Ovarian cyst treatment depends upon the type of cyst
Functional cysts will resolve without treatment
Expert ultrasound scans can help determine the type of cyst
Risk scores predict the likely cyst type. The most recent risk scores are much better than RMI for identifying the type of cyst
Ovarian cyst treatment
Many cysts will resolve without treatment and watchful waiting will often see these cysts resolving without treatment.
When is surgery necessary?
If a cyst has divisions within it called septae, or solid areas it is complex and more concerning.
Cysts larger than 5 cm are more concerning than smaller cysts
Ovarian cyst symptoms
If the cyst appears to be causing symptoms often the best course of action is excision of the cyst
Increased blood flow to the ovarian cyst is a danger signal, and increases the risk that the ovarian cyst is malignant
Ovarian cyst surgery
Laparoscopic (Keyhole) surgery
Many cysts can be removed using keyhole surgery. This allows dissection and removal of the cyst without an abdominal incision with a quicker return to normal activities. The operation is performed using a telescope in an incision in the umbilicus and usually two other ports lower down on the abdomen. The cyst is placed in a bag and the fluid removed before the cyst wall is removed through one of the ports.
Robotic surgery for ovarian cysts
Recently robotic surgery has been used to improve keyhole surgery. This approach allows very much more precise surgery with even quicker recovery. Robotic surgery can be performed through a single port in the umbilicus making it virtually “scarless”
If the cyst is possibly a cancer, even if that risk is low, an open operation is usually better, as laparoscopic surgery is more likely to spread the tumour than an open operation. Often this can be performed through a small incision and return to normal activities is almost as quick as with keyhole surgery.
Ovarian cyst treatment FAQ
Will I need any follow-up?
Most women are seen for one or two visits after surgery to make sure that they have healed well. The risk of a further ovarian cyst depends on the nature of the cyst. Most ovarian cysts have no tendency to recur and so further follow-up is not necessary.
Does removal of an ovarian cyst affect fertility?
Removing a cyst from one or both ovaries should not affect the function of the ovary and so fertility and periods should not be affected. Sometimes surgery can cause adhesions where organs within the abdomen stick together. If adhesions occur around the ovaries or fallopian tubes, they can affect the transfer of eggs released from the ovaries to the fallopian tubes. During surgery it is important to handle the tissues within the pelvis gently to avoid damage to the surface and to reduce the risk of adhesion formation. With careful surgery, adhesions that affect fertility are very uncommon unless another abnormality is present such as endometriosis or pelvic infection.