Management depends on your symptoms, characteristics of the cyst and results of blood tests.
Small asymptomatic ovarian cysts that have no suspicious features on ultrasound may be managed expectantly. This usually involves a follow-up ultrasound scan in about three to four months to monitor for any change in size or appearance of the cyst.
Surgery will be recommended if the ovarian cyst is symptomatic or has abnormal features.
Laparoscopy (keyhole surgery) is the approach of choice if the risk of malignancy is low, as it is associated with less post-operative pain and a faster recovery.
Laparotomy (open surgery) may be recommended if you have had previous surgery, if the ovarian cyst is large or if it has suspicious features.
Cystectomy involves the removal of the cyst with preservation of normal ovarian tissue. This is usually done for pre-menopausal women in order to conserve ovarian tissue for reproductive and hormonal function.
Oophorectomy is the surgical procedure to remove the entire ovary. Post-menopausal women will usually be offered removal of both ovaries as this has the advantage of reducing the risk of developing ovarian cancer or cysts in the future.
If the risk of ovarian cancer is high, your doctor will discuss frozen section and surgical staging.
Frozen section involves sending the excised ovarian tissue for microscopic examination while you are still under general anaesthesia. If this test reveals malignant cells and you have given prior consent, your surgeon may then proceed to perform a full staging surgery as part of the treatment for ovarian cancer. This involves removing the uterus, both fallopian tubes and ovaries, the omentum (a layer of fatty tissue that covers the abdominal contents like an apron) as well as lymph nodes.
