If you have an ovarian cyst, whether it needs to be treated will depend on:
- its appearance and size
- whether you have any symptoms
- whether you have had the menopause (post-menopausal women have a slightly higher risk of developing ovarian cancer)
Watchful waiting
In the majority of cases, a policy of ‘watchful waiting’ will be recommended where you receive no immediate treatment. This is because most cysts will disappear after a few weeks without the need for treatment. A follow-up ultrasound scan will usually confirm that this is the case.
Due to the slightly higher risk of ovarian cancer in women who have experienced the menopause, regular ultrasound scans and blood tests are usually recommended until the cyst disappears. In addition, post-menopausal women are advised to have a follow-up ultrasound scan four months after the cysts have gone.
Surgery
If the cyst is large, or if it is causing symptoms, it will probably need to be removed. Doctors sometimes recommend removing the cyst even if it is not causing symptoms. This is because it is not always possible to tell what type of cyst it is without looking at it under a microscope. Removing it also reduces the risk of the cyst becoming cancerous later on.
There are two types of operation, which are usually carried out under general anaesthetic (you will be asleep during the operation and will feel no pain). They are:
Both procedures are described below.
Laparoscopy
Smaller cysts can sometimes be removed using a surgical technique called a laparoscopy. This is a type of keyhole surgery where small cuts are made in your lower abdomen and gas is blown into the pelvis to lift the wall of the abdomen away from the organs inside.
A laparoscope, which is a small, tube-shaped microscope with a light on the end, is passed into your abdomen so that the surgeon can see your internal organs. Using tiny surgical tools, the surgeon will be able to remove the cyst through the small cut in your skin.
After the procedure, the cuts are closed using dissolvable stitches. The operation takes about half an hour to perform, depending on the size and type of cyst. Most women can go home on the same day as the operation.
A laparoscopy is the preferred approach because it causes less pain, helps to preserve fertility and lets you resume normal activity sooner.
Laparotomy
If there is a risk that the cyst is cancerous, a more invasive procedure called a laparotomy may be recommended.
During a laparotomy, a larger cut is made to give the surgeon better access to the cyst. The whole cyst and ovary is removed and sent to a laboratory to check whether it is cancerous. The skin is then closed using stitches. You may have to stay in hospital overnight or for a few days.
If only one of your ovaries is removed, your remaining ovary will still release hormones and eggs as normal, so your health and fertility should be unaffected.
If both ovaries needed to be removed then this would trigger an early menopause (if you had not already gone through the menopause).
However, it may still be possible to have a baby by having a donated egg implanted into your womb.
Treatment for cancer
If the cyst is found to be cancerous, you may need to have treatment to remove both of your ovaries, your womb (uterus) and some of the surrounding tissue.
This would trigger an early menopause and mean that you would be infertile.
See ovarian cancer - treatment for more information
