Cystectomy (Ovarian Cysts Removal)

You may need surgery to confirm the diagnosis of an ovarian cyst, to remove a cyst that is causing symptoms, or rule out ovarian cancer and to preserve fertility and the ovary. Cystectomy is performed when there are indicators or suspicion of malignancy (cancer).

This procedure is often performed as a laparoscopic (keyhole) surgery, but in some cases may be done by open surgery. Laparoscopic surgery is a minimally invasive surgery technique that uses a few small incisions in your lower abdomen.

When to seek treatment for ovarian cysts?

Most functional ovarian cysts go away on their own over time. If you have a functional cyst that is causing some symptoms, your doctor may use conservative management methods, such as over-the-counter medications, depending on your case.

Your doctor may recommend an ovarian cystectomy if the cyst:

• Doesn’t go away after several menstrual periods
• Gets larger
• Looks unusual on the sonogram
• Causes pain

Cysts can grow, twist (called torsion and can be very painful), rupture (can have lots of blood in the abdomen) or shrink and disappear. Cysts can be benign or cancerous.

Please consult your gynaecologist for the recommended treatment based on individual medical condition. Some patients who have undergone laparoscopic cyst removal may even go home on the same day.

To prepare for your cystectomy, your doctor may ask you to undergo the following:

• Physical examination
• Blood tests and urine test
• Ultrasound
• CT scan

Your doctor may also ask about any medications you are taking and may ask you to stop taking certain medications a week before your cystectomy.

A general anaesthesia may be given through an IV to block pain and keep you asleep during the procedure which takes 1 – 2 hours. Thus, you will need a companion who can assist you with your needs and take you home after the procedure.

The procedure is often performed as a laparoscopic (keyhole) surgery, a minimally invasive surgery technique that uses a few small incisions in your lower abdomen. A laparoscope, a thin tube with a camera on the end, will then be inserted into the small incision. It will be used by the doctor to locate your cyst.

Once the cyst is located, the doctor may make 1 or 2 more incisions to insert surgical instruments that will remove the cyst. Likewise, the doctor may remove some tissues for testing. The doctor will close the incisions in your abdomen with stitches and skin adhesive.

In some cases, the doctor may perform an open surgery, wherein a larger incision in the abdomen is needed.

After the procedure, IV fluids and pain medications may be given to you. Your doctor may allow you to leave the hospital the same day as your procedure or may ask you to stay overnight. After your cystectomy, it is normal to feel pain in your abdomen, shoulders and back. The pain medications will help relieve your discomfort. After the procedure, you may experience spotting or vaginal discharge.

Your recovery may take 1 – 2 weeks. To reduce risks of infection during your recovery, make sure to wash your hands regularly and don’t allow others to touch your incisions. Likewise, make sure to take home medications and follow instructions of your doctor on how to manage your incisions.

Complications after a cystectomy

While complications after cystectomy are rare, there is a small risk of:

• Bleeding
• Infection
• Possibility of removing one or both ovaries
• Cyst may return
• Infertility
• Blood clots
• Damage to other organs

Factors that increase your risk of developing these complications include chronic diseases like diabetes or obesity, use of some prescription medications, drinking, smoking, pregnancy, and previous abdominal surgery.