Cystectomy (Ovarian Cyst Removal)

What is a cystectomy?

Cystectomy, or ovarian cyst removal, is a surgical procedure to remove a cyst (fluid-filled sac) from your ovary or its surface.

Every woman has 2 ovaries, 1 on each side of the uterus. Each ovary is about the size and shape of an almond. Your ovaries have 2 functions – to produce female hormones and eggs.

Ovarian cysts can grow in the ovary or on its surface. Your risk of developing an ovarian cyst may increase due to:

• Increase in age
• Family history of ovarian cancer
• Previous history of breast cancer
• Obesity

Many women have ovarian cysts at some point, often with no signs or symptoms. Most cysts disappear without treatment within a few months.

However, ovarian cysts can also grow and sometimes cause pain and bleeding. Persistent or symptomatic cysts larger than 5 cm may require surgery.

How it works

Ovarian cyst removal is often performed as a laparoscopic (keyhole) surgery. Laparoscopic surgery is a minimally invasive surgery that makes a few small incisions in your lower abdomen to remove the cyst.

However, if the cyst is too large or if cancer is suspected, your doctor may recommend open surgery to prevent spillage of the cyst fluid or spreading the cancer cells to other areas in the body.

Why do you need a cystectomy?

Your doctor may recommend an ovarian cystectomy if conservative management methods such as medication do not work and your cyst:

• Remains after several menstrual cycles
• Looks unusual on the sonogram
• Grows larger
• Causes pain

Cystectomy will allow your doctor to:

• Confirm the diagnosis of an ovarian cyst
• Remove a cyst that is causing symptoms
• Preserve your ovary and your fertility
• Treat conditions such as polycystic ovary syndrome (PCOS)
• Rule out ovarian cancer

What are the risks and complications of a cystectomy?

Although complications after an ovarian cystectomy are rare, the surgery carries a small risk of:

• Bleeding
• Infection
• Infertility
• Blood clots
• Recurring cysts
• Damage to other organs

These complications may make it necessary to remove 1 or both of your ovaries in future. The risk of complications increases if you have chronic diseases like diabetes or obesity. Complications are also more likely if you use certain prescription medications, drink, smoke, are pregnant, or have done previous abdominal surgery.

How to prepare for a cystectomy?

To prepare for your cystectomy, your doctor may recommend the following tests:

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

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

What to expect for a cystectomy?

Both laparoscopic and open surgery cystectomy are performed under general anaesthesia.

Estimated duration

Surgery to remove the ovary cyst can take 1 – 3 hours depending on the size of the cyst and the complexity of the surgery required.

Before the procedure

You will be given general anaesthesia through an intravenous drip to block the pain and keep you asleep during the procedure.

Procedure for laparoscopic surgery

Your doctor will make a small incision in your lower abdomen and insert a laparoscope (thin tube with a camera at its end) to locate your cyst.

Once the cyst is located, your doctor may make 1 – 2 more incisions to insert surgical instruments to remove the cyst. Your doctor may also remove some tissues for testing. After the procedure, the doctor will close the incisions in your abdomen with stitches and skin adhesive.

Procedure for open surgery

During an open cystectomy, your doctor will make a large incision in the abdomen to perform the procedure.

After the procedure, the doctor will close the incisions in your abdomen with stitches and skin adhesive.

Care and recovery after a cystectomy

Following a laparoscopic (keyhole) surgery, you may be discharged on the same day. You should be able to resume normal activities in 24 hours. However, you should avoid any strenuous activity for at least a week or until your doctor says it is safe to do so.

If you had open surgery, your doctor may recommend a hospital stay of 2 – 4 days for observation. You should expect to resume normal activities in 4 – 6 weeks.

After your cystectomy, it is normal to feel pain in your abdomen, shoulders and back. Your doctor may prescribe pain medications to relieve your discomfort. You may also experience spotting or vaginal discharge.