Ovarian Cystectomy: Your Guide to Surgery, Recovery, and What to Expect

An ovarian cystectomy is a surgical procedure designed to remove cysts from your ovaries while preserving the healthy ovarian tissue. 

It’s important to understand that ovarian cysts are usually benign (non-cancerous) growths that form on or within the ovaries. While the vast majority of cysts are harmless, a small portion of complex cysts can be borderline or malignant. These cysts are fundamentally different from cancerous tumors and typically have much more favorable outcomes. 

For many women facing ovarian cysts, understanding the ovarian cystectomy procedure can provide clarity during what might feel like an overwhelming time.

Whether you’re dealing with painful symptoms or have been told you need surgery, knowing what to expect can help you feel more confident about your treatment journey. 

This guide covers everything from the basics of the procedure to recovery expectations and important considerations for women navigating ovarian cancer concerns.

What is an Ovarian Cystectomy?

An ovarian cystectomy is a targeted surgical procedure that removes cysts from your ovaries while keeping the ovary itself intact. Think of it as precisely removing the unwanted growth while preserving your reproductive organs.

This procedure differs significantly from an oophorectomy surgery, which involves removing the entire ovary. The distinction matters enormously, especially for women of reproductive age or those dealing with cancer-related concerns.

During the surgery, your surgeon carefully separates the cyst from healthy ovarian tissue. The goal is always to maintain as much normal ovarian function as possible while addressing the problematic cyst.

Most ovarian cysts are benign, but surgery becomes necessary when they cause symptoms, grow large, or when there’s concern about their nature. Your healthcare team will determine the best approach based on your specific situation.

Learn more: “What Causes Ovarian Cysts?”

Types of Ovarian Cystectomy: Laparoscopic vs. Open Surgery

When it comes to removing ovarian cysts, surgeons have two main approaches at their disposal. The choice between these methods depends on factors like cyst size, location, your medical history, and whether cancer is suspected.

Laparoscopic Ovarian Cystectomy

Laparoscopic surgery represents the preferred approach for most ovarian cyst removals. This minimally invasive technique uses several small incisions rather than one large opening.

Your surgeon inserts a laparoscope — a thin tube with a camera — through a small incision near your belly button. Two to three additional small incisions allow for surgical instruments to be inserted. The camera provides a clear view of your pelvic organs on a monitor.

Carbon dioxide gas inflates your abdomen, creating space for the surgeon to work safely. This technique offers several advantages: less pain, smaller scars, and faster recovery times.

Open Surgery (Laparotomy)

Sometimes open surgery becomes necessary. Your surgeon makes a single, larger incision in your lower abdomen — similar to a cesarean section incision.

Open surgery might be recommended if:

• The cyst is extremely large
• There’s concern about cancer
• Previous surgeries have created scar tissue
• The cyst has ruptured or caused complications

While recovery takes longer with open surgery, it allows your surgeon better access and visibility for complex cases.

When Do You Need an Ovarian Cystectomy?

Not every ovarian cyst requires surgery. Many cysts resolve on their own within a few menstrual cycles. However, your doctor might recommend surgery in several situations.

Size matters significantly. For premenopausal women, cysts smaller than 5 cm (about 2 inches) will usually resolve naturally with menstrual cycles. Cysts measuring 5-7 cm should be monitored yearly with ultrasound, while those larger than 7 cm typically require surgical intervention. 

However, many physicians recommend surgery for cysts larger than 5 cm. Research shows that up to two-thirds of women with cysts 10 cm or smaller may see spontaneous resolution, though larger cysts are less likely to disappear naturally and carry higher risks of complications.

Persistent symptoms often drive the decision for surgery. If you’re experiencing ongoing pelvic pain, bloating, or pain during intercourse, removing the cyst might provide relief.

Cancer concerns make surgery urgent. While most ovarian cysts are benign, certain characteristics on imaging or elevated tumor markers like CA-125 might indicate a need for immediate evaluation and removal.

Complications such as ovarian torsion or cyst rupture require emergency surgical intervention. These situations can cause severe pain and potentially threaten your ovary’s blood supply.

For women going through menopause, any new ovarian cysts warrant closer scrutiny since functional cysts become less common after menopause.

How Long Does Ovarian Cystectomy Surgery Take?

The duration of ovarian cystectomy surgery varies based on several factors, but most procedures take between 30 minutes to 2 hours.

Laparoscopic procedures typically require 30 to 60 minutes for straightforward cases. Simple cysts with clear boundaries often fall into this timeframe.

Complex cases might extend the surgery time. Large cysts, multiple cysts, or unexpected findings can increase the duration to 90 minutes or more.

Open surgery generally takes longer, often 1 to 2 hours, due to the more extensive approach and closure requirements.

Your surgeon’s experience and your specific anatomy also influence timing. Don’t worry if your surgery takes longer than expected — your surgical team prioritizes thoroughness and safety over speed.

The Ovarian Cystectomy Procedure

Understanding what happens during your surgery can help reduce anxiety and prepare you mentally for the experience.

After you’re under general anesthesia, your surgeon begins the laparoscopic approach with small incisions — one near your belly button for the camera and 2 to 3 others for instruments. Carbon dioxide inflates your abdomen for better visibility.

The critical step involves carefully separating the cyst from healthy ovarian tissue. Your surgeon scores the cyst’s surface and develops the plane between the cyst wall and normal ovary, preserving as much healthy tissue as possible.

Once removed, the cyst goes into a special bag for safe extraction. The ovary is repaired with dissolvable sutures, incisions are closed, and you’ll wake up in recovery where nurses monitor your comfort and vital signs.

How Long is Recovery After Ovarian Cystectomy?

Recovery timelines vary significantly between laparoscopic and open surgery approaches, but understanding what to expect helps you plan accordingly.

Immediate Post-Surgery (First 24 to 48 Hours)

Laparoscopic recovery allows most patients to go home the same day or after an overnight stay. You’ll feel tired from the anesthesia, and some shoulder pain from residual gas is normal.

Open surgery typically requires a 1 to 3-day hospital stay. Your surgical team monitors your incision, pain levels, and overall recovery progress.

Pain medication helps manage discomfort during these first crucial days. Many patients find the shoulder pain from laparoscopic surgery more bothersome than the incision sites.

Week One: Taking It Easy

The first week focuses on rest and gentle movement. Short walks help prevent blood clots and aid recovery, but avoid strenuous activities.

Laparoscopic patients often return to desk jobs within 1 to 2 weeks. Physical jobs might require 2 to 3 weeks off, depending on lifting requirements.

Open surgery patients need more time, typically 4 to 6 weeks before returning to full activities. The larger incision requires more healing time.

Weeks 2 to 4: Gradual Return to Normal

Most laparoscopic patients feel significantly better by week two. You can gradually increase activity levels, but listen to your body’s signals.

Sexual activity can usually resume when you feel comfortable, typically 2 to 3 weeks after laparoscopic surgery and 4 to 6 weeks after open surgery. However, it’s important to follow the guidelines that your surgeon set for you. 

Long-Term Recovery Considerations

Full recovery occurs over 6 to 12 weeks, depending on your surgery type and individual healing process. Some patients experience ongoing fatigue or emotional adjustment during this period.

Regular follow-up appointments ensure proper healing and address any concerns. Your surgeon will provide specific activity restrictions based on your procedure and recovery progress.

Cystectomy vs. Oophorectomy: Understanding Your Options

The distinction between ovarian cystectomy and oophorectomy becomes particularly important for women dealing with ovarian cancer concerns or borderline ovarian tumors.

Cystectomy removes only the cyst while preserving healthy ovarian tissue. This approach maintains hormone production and fertility potential when possible. For young women with borderline ovarian tumors, fertility-sparing surgery might be an option with careful evaluation.

Meanwhile, oophorectomy surgery removes the entire ovary and becomes necessary when cancer risk is high, the cyst involves most of the ovary, or you’re postmenopausal. For women with BRCA mutations, preventive oophorectomy might be discussed as a risk-reduction strategy.

Making the Right Choice

Gynecologic oncologists provide specialized expertise for complex cases, considering your age, cancer risk, fertility desires, and the cyst’s characteristics. The goal is always effective treatment while preserving as much normal function as possible.

Risks and Complications

Like any surgical procedure, ovarian cystectomy carries potential risks, though serious complications are relatively uncommon.

Common, Minor Complications

Bleeding at the surgical site occurs occasionally but rarely requires intervention. Infection at incision sites is uncommon with proper care.

Shoulder pain from residual gas affects most laparoscopic patients but resolves within days.

Serious but Rare Complications

Damage to surrounding organs including the bladder, bowel, or ureters can occur but is uncommon with experienced surgeons.

Blood clots represent a serious risk, which is why early mobilization after surgery is encouraged.

Need for oophorectomy might arise if the cyst involves too much of the ovary or if unexpected findings occur during surgery.

Long-Term Considerations

Ovarian function typically returns to normal after cystectomy, though some reduction in ovarian reserve is possible.

Fertility generally remains intact, though individual cases vary based on the extent of ovarian tissue removed.

When to Call Your Doctor

Severe pain that doesn’t improve with prescribed medication warrants immediate attention.

Signs of infection including fever over 100.4°F, redness, warmth, or discharge at incision sites require prompt evaluation.

Heavy vaginal bleeding (soaking more than one pad per hour) needs immediate medical attention.

Difficulty urinating or signs of blood clots in your legs (pain, swelling, warmth) require urgent care.

Ovarian Cystectomy: Your Path Forward

An ovarian cystectomy can provide significant relief from symptoms while preserving your ovarian function when possible. Understanding the procedure, recovery expectations, and potential outcomes helps you make informed decisions about your care.

For women dealing with ovarian cancer concerns, working with specialists who understand the nuances of ovarian cancer treatment ensures you receive the most appropriate care for your situation.

Remember that every patient’s journey is unique. Your healthcare team is your best resource for personalized guidance based on your specific circumstances and health goals.