When is surgery necessary to treat ovarian cysts? How large does an ovarian cyst have to be for surgery?
Ovarian cysts which are not part of a normal menstrual cycle are also known as ovarian tumours. Some tumours are filled with fluid (cystic) and some are solid, and some can have both characteristics.
Most ovarian cysts resolve spontaneously and are harmless. But if your cyst is causing you pain or discomfort or if it could be cancerous, you may need a surgery to remove it.
Surgery for an ovarian cyst may be advised in the following conditions:
- An ovarian cyst is larger than 7.5 cm (3 inch)
- Ovarian masses are present in both ovaries
- An ovarian cyst that is on watch is not getting smaller or resolves in 2 to 3 months
- An ultrasound diagnosis confirming that a cyst is not a simple functional cyst
- You have an ovarian growth and you:
- have never had a menstrual period (for example, a young girl)
- have been through menopause (post-menopausal woman)
- use birth control pills (unless you are using low-dose progestin-only pills or have missed a pill, which would make an ovulation-related functional cyst more likely)
- your doctor is concerned that ovarian cancer may be present. In this case, it is also advised that you see a gynaecologic oncologist
What is an ovarian cyst operation? What happens during ovarian cyst removal surgery?
Persistent or large ovarian cysts, or those cysts that are causing symptoms, usually need to be surgically removed. If your doctor suspect cyst to be cancerous or have concern of it getting cancerous in future, you may be advised for a surgery by your doctor.
More: Ruptured ovarian cyst
More: Ovarian Cyst During Pregnancy: How Do Ovarian Cysts Affect Pregnancy
Types of ovarian cyst surgery
There are two types of surgery used to remove ovarian cysts:
- A laparoscopy or keyhole surgery
- A laparotomy or open surgery
These procedures are usually carried out under general anaesthetic.
Laparoscopic ovarian surgery
This is also known as keyhole surgery where small cuts are made in your tummy and gas is blown into the pelvis to inflate your abdomen which allows the surgeon to access your ovaries. Most of the cysts can be removed using laparoscopy.
An instrument which is small, tube-shaped microscope with a light on the end called laparoscope is passed into your abdomen so the surgeon can see your internal organs. The surgeon then removes the cyst through the small incision in your skin. The cuts are closed using dissolvable stitches after the cyst removal.
This procedure of surgery is preferred because it causes less pain and has a quicker recovery time. You will be able to go home on the same day or the following day.
Laparotomy
If your cyst is very large, or there’s a concern that it could be cancerous, a laparotomy may be recommended.
In this procedure, a single, larger incision is made in your tummy so that your surgeon has better access to the cyst. The cyst and sometimes the ovary is removed and maybe sent for diagnosis to see whether it’s cancerous. Staple or stitches are used to close the incision.
You may be required to stay in the hospital for a few days after the procedure.
What to expect after ovarian cyst surgery?
You may experience anaesthetic effects after the procedure, and it’s different for everyone. You may find yourself not so coordinated or face difficulty in thinking clearly. This should settle within 24 hours. During this time you should not drive, drink alcohol, operate machinery or sign anything important.
You may be recommended to take rest until the effects of the anaesthetic have worn off. You may also need some painkillers to help ease any discomfort.
Your nurse may give you some advice about caring for your speedy healing of your wounds before you go home. They may also prescribe you some painkillers to take and might get a date for a follow-up appointment.
If your surgeon used glue or dissolvable stitches, these will disappear on their own. Other stitches may need to be removed by the nurse. This will usually happen around five to seven days after your operation.
What is ovarian cyst removal recovery time? How long does it take to recover from laparoscopic surgery?
Your body takes time to heal after surgery. But you’ll usually feel well enough to go back to your normal activities or work within a week after the procedure. The recovery time will depend on whether you had keyhole or open surgery.
Women who have laparoscopic surgery are almost always discharged the same day, with maximum pain control and speedy recovery.
What are the side-effects of ovarian cyst removal surgery?
There may be some side effects after the surgery. Most of them are temporary and may include:
- discomfort or pain in your lower tummy for a few days after your surgery
- some pain in your shoulders
- vaginal bleeding for up to 48 hours in small quantity
- feeling of tiredness more than usual for a few days
