Ovarian Cystectomy

Overview

When an ovarian cyst needs to be removed surgically, it can be done by removing just the cyst itself “ovarian cystectomy.” Occasionally, the surgeon may need to remove the entire ovary and tube on the side with the cyst in a procedure called a “salpingo-oophorectomy.” Rarely, the surgeon may need to remove all of the surrounding tissues, including the uterus and opposite ovary.

The surgery can be performed laparoscopically (using a camera through several small incisions) or with a laparotomy (through a larger incision in the abdomen). The suspicion for cancer, size of the cyst and previous surgeries will all contribute to the decision for whether the surgery can or cannot be performed laparoscopically.

Alternatives

Ovarian cysts do not always require treatment. In fact, ovarian cysts may resolve on their own without treatment particularly for women in childbearing years.

Before deciding on the best course of treatment, other tests may be needed for a woman who has or is suspected of having an ovarian cyst. Once all of the associated testing has been done, a treatment plan will be developed.

“Watchful waiting” may be recommended for ovarian cysts that are causing few or no symptoms, or do not appear suspicious for cancer. Watchful waiting involves repeating an ultrasound periodically (usually after six to eight weeks) to see if cysts have resolved on their own or decreased in size. When cysts are large or causing symptoms like pain or when a cyst appears suspicious for cancer, treatment may involve surgery.

Surgery may be appropriate in the following situations:
  • A cyst is causing severe pain or pressure, and concern exists that the cyst has burst (also known as “cyst rupture”) or twisted (also known as “ovarian torsion”).
  • A cyst appears suspicious for cancer.
  • A cyst does not decrease in size or resolve on its own after a period of watchful waiting.
  • A cyst is associated with endometriosis and concern exists that it may impact fertility.

Effectiveness

Ovarian cystectomy is a generally effective method of treating an ovarian cyst, but an ovarian cyst may recur in 6-10 percent of patients. Additional tissue may need to be removed (such as the entire ovary and surrounding tissues) depending on what surgery initially reveals.

Risks

Ovarian cystectomy involves a surgery. The surgeon will determine whether the surgery can be done laparoscopically through small incisions or with a laparotomy, which involves a larger incision. Both types of procedures involve risks, including a risk of blood loss, infection or damage to the structures surrounding the ovary.

If only the ovarian cyst is removed, it is possible for another to form in the remaining ovarian tissue. Your doctor may discuss strategies for reducing the likelihood of ovarian cysts. Often, this involves taking birth control pills as a way to prevent ovulation. Ovulation naturally forms a cyst on the ovary each month that disappears when a woman has her period. Some women may be prone to forming persistent ovarian cysts and preventing ovulation with birth control pills is an excellent method of avoiding recurrent ovarian cysts.