We aim to examine inside your pelvis to confirm that the cyst is on your ovary. We will find out what type of cyst it is, so we can decide on the best treatment. If you need a cystectomy, where we remove the cyst, we will leave you with as much healthy ovary as possible.
An open operation gives us a direct view inside your pelvis. We can confirm that you have a cyst in your ovary and what type it is. We can then decide on the best treatment. If we remove the cyst from your ovary, we send any removed tissue for microscope examination. If the cyst is somewhere else in your pelvis we can usually treat it as needed.
An open operation is often the safest way of dealing with very large cysts that cannot be removed with a keyhole operation. It is also safer than a keyhole operation if you have a lot of internal scarring, called adhesions, usually from a previous operation or infection.
Are there any alternatives?
Ultrasound scans, x-rays, CT scans and MRI scans can all be used to examine your ovaries to give more information.
The tests may reveal that an open ovarian cystectomy is the only option due to the size or type of cyst. For example, a large dermoid cyst must be removed without spilling its contents as the sebaceous material inside it could irritate other internal organs.
Instead of an open operation you could have a keyhole operation. This is called a laparoscopic ovarian cystectomy. We can do this for small cysts that are less than about 10cm and are not stuck to the surrounding tissues. A keyhole operation may not be safe if you have adhesions from past operations or infections.
Discuss the options with your surgeon. There is another leaflet in this series covering laparoscopic ovarian cystectomy.
What if you do nothing?
If you do nothing, the cause of the cysts will remain in doubt. You may miss out on important treatment. Your symptoms will probably get worse. You could develop serious complications, such as bleeding into the cyst or twisting of the cyst cutting off its blood supply. This would leave no alternative but an emergency operation.
If an ultrasound scan shows that you only have a small cyst or cysts, less than a centimetre in diameter, they are unlikely to cause problems. These small follicular cysts do not cause symptoms and can often be ignored. You may need a repeat ultrasound to check this. If the cysts cause problems we usually need to operate to relieve the symptoms.
Author: Dr David Hutchon M.R.C.O.G, F.R.C.O.G. Consultant Gynaecologist.
© Dumas Ltd 2006