Surgery is generally the treatment method of last resort for ovarian cysts.  It is done for cysts that are especially large, cysts that are made of solid materials, or cysts that are suspected to be cancerous.  Whenever possible, surgery is performed through laparascopy.  However, if the cyst is solid and bigger than 2.5 inches in diameter, a more invasive surgery is necessary.

Cysts that Require Surgery

The majority of cysts do not require surgical treatment.  However, a few do.  Of those that are surgically removed, only 10% turn out to be cancerous.

Cysts that are made up of solid material, such as a dermoid cyst, or cysts that are septated (have more than one section divided by a wall) are removed through surgery.  Solid or septated cysts are considered to be a higher risk of cancer than fluid filled cysts.

Laparascopy

A laparascopy usually involves two to four incisions about 1 inch in length.  One is through your belly button, where the laparascope is inserted.  The others are in the lower abdomen, and used to insert tools to move your organs around as necessary.

After the incisions are made, a lighted tube is inserted through your belly button.  The doctor guides this to the ovary with the cyst.  If possible, only the cyst is removed.  However, if the cyst is large or solid, the ovary is removed as well.  If the cyst is large but fluid filled, it is drained, then removed.

Afterwards, it takes about a week to recover enough to go back to work or school.  Most people say the most painful incision is the one through the belly button, so plan on wearing low cut pants.  Also, air is pumped into your abdomen to give the doctor more room to work during the surgery.  Many people will experience gas pains until this air has been reabsorbed in the blood stream (usually in 2 to 3 days).

There is some research into performing this surgery in less invasive way.  One doctor in Germany is experimenting with going in through the uterus, with positive results.

To read some stories of people’s experiences with this type of surgery, please visit this forum post.

Laparatomy

Laparatomy is abdominal surgery for ovarian cysts.  It is generally only done when cancer is suspected, as it allows the doctor to remove all possible cancerous tissue while in the abdomen.  Sometimes, it is even performed after a laparascopy has been started.  If the doctor discovers evidence of cancer during laparascopy, he will make the incision larger in order to remove as much of the cancerous material as possible.

The biggest difference between this surgery and laparascopy is a larger incision and a longer recovery time.  In most cases, the ovary is removed.  Sometimes the uterus and the other ovary are removed as well, especially if cancer is suspected.

Risks of Surgery

All surgery carries risks.  For ovarian cyst surgery, the biggest risk is that the cyst will return.  As long as the ovary is still present, there is a risk for additional cysts unless the underlying cause of the cysts is treated.

Additional risks include infection and the risk of scar tissue forming.  Scar tissue can damage the fallopian tubes and reduce your ability to get pregnant.  Also, there is the remote possibility of the intestines or bladder being damaged during the surgery.