Treatment - Ovarian cyst

In most cases, ovarian cysts disappear in a few months without the need for treatment.

Whether treatment is needed will depend on:

• its size and appearance
• whether you have any symptoms
• whether you've had the menopause – if you are postmenopausal there is a slightly higher risk of ovarian cancer

Watchful waiting

In most cases, a policy of "watchful waiting" is recommended.

This means you will not receive immediate treatment, but you may have an ultrasound scan a few weeks or months later to check if the cyst has gone.

If you have been through the menopause you may be advised to have ultrasound scans and blood tests every 4 months for a year, as you will have a slightly higher risk of ovarian cancer.

If the scans show that the cyst has disappeared, further tests and treatment are not usually necessary. Surgery may be recommended if the cyst is still there.

Surgery

Large or persistent ovarian cysts, or cysts that are causing symptoms, usually need to be surgically removed.

Surgery is also normally recommended if there are concerns that the cyst could be cancerous or could become cancerous.

There are 2 types of surgery used to remove ovarian cysts:

• a laparoscopy
• a laparotomy

These are usually carried out under general anaesthetic.

Laparoscopy

Most cysts can be removed using laparoscopy. This is a type of keyhole surgery where small cuts are made in your tummy and gas is blown into the pelvis to allow the surgeon to access your ovaries.

A laparoscope (a small, tube-shaped microscope with a light on the end) is passed into your abdomen so the surgeon can see your internal organs. The surgeon then removes the cyst through the small cuts in your skin.

After the cyst has been removed, the cuts will be closed using dissolvable stitches.

A laparoscopy is preferred because it causes less pain and has a quicker recovery time. Most people are able to go home on the same day or the following day.

Laparotomy

If your cyst is particularly large, or there's a chance it could be cancerous, a laparotomy may be recommended.

During a laparotomy, a single, larger cut is made in your tummy to give the surgeon better access to the cyst.

The whole cyst and ovary may be removed and sent to a laboratory to check whether it's cancerous. Stitches or staples will be used to close the incision.

You may need to stay in hospital for a few days after the procedure.

After surgery

The time it takes to recover from surgery is different for everyone. After the ovarian cyst has been removed, you'll feel pain in your tummy, although this should improve in a few days.

After a laparoscopy or a laparotomy, it may take as long as 12 weeks before you can resume normal activities.

If the cyst is sent off for testing, the results should come back in a few weeks and your consultant will discuss with you whether you need any further treatment.

Contact a GP if you notice the following symptoms during your recovery:

• heavy bleeding
• severe pain or swelling in your abdomen
• a high temperature (fever)
• dark or smelly vaginal discharge

These symptoms may indicate an infection.

Your fertility

If you have not been through the menopause, your surgeon will try to preserve as much of your reproductive system as they can. It's often possible to just remove the cyst and leave both ovaries intact, which means your fertility should be unaffected.

If 1 of your ovaries needs to be removed, the remaining ovary will still release hormones and eggs as usual. Your fertility should not be affected, although you may find it slightly harder to get pregnant.

Occasionally, it may be necessary to remove both ovaries, even if you have not been through the menopause. This triggers an early menopause and means you no longer produce any eggs.

However, it may still be possible to have a baby by having a donated egg implanted into your womb. This will need to be discussed with specialists at a centre that specialises in assisted reproduction techniques.

If you have been through the menopause, both ovaries may be removed because they no longer produce eggs.

Make sure you discuss your fertility concerns with your surgeon before your operation.

Cancer treatment

If your test results show that your cyst is cancerous, both of your ovaries, your womb (uterus) and some of the surrounding tissue may need to be removed.

This would trigger an early menopause and mean that you're no longer be able to get pregnant.

Read more about treating ovarian cancer

Treating conditions that cause ovarian cysts

If you have been diagnosed with a condition that can cause ovarian cysts, such as endometriosis or polycystic ovary syndrome (PCOS), your treatment may be different.

For example, endometriosis may be treated with painkillers, hormone medication, and/or surgery to remove or destroy areas of endometriosis tissue.

Read more about treating endometriosis and treating PCOS.