Surgery may be needed to confirm the diagnosis of an ovarian cyst or to evaluate ovarian growths when ovarian cancer is possible. Surgery does not prevent ovarian cysts from coming back unless the ovaries are removed (oophorectomy).

Surgery may be needed in the following situations:

• An ovary and cyst have twisted (torsion) or ruptured.
• You have severe pain or bleeding.
• A cyst is larger than 3in or is pressing on other abdominal organs.
• A cyst has not gone away after 2 to 3 months of observation without treatment (watchful waiting), especially if you have had 1 or 2 menstrual periods during this time.
• Ovarian cancer is suspected based on your risk factors for ovarian cancer or an unusual appearance of the cyst on ultrasound.

Goals of surgical treatment for an ovarian cyst are to:

• Confirm a diagnosis of an ovarian cyst.
• Rule out the diagnosis of ovarian cancer.
• Remove cysts that are causing pain.
• Relieve the pressure that cysts larger than 3in may cause on the bladder and other pelvic organs.

Surgery Choices

Surgery for an ovarian cyst or growth can be done through a small incision using laparoscopy or through a larger incision (laparotomy). The cut is made in your stomach area.

Laparoscopy may be used to confirm the diagnosis of an ovarian cyst in a woman of childbearing age. Persistent, large, or painful ovarian cysts that have no signs of cancer risk can be removed during laparoscopy, leaving the ovary intact.

Laparotomy is used when an ovarian cyst is very large, ovarian cancer is suspected, or other problems with the abdominal or pelvic organs are present. If cancer is found, the larger incision lets the surgeon closely examine the entire area and more safely remove all cancerous growth.

What To Think About

For the most part, functional ovarian cysts stop forming when menopause occurs (in rare cases, a functional ovarian cyst will occur or persist within 5 years of menopause). Relieving symptoms with medicine until menopause is complete may be an option.

Some women prefer the risks of surgery to symptoms that reduce their quality of life. If your doctor recommends surgery, ask whether laparoscopic surgery or laparotomy would be the best choice for you.

Unless the ovaries are removed, surgery does not prevent the formation of new functional ovarian cysts.