Very rarely, the ovary may have to be removed

When to See a Gynecologist?

Go to the follow-up visits scheduled for examination of healing. However, rush to the doctor if you have:

• Chronic pelvic pain
• Recurrent cysts of the ovary
• Menstrual pain (dysmenorrhea)
• Swollen abdomen
• Pain during intercourse
• Acute pain in the lower abdomen

Can Ovarian Cysts be taken out Without Taking out the Ovary?

Yes. In many cases, only the cyst is removed, and healthy ovarian tissue is left intact, especially in women who wish to conceive in the future. However, if the cyst is very large, if the cyst has twisted and cut off the blood supply to the ovary, or there is a high risk or a confirmed presence of ovarian cancer, then the ovary may have to be removed.

Does Laparoscopic Removal of an Ovarian Cyst Hurt?

The procedure is done under general anesthesia. After surgery, it is normal to be a little sore, and the pain generally goes away after a few days. Using the prescribed painkillers and following the aftercare steps during the early days following surgery will help with easier recovery.

Can Ovarian Cysts Come Back After Surgery?

Certain kinds of ovarian cysts can come back. Surgery will remove the cysts that are there, but it will not stop the body from creating new cysts. Regular follow-up with your gynecologist can help monitor ovarian health and deal with future problems as they arise.

Will Ovarian Cyst Removal Affect Fertility?

Most procedures for ovarian cyst removal are performed to preserve ovarian function. In ovarian cystectomy, the surgeon removes only the cyst, trying to save as much healthy ovarian tissue as possible. Your gynecologist will recommend the best treatment plan based on your age, your desire for fertility, size, the type of cyst, and your overall reproductive health. If the cyst is very large, causes severe damage to the ovary, or is suspected to be cancerous, the affected ovary may need to be removed (oophorectomy). Usually, removing one ovary does not make a woman infertile because the other healthy ovary can still make hormones and release eggs. However, if both ovaries are to be removed, natural pregnancy is no longer possible because ovulation stops.