Ovarian Cystectomy

An ovarian cystectomy is surgery to remove an ovarian cyst. An ovarian cyst is a fluid-filled sac on or in your ovary. Ovarian cysts are common and often go away on their own. But if a cyst doesn’t go away, gets bigger or causes pain, your healthcare provider may recommend surgery to remove it.

There are two ways to surgically remove ovarian cysts:

• Laparoscopic ovarian cystectomy: Your surgeon makes a few small cuts in your belly. They insert a tiny camera and small surgical tools through these cuts. This method is less invasive and usually has a faster recovery.
• Open cystectomy (laparotomy): Your surgeon makes one larger cut in your abdomen (belly) to remove the cyst. They may need to do this if the cyst is very large or may be cancerous. Recovery usually takes longer than with laparoscopic surgery.

Most surgeons prefer laparoscopic surgery because it uses smaller cuts and is easier to recover from. They use open surgery when a cyst is too large or there’s concern for cancer.

Why is an ovarian cystectomy done?

An ovarian cystectomy is surgery to remove an ovarian cyst. Most ovarian cysts go away on their own and don’t need treatment. Your healthcare provider may recommend surgery if:

• The cyst is large (typically more than 2.5 to 3 inches wide).
• The cyst causes pain or other symptoms.
• The cyst may be cancerous.
• The cyst doesn’t go away or keeps coming back.

Your healthcare provider will choose the best treatment based on the cyst size, your symptoms, your plans for pregnancy, your medical history and your risk of cancer.

What happens during an ovarian cystectomy?

Your surgeon will go over how to prepare for surgery. This could include things like when to stop eating and drinking, when to stop medications and what time to arrive at the hospital or surgical center. Be sure to ask any questions you have before the day of surgery.

During a laparoscopic ovarian cystectomy:

1. You’ll receive general anesthesia and be asleep during the procedure. Your anesthesia provider will place an IV to give you medications and fluids.
2. Your surgeon will make a small incision near your belly button and insert a laparoscope (a thin tube with a camera). They’ll use carbon dioxide gas to inflate your abdomen, giving your surgeon more room to work.
3. Your surgeon will make two to three more small cuts in your lower abdomen so they can insert surgical tools.
4. They’ll remove the cyst through one of these small cuts. Your provider may send the cyst to a lab for testing.
5. Your surgeon will release the gas from your abdomen and close the incisions with dissolvable stitches. They’ll put bandages on each cut.

Open surgery involves making one larger incision in your abdomen to remove the cyst. Once your surgeon removes the cyst through the incision, they sew your skin back together with stitches and put a bandage on top.

Is it painful to get an ovarian cyst removed?

You won’t feel pain during surgery, as you’ll be asleep. You may have some discomfort after the procedure. Your provider will discuss options for pain relief with you.

What happens after an ovarian cystectomy?

You’ll go to the recovery room after surgery. Your surgical team will monitor your blood pressure, heart rate and other vital signs.

If you’ve had a laparoscopic cystectomy, you may be able to go home within two or three hours. If you had open surgery, you’ll need to stay overnight until your pain is managed, you’re able to eat and you’re pooping normally.

Your surgeon will give you specific instructions to follow. This could include:

• When you can shower or bathe
• How to care for your incision
• What changes you’ll need to make to your normal activities
• How much vaginal bleeding or other symptoms you can expect
• What medications you can take for pain and discomfort
• When you can have sex or put objects into your vagina
• When you should come back for a follow-up appointment
• When you can return to work

Is it a major surgery?

It depends on what type of surgery you have. If your surgeon can do the procedure laparoscopically, you can usually go back to your normal activities within two to three weeks. There are still risks to surgery, but they’re low.

If you need open surgery, it uses a larger incision and has a longer recovery time. It also has a higher risk of complications. It may take up to 12 weeks to fully recover.

What are risks and benefits of an ovarian cystectomy?

The benefit is that your provider removes a cyst that may be painful or harmful. Some ovarian cysts can be cancerous, especially after menopause. If a cyst isn’t removed, other problems may include:

• Ruptured ovarian cyst: The cyst breaks open (ruptures) and causes severe pain.
• Ovarian torsion: The weight of the cyst causes the ovary to twist so much that it cuts off blood flow to your ovary.

The benefits of removing an ovarian cyst still outweigh the risk of surgery. The procedure is safe, but possible complications include:

• Infection
• Irritation at the incision site
• Injury to your ovary or fallopian tube
• Bleeding
• Allergic reaction to anesthesia
• Blood clots
• The cyst comes back after surgery
• Needing to remove one or both ovaries

Other factors can increase your risk of surgery complications. Talk to your healthcare provider to be sure you understand the risks of surgery.

How long is recovery after an ovarian cystectomy?

It varies. If you have a laparoscopic cystectomy, recovery time is about two to three weeks. If your surgeon performs an open cystectomy, your recovery will be four to six weeks.

Can you get pregnant after an ovarian cystectomy?

Yes. Having ovarian cyst surgery doesn’t affect your chances of getting pregnant. But the condition that causes the ovarian cyst may make it harder to get pregnant.

If damage occurs to your ovary or fallopian tube during surgery, it may affect your ability to get pregnant. But this is rare.

Will I lose weight when they remove ovarian cysts?

It’s possible to lose weight if you had a large ovarian cyst removed. You may feel lighter and less bloated. Having a small cyst removed is unlikely to change your weight.

When should I call my healthcare provider after ovarian cyst surgery?

Contact your provider if:

• The area around your incision becomes red, painful or leaks pus.
• It hurts to pee or you can’t pee.
• You have severe pelvic pain.
• Your legs begin to throb, swell or ache.
• You have flu-like symptoms or a fever.
• You have severe vaginal bleeding.