Surgical removal of an ovarian cyst may be necessary if a cyst is large, grows, or appears unusual in ultrasounds. Depending on the size and location, your surgeon may remove the cyst or an ovary.

Ovarian cysts are fluid-filled sacs on the ovaries. Although they are common and usually noncancerous, when they are large or have concerning properties, they may require surgical removal.

Depending on the size and location of an ovarian cyst, your surgeon may be able to remove just the cyst. In some cases, they may also need to remove your ovary.

After undergoing a surgical procedure to remove an ovarian cyst, your doctor may recommend taking hormonal birth control to help prevent future cysts.

Your doctor may recommend surgery if they notice:

  • possible ovarian torsion
  • persistent adnexal mass (cyst)
  • acute abdominal pain
  • signs of malignancy

Surgery to remove an ovarian cyst may also be necessary if it remains after several menstrual cycles or appears unusual in ultrasound images.

Your surgeon can remove an ovarian cyst by using laparoscopy or laparotomy. During surgery, your surgeon may remove just the cyst, part of your ovary, or the entire ovary, depending on factors like the location and size of the cyst.

Laparoscopy

To perform a laparoscopy, the surgeon will enter the body through a small hole, often in the belly button.

Your surgeon will pass through a small microscope with a light on the end, called a laparoscope, to get a better view of the internal organs. Your surgeon will then use minor cuts in the skin to remove the cyst or ovary. They will then use dissolvable stitches to close these cuts.

Laparotomy

A laparotomy involves a single, more significant cut that allows the surgeon access to the ovaries.

After the surgeon removes the cyst or ovary, stitches or staples will be used to close the cut. Recovery from a laparotomy is often longer and more painful than from a laparoscopy.

Before and during surgery

Before surgery, your doctor will use an ultrasound to diagnose a cyst and determine its size and location. Your doctor will then use this information to determine whether surgery is necessary.

You may undergo either a laparoscopy or laparotomy. Your doctor will explain the specific plan for your cyst removal procedure. During either type of surgery, you will be under anesthesia.

Before your surgery, you may wish to speak with your doctor about potential impacts on your fertility. Your surgeon may need to remove part or all of your ovaries, which can impact your future ability to become pregnant.

Consider discussing possible fertility concerns, resources for infertility support, and alternative family planning options that may be available to you.

After surgery

After the surgery, your doctor may send the cyst for testing to ensure that cancerous cells are not present.

Depending on your exact procedure and the time of day you undergo surgery, you may go home the same day or spend a few days in the hospital. Recovery times from surgery can vary, but it may take you as long as 12 weeks to resume your usual activities fully.

Following surgery, your doctor will instruct you to care for your wounds and prevent infection properly.

Research from 2021 also indicates that ovarian reserve, or the number and quality of your eggs, can be impacted after laparotomy. However, researchers suggested that an optimal time for ovarian reserve recovery may occur 6 months after laparoscopic ovarian unilateral cystectomy.

More research is needed to better understand the connection between ovarian cysts, ovarian reserve, and the impact of surgery.

Your outlook following an ovarian cyst removal surgery depends on the type of cyst removed and whether any part of the ovary also had to be removed.

Most ovarian cysts are asymptomatic or benign, with approximately 70% to 80% of follicular cysts improving without treatment. If the cyst is suspected to be malignant, the outlook for ovarian cancer is usually low since it tends not to be detected until later stages.

Research indicates that infertility rates were higher for women after cyst removal surgery. However, findings suggest that those who have ovarian cysts may also face challenges due to prior conditions that may be associated with fertility challenges.

Ovarian cysts are common, but most are benign. Your doctor may recommend surgical removal if your ovarian cyst is large, grows more prominent, or appears unusual in ultrasounds.

Depending on the size and location of the cyst, your surgeon may be able to remove just the cyst, or they may need to remove the entire ovary.

Consider speaking with your doctor about possible fertility concerns and what to expect during recovery. Returning to your typical daily routines may take up to 12 weeks. Your care team should provide information and support before and after surgery.