Ovarian cyst removal

About ovarian cyst removal

Ovarian cysts are common in women of childbearing age. Most ovarian cysts are harmless and go away on their own. You may need surgery to remove ovarian cysts if they cause pain or discomfort.

What are the alternatives to ovarian cyst removal?

If the cysts aren't causing any symptoms, your doctor may suggest watchful waiting. You will be asked to attend regular ultrasound appointments to check whether the cyst changes size. Most ovarian cysts are likely to go away on their own within a couple of months.

Preparing for ovarian cyst removal

Your surgeon will explain how to prepare for your operation. For example, if you smoke, you will be asked to stop as smoking increases your risk of getting a chest or wound infection, which can slow your recovery.

Ovarian cysts are usually removed as a day-case procedure. This means you have the procedure and go home the same day. The operation is done under general anaesthesia. This means you will be asleep during the procedure. You will be asked to follow fasting instructions. This means not eating or drinking, typically for about six hours beforehand. However, it's important to follow your anaesthetist or surgeon's advice.

You may be asked to wear compression stockings to help prevent blood clots forming in the veins in your legs.

Your surgeon will discuss with you what will happen before, during and after your procedure, and any pain you might have. This is your opportunity to understand what will happen, and you can help yourself by preparing questions to ask about the risks, benefits and any alternatives to the procedure. This will help you to be informed, so you can give your consent for the procedure to go ahead, which you may be asked to do by signing a consent form.

What happens during ovarian cyst removal?

Your surgeon will make three small cuts (about 1cm long) near your belly button. He or she will pass special instruments and a tube-like telescopic camera (called a laparoscope) through the cuts. Your surgeon will then examine your ovaries and remove the cysts. The cuts on your skin are closed with dissolvable stitches.

There is a chance your surgeon may need to convert your keyhole procedure to open surgery (a single, large cut is made in your lower abdomen to reach your ovary). This will only happen if he or she is unable to complete the operation safely using keyhole surgery.

What to expect afterwards

You will need to rest until the effects of the anaesthetic have passed. You may need pain relief to help with any discomfort as the anaesthetic wears off.

You will usually be able to go home when you feel ready. You will need to arrange for someone to drive you home. Try to have a friend or relative stay with you for the first 24 hours after your operation.

General anaesthesia temporarily affects your co-ordination and reasoning skills, so you must not drive, drink alcohol, operate machinery or sign legal documents for 24 hours afterwards. If you're in any doubt about driving, contact your motor insurer so that you're aware of their recommendations, and always follow your surgeon’s advice.

Your nurse will give you some advice about caring for your healing wounds before you go home. You may be given a date for a follow-up appointment.

The length of time your dissolvable stitches will take to disappear depends on what type you have. However, for this procedure they should usually disappear in about two to three weeks.

Recovering from ovarian cyst removal

It usually takes about two weeks to make a full recovery from ovarian cyst removal, but this varies between individuals, so it's important to follow your surgeon's advice.

If you need pain relief, you can take over-the-counter painkillers such as paracetamol or ibuprofen. Always read the patient information that comes with your medicine and if you have any questions, ask your pharmacist for advice.

What are the risks?

As with every procedure, there are some risks associated with ovarian cyst removal. We have not included the chance of these happening as they are specific to you and differ for every person. Ask your surgeon to explain how these risks apply to you.

Side-effects

Side-effects are the unwanted but mostly temporary effects you may get after having the procedure.

After keyhole surgery, you will have some bruising and pain in your abdomen. You may also have some pain in the tips of your shoulders. The pain in your shoulders is known as referred pain and usually improves within 48 hours.

Complications

Complications are when problems occur during or after the operation. The possible complications of any operation include an unexpected reaction to the anaesthetic, infection, excessive bleeding or developing a blood clot, usually in a vein in the leg (deep vein thrombosis).

Specific complications of ovarian cyst removal are uncommon but can include damage to other organs in your abdomen (such as your bowel, bladder, major blood vessels, womb, one or both of your ovaries or fallopian tubes).

You should contact your doctor if you develop symptoms such as:

  • severe lower abdominal pain or swelling
  • a high temperature
  • dark or unpleasant smelling vaginal discharge
  • unpleasant smelling discharge, pain or swelling around your belly button

If you have these symptoms, it’s possible you may have developed an infection and will need treatment.

I'm pregnant and have an ovarian cyst. Can it be removed?

Answer

An ovarian cyst is unlikely to cause harm to your baby during pregnancy. Your surgeon will only advise removing the cyst if it's causing you symptoms or there’s a risk of it being cancerous.

Explanation

Ovarian cysts are usually harmless, slow-growing and go away on their own without treatment. If you’re pregnant and have an ovarian cyst, your surgeon will usually wait until you're 14 weeks pregnant before considering whether to remove the cyst.

You won’t need any treatment if the cyst isn’t causing you pain or discomfort, and there is nothing to indicate that it may be cancerous. Your surgeon will monitor the cyst with regular ultrasound scans.

If the cyst causes you pain or shows signs of being cancerous, your surgeon will recommend having keyhole surgery to remove it. Keyhole surgery is safe to perform during pregnancy, but as with every procedure, there are some risks associated with it. Your surgeon will explain these risks to you.

Can I still get pregnant if my ovary has to be removed?

Answer

If one of your ovaries is removed, you can still get pregnant, provided that your other ovary is healthy.

Explanation

If you have ovarian cysts, sometimes it’s necessary to remove the ovary to which the cysts are attached. This procedure is known as oophorectomy. Your surgeon may not know whether you need to have an oophorectomy until the procedure for removing the cyst is performed.

If you have your ovary removed, it shouldn’t affect your fertility if your other ovary is healthy. However, if you do find it difficult to get pregnant, you may need to consider IVF (in vitro fertilisation) treatment. For more information on IVF, ask your GP or gynaecologist.

Can I use contraception after I've had surgery for ovarian cysts?

Answer

Yes, although you should discuss methods of contraception with your GP first to find out which one is most suitable for you.

Explanation

If you have had ovarian cysts removed, there is no reason why you can't use contraception immediately after surgery.

Ovarian cysts are fluid-filled sacs (pockets) that can occur on the surface of your ovaries after an egg is released. The oral contraceptive pills stops your ovaries from releasing an egg and therefore reduces the risk of you having ovarian cysts. For this reason, your doctor may suggest using this method of contraception.

The oral contraceptive pill isn’t suitable for everyone. Your doctor will be able to advise which type of contraceptive is best for you.