Do Ovarian Cysts Usually Need To Be Surgically Removed?

Pictures of ovarian cysts
Should All Ovary Cysts Be Surgically Removed?

No, not all ovarian cysts need to be surgically removed. Functional cysts (by far the most common type) rarely need surgery because they tend not to produce serious problems and often clear up on their own. Surgery is only usually recommended in the following situations:

• A cyst is larger than 5cm.
• Oral contraceptives do not suppress the cyst after 2 or 3 months.
• A cyst is persistently painful. See what causes ovarian cysts to rupture?
• An ultrasound examination suggests that the cyst is not an ordinary functional cyst. It may be a solid dermoid cyst containing teeth or hair; or a cystadenoma which can become cancerous.
• You have a cyst and have never had a menstrual period.
• A cyst starts to grow after menopause. While the vast majority of such cases are benign, the risk of a cyst turning cancerous postmenopause is much higher. At the very least the cyst should be monitored periodically for signs of changes.
• You have a cyst and are taking contraceptive pills which should technically prevent growths. The only exception is if you are taking low dose progestin-only pills or have missed a pill - both situations can make a functional cyst more likely.
• The doctor is concerned you may have ovarian cancer.

Useful Articles
Locate the ovaries: Diagram of the female body.
Other gyno medical issues: Reproductive system disorders.
From puberty to menopause: Development of the female body.

How Are They Removed?

Initially your doctor may recommend laparoscopy to diagnose the presence of ovarian cysts (and to rule out other conditions such as endometriosis, uterine fibroids or pelvic infection). During this surgery (sometimes called keyhole surgery), a small incision is made through the tummy and a thin scope with a camera on the end is inserted. This allows the surgeon to investigate the problem more closely. Sometimes the surgeon will need to create a larger incision in the abdomen to see the organs. This is called a laparotomy. Laparotomy is more commonly used when cancer is suspected because it gives the best view of the internal organs. If a cyst is found, the surgeon may remove it at the same time (cystectomy). The ovaries are usually left intact. Both laparoscopy and laparotomy are usually performed under general anesthesia. As laparoscopy is a minor procedure it does not require an overnight hospital stay. You may need to stay in hospital for 2 to 4 days after a laparotomy.

Does It Work?

A cystectomy, the removal of a cyst, is a popular procedure for treating painful cysts and for maintaining fertility. However, it is possible for a new cyst to form in the same spot or on any other spot on either ovary. The only way to prevent a recurrence is to remove both ovaries (oophorectomy) but this will result in infertility. For alternative therapies, see: how can I cure ovarian cysts naturally?

Personal Stories

I had laparoscopic surgery to remove a dermoid cyst. It hurt for the few days after surgery and I needed help to get out of bed to go to the bathroom for a few days. The site of incision can be quite sore and needs a few days to heal. I had limited movement for about 3 days but couldn't really lift anything or felt like myself for about two months. The recovery process is very similar to cesarean section recovery. I still felt the incision after 6 months, but I was back to doing my aerobic classes.
Abagail, Denver

I had a cystectomy last fall with laparoscopic surgery. My ob/gyn said that the surgery qualified me for two weeks disability pay. To tell you the truth I needed it. I couldn't get out of bed for the first week, the second week I could just about stand. It was 2 months before I properly returned to normal. I really recommend putting plans in place before surgery, someone to take care of the kids or cook meals because you won’t be able to.
Gabriella, San Diego

I had a tiny, functional cyst at the time of becoming pregnant - it was the size of a grapefruit by birth - basically pregnancy hormones put it into overdrive. The ob/gyn said it had to be removed to make sure that it wasn't cancerous (which it wasn't) and because it was so big it could damage my ovary. Despite the size, the surgeon was still able to remove it laparoscopically. The surgery was really quick, I was home in bed by the afternoon nursing my baby.
Gemma, Portland
Useful: Ovarian cysts during pregnancy.

Symptoms And Signs: Top Questions And Articles
Spot the symptoms: What are the signs of ovarian cysts?
Fertility issues: Can ovarian cysts cause infertility?
Menstrual cycles: Can ovarian cysts cause a missed period?
Looking after your health: Recommended health screenings.

• Need more information? See: Guide to Ovary Cysts and treatment of ovarian cysts.
• Got another question? See: Womens Health Questions

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WOMENS HEALTH ADVICE: ABOUT QUESTIONS ON FEMALE HEALTH
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