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Ovarian Cystectomy

What is an Ovarian Cystectomy? 

An Ovarian cystectomy is the removal of an ovarian cyst.

Reason for having an ovarian cystectomy:

Ovarian cystectomy should be done if you have an ovarian cyst that: 

  • Does not go away after several periods;
  • Has grown larger over several menstrual cycles;
  • Is causing you pain;
  • Is contributing to fertility problems;
  • Starts bleeding;
  • Shows signs of being cancerous.

Having ovarian cysts does not lead automatically to surgery. In most cases, ovarian cysts do not cause any problems and go away on their own. You doctor might choose to prescribe birth control pills to prevent ovulation.

What are the benefits?

The benefits of an ovarian cystectomy are the alleviation of symptoms which ovarian cyst cause. Symptoms can vary from patient to patient but may include: irregular and/or heavy periods, pain which can be constant or sudden and quite sever/ and or a swollen abdomen.

What are the risks?

Risks following surgery include the following:

  • Risks of general anaesthetic: there is a 1 in 100 risk of vomiting, dizziness, blurred vision and headache after general anaesthetic. Your anesthetist will provide you with more information.
  • 15 in 1000 risk of damage during surgery to the bowel or bladder or ureter.
  • 2 in 1000 risk of infection
  • Less that 1 in 500 risk of thrombosis (clots) in legs or lungs
  • Haemorrhage (bleeding) during or after surgery.
  • Problems at wound opening / scars including hernia.
  • Ovarian cysts may come back after cystectomy
  • Pain may not be controlled
  • Scar tissue (adhesions) may form at the surgical site, on the ovaries or fallopian tubes or in the pelvis.
  • Failure to complete the keyhole surgery may result in you needing either a laparotomy (opening the abdomen), a cystoscopy (camera in to the bladder) or catheter to visualize the ureters.

What are the alternatives?

Watchful waiting: do nothing and monitor the cyst using scanning or other imaging methods and only operate if the cyst becomes bigger or symptomatic. However in taking this option, we will not know the nature of the cyst that may contain some cancerous cells. We would discuss this with you and the likelihood of this cyst being cancerous.
Hormones Therapy: contraceptive pills may be used to reduce the size of the cyst
Oophorectomy: (removal of the ovary) if the ovarian cyst has affected your ovary too much, the whole ovary may have to be removed.
Hysterectomy: (removal of the uterus) this usually is not necessary unless the cyst is cancerous.

Before the operation

You will be advised of when you should stop eating and drinking before your operation

During the operation

The operation is carried out under general anaesthetic and takes about 40-60 minutes.

  • The operation is commonly performed laparoscopically, using a small fiber ‘telescope’ which is inserted through a small incision. Occasionally a conventional operation (laparotomy) is used.
  • The cyst is carefully cut away from the ovary and sent for laboratory testing. The ovary is then stitched and returned to its normal size and shape.

After the operation

The average hospital stay is overnight and complete recovery usually occurs within 6 weeks. If the operation has been performed using Keyhole surgery (laparoscopy) the recovery time will be shorter. There will be some discomfort following the surgery which will be controlled with pain killers.

The following guidelines are intended to give you a general idea of your postoperative course. Since every patient is unique and has a unique procedure, your recovery may differ.

Pain relief

Anti-inflammatory pain medicine is usually required for the first several days to manage soreness and inflammation. We recommend that anti inflammatory medications, such as ibuprofen, naproxen etc.. Be used on a scheduled (regular) basis and that narcotic pain medicine be utilized on an “as needed” basis. Narcotic pain medicine will be provided to assist with discomfort from the incisions.

Driving

Driving is allowed after your procedure only when you do not require the narcotic pain medicine to manage your pain.

Work

Patients may return to work in 5-7 days following the procedure.

Your wounds

Incision may bruise but they should not become red or inflamed.

Going home

You will be given some advice / information before you leave which is specific to your operation and recovery. Once home, you should rest and take painkillers as advised. If you are worried about your condition (bleeding, fever or severe pain) you can either ring back within in 24 hours or contact your GP for advise. A check up will be done either by your GP or in the gynaecology clinic in the hospital (depending upon each case) 6 weeks after the operation.

Following the 6-week check, if all is well, you can go back to your normal routine including driving, sport, sex and work.

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