Ovarian cysts are fluid-filled sacs that develop on or within an ovary. While most ovarian cysts are harmless and resolve on their own, some may cause discomfort, grow large, or pose a risk of complications such as rupture or torsion. When this happens, a surgical procedure called an ovarian cystectomy may be recommended to remove the cyst while preserving the healthy part of the ovary.
Understanding Ovarian Cystectomy Surgery Procedure
Not all ovarian cysts require surgery. Many women develop cysts during their menstrual cycles, which typically go unnoticed and disappear without intervention. However, surgery may be necessary if the cyst is unusually large, persistent, painful, or appears suspicious on imaging tests. If the cyst causes symptoms like pelvic pain, bloating, or changes in menstrual patterns, your doctor may recommend further evaluation. A cystectomy is generally performed when a cyst needs to be removed but there is a desire to preserve fertility and avoid removing the entire ovary.
Preparing for Ovarian Cystectomy
Before undergoing ovarian cystectomy, your healthcare provider will perform a series of evaluations to determine the nature of the cyst. This often includes a pelvic ultrasound, blood tests such as CA-125 to rule out cancer, and sometimes MRI or CT scans. Based on these findings, the surgeon will decide whether the procedure can be done laparoscopically or requires open surgery.
Laparoscopic surgery is a minimally invasive approach and is the preferred method in many cases. It uses small incisions and a camera to guide the surgeon. If the cyst is very large or suspected to be malignant, open surgery through a larger abdominal incision may be necessary.
You may be asked to stop eating or drinking several hours before the procedure. In some cases, bowel preparation may be recommended. Your medical history, current medications, and allergies will also be reviewed prior to surgery.
The Surgical Procedure
On the day of the surgery, you will be given general anesthesia so you will be asleep and pain-free during the operation. Once the anesthesia takes effect, the surgical team will proceed with either laparoscopic or open surgery depending on the preoperative plan.
In a laparoscopic ovarian cystectomy, the surgeon will make a few small incisions in your lower abdomen. A laparoscope, which is a thin tube with a camera at the end, is inserted through one of the incisions to provide a clear view of the internal organs. Specialized surgical instruments are inserted through the other small incisions. The surgeon then locates the cyst and carefully removes it from the ovary while trying to preserve as much healthy ovarian tissue as possible. The removed cyst is sent to the lab for histopathological examination. Once the cyst is removed, the surgeon closes the incisions with sutures or surgical glue.
In an open cystectomy, a larger incision is made in the lower abdomen to allow direct access to the ovaries. This method is used when the cyst is too large for laparoscopic removal or if cancer is suspected. The procedure involves similar steps but allows for more room to maneuver. Once the cyst is removed, the incision is closed with stitches or staples.
Recovery and Aftercare
Recovery time depends on the type of surgery performed. Most women who undergo laparoscopic surgery can go home the same day or within 24 hours. Recovery is typically faster, with many returning to normal activities within one to two weeks. There may be some discomfort around the incision sites, mild bloating, or shoulder pain due to the gas used to inflate the abdomen during laparoscopy. These symptoms usually subside within a few days.
For women who have open surgery, the hospital stay may be slightly longer, and the recovery time can take four to six weeks. During recovery, it’s important to avoid heavy lifting and strenuous activities. Your doctor will provide specific guidelines on wound care, signs of infection to watch for, and when to return for a follow-up visit.
Pain management is usually handled with over-the-counter or prescribed pain medications. Some women may also be advised to avoid sexual intercourse, swimming, or using tampons for a few weeks following surgery to allow internal tissues to heal properly.
Risks and Complications
As with any surgical procedure, ovarian cystectomy carries some risks. Common risks include bleeding, infection, or adverse reactions to anesthesia. In rare cases, damage to nearby organs such as the bladder, bowel, or blood vessels may occur. There is also a small chance of ovarian tissue being damaged, which could affect fertility, especially if both ovaries are involved.
If the cyst is found to be cancerous, additional treatment such as further surgery or chemotherapy may be necessary. That’s why preoperative assessment and histological examination of the removed tissue are so crucial.
Fertility and Hormonal Considerations
One of the primary goals of ovarian cystectomy, especially in women of childbearing age, is to preserve fertility. By removing only the cyst and not the entire ovary, the chances of natural conception remain high. In some cases, fertility treatments may be recommended afterward if there are concerns about ovarian reserve or ovulation.
Hormonal function is usually maintained if at least one ovary remains functional. In very rare circumstances, both ovaries may need to be removed, which leads to early menopause. However, this is not typical in a standard cystectomy unless there are significant concerns about malignancy or severe damage.
When to Contact Your Doctor
After surgery, it is essential to monitor your recovery and reach out to your healthcare provider if you experience signs of complications. These may include high fever, persistent or worsening abdominal pain, heavy vaginal bleeding, foul-smelling discharge, or signs of infection around the incision site. Difficulty urinating or bowel changes should also be discussed with your doctor.
Conclusion
Ovarian cystectomy is a common and generally safe procedure used to remove problematic ovarian cysts while preserving ovarian function. Advances in minimally invasive surgery have made recovery quicker and reduced the risks associated with open surgery. If you’re facing the possibility of this procedure, understanding what to expect can help ease anxiety and prepare you for a smooth recovery. Always consult with your gynecologist or surgeon about your specific condition and treatment options to make an informed decision that supports your health and future fertility.
