Dr Komalas Women Clinic - Ovarian Cysts

Introduction to Ovarian Cysts

The ovaries are the female pelvic reproductive organs that hold the ova and are responsible for sex hormone production. They are paired organs on either side of the uterus within the wide ligament beneath the uterine (fallopian) tubes. 

Ovarian cysts are fluid-filled sacs that form in or on the ovaries. Ovarian cysts are rather prevalent in women of all ages. Some women with ovarian cysts experience pain or pelvic pressure, while others do not. Irregular menstrual cycles are not typically associated with ovarian cysts. Cyst size ranges in centimeters. 

The most common causes of ovarian cysts are based on whether you still get your period or have not had menstrual periods for at least a year (postmenopausal). Other causes include ovulation issues, dermoid cysts, polycystic ovarian syndrome, endometriosis, pregnancy, severe pelvic infections, etc. 

Ovarian cysts can be painful or asymptomatic. Ovarian cyst symptoms often manifest as pain or pressure in the lower abdomen on the side of the cyst. This discomfort could be subtle or intense. It could be continuous or intermittent. Lower abdominal cramping is not frequently associated with ovarian cysts. When an ovarian cyst ruptures, a woman may feel a sharp, severe pain. Women who have ovarian twisting may experience discomfort, nausea, and vomiting. Ovarian cysts are not frequently associated with irregular periods or vaginal bleeding. 

Ovarian Cyst Treatment

Ovarian cysts do not usually necessitate medical attention. Ovarian cysts in premenopausal women usually disappear on their own within months without therapy. They are less likely to dissolve in postmenopausal women. If a cyst is big, causes discomfort, or seems cancerous, surgery to remove the cyst or the entire ovary is usually required. Watchful waiting and surgery are the possible treatments of cysts.

When is Surgery Needed?

Surgery may be required in the following cases:

  • When a cyst causes chronic pain or pressure, and it may explode or twist
  • When a cyst is detected on ultrasound as a result of endometriosis, and it is excised for fertility concerns
  • Large cysts (>5 to 10 cm) are more likely to necessitate surgical removal than smaller cysts. However, a cyst’s size does not predict whether it is malignant. 

Ovarian Cystectomy Overview

An ovarian cystectomy is a surgical procedure that removes a cyst from a patient’s ovary. Laparoscopic surgery is a type of minimally invasive surgery that requires only a few small incisions in your lower abdomen. A typical ovary is a somewhat cystic structure by nature. The majority of ovarian cysts form as a result of abnormal ovulation, in which the follicle fails to release the oocyte. Follicular cells persist to produce fluid and grow the follicle, which can become cystic with time. 

Why is this Surgery Needed?

The majority of women will develop an ovarian cyst at some point in their lives. Cysts typically generate little to no symptoms. However, if a cyst is causing pain or discomfort in the body, surgical excision of the cysts may be the best alternative. Pelvic pain, especially during your period or sexual intercourse, is one of the signs of an ovarian cyst.

What Happens During this Surgery?

You will be put to sleep with an anesthetic before the surgery. A laparoscope (a thin tube with a camera on end) is inserted in the belly through a small incision, generally near the navel. On your abdomen, further incisions will be made. In the belly, air/gas will be used to create extra space between your abdominal wall and internal organs. Surgical devices will be used to heal the cyst.

Risks Associated with Ovarian Cystectomy

This surgery carries the risk of:

  • The ovary may need to be removed.
  • Bleeding during surgery that may need a blood transfusion
  • Infection at the bladder or surgical site
  • Organ damage in the nearest areas (bladder, bowel, and ureters)
  • Ovarian cysts may reappear after surgery, and the patient may need another surgery.
  • Uncontrolled pain 
  • Scars may appear at the surgical site on the ovaries or fallopian tubes or in the pelvic cavity.

Preparation for Ovarian Cystectomy

  • Do not eat or drink anything about 12 hours before your surgery.
  • Due to sedation, you will require assistance after the procedure. 
  • Before the treatment, ask your surgeon any questions you have, especially about discontinuing or continuing to take any drugs you already take.

Expectations During Recovery

It is common for your navel and belly to be uncomfortable and even bruised after the surgery. The gas inserted in your belly during the surgery may cause pain in your shoulders and back. Following surgery, you may experience vaginal discharge or spotting. 

Your abdominal incisions will be closed with skin adhesive or stitches and may be covered in bandages. If you have bandages, you can remove them 24 hours following surgery, and the adhesive or sutures will dissolve naturally. Leave little bandage strips on your incisions, and they will fall off on their own. If they do not fall off after seven days, you can have them removed. Do not bathe your incisions in the bathtub or swim wearing them. You may shower, but you must not rub your stitches. 

You may feel more exhausted than usual in the first week following surgery. Take it easy for the first week, then gradually raise your activity level with brief walks and gentle exercise. When you are ready, you can resume sexual activity.


A cystectomy can remove an ovarian cyst while preserving the ovaries and your fertility. However, after a cystectomy, a new cyst can grow on the same or opposite ovary.

Most women feel better after a week of surgery. Nevertheless, do not lift, push, or pull large objects for a few weeks. Do not resume sexual activity until your doctor thinks it is safe. Internal healing takes four to six weeks for a full recovery.

Sleeping straight on your back, commonly known as an upright position, is one of the best ways to recover from surgery. This position will be most beneficial if you have had surgery on your legs, hips, spine, or arms. Furthermore, placing a pillow below your body parts provides additional support and comfort.

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