Surgery for an ovarian cyst or growth may be advised in the following situations:
- A cyst is causing persistent pain or pressure, or may rupture or twist.
- A cyst appears on ultrasound to be caused by endometriosis and is removed for fertility reasons.
- Large cysts (>5 to 10 cm) are more likely to require surgical removal compared to smaller cysts. However, a large size does not predict whether a cyst is cancerous. Surgery is also needed if an ovarian cyst that is being watched does not get smaller or go away in 2 to 3 months.
- If the cyst appears suspicious for cancer. If you have risk factors for ovarian cancer or the cyst looks potentially cancerous on imaging studies, your healthcare provider may recommend surgery.
- Ovarian growths (masses) are present in both ovaries.
- Ovarian cyst surgery is needed if you have an ovarian growth and you have never had a menstrual period (for example, a young girl). If you’re having periods, only mild symptoms and the cyst is functional, you probably won’t need to have surgery.
- If you’re past menopause and have an ovarian cyst, your doctor will probably want you to have surgery. Ovarian cancer is rare, but women 50 to 70 years of age are at greater risk. Women who are diagnosed at an early stage do much better than women who are diagnosed later.
- Ovarian cyst surgery is recommended if you have an ovarian growth and use birth control pills (unless you are using low-dose progestin-only pills or have missed a pill, which would make an ovulation-related functional cyst more likely).