Ovarian cysts treatment

Anna Janusz, a gynaecologist from the Medfemina Hospital in Wrocław, talks about methods of treating ovarian cysts.

The optimal method of treating ovarian cysts is laparoscopy. It is the gold standard of treatment in most cases. This method is
a very non-invasive method of treatment that leaves little trace and allows for a very quick return to normal functioning. It is very precise and allows for a very accurate removal of lesions, as the camera used for laparoscopy allows high image magnification; 3D screens are also used which further increase the precision of the operation. Laparoscopy is a method recommended also for people with an increased BMI, because it significantly improves healing after surgery.

In the laparoscopic technique, 3 or 4 incisions are made in the abdominal skin, 5-10mm in length: the first at the navel, the others above the pubic hair line.

If the lesion is suspicious in nature, very large or in large adhesions, surgery by laparotomy with cutting through a longer section of abdominal skin may be required.

Surgery to remove an ovarian cyst involves removing it from a healthy part of the ovary. We do it very carefully, with the aim of removing the entire cyst so that it does not grow back and sparing as much of a healthy ovary as possible, in order to maintain the proper ovarian reserve and thus fertility and the proper hormonal function of the ovary. Sometimes the preservation of the ovary is inadvisable or impossible, in which case it is necessary to remove the entire ovary, optimally including the fallopian tube. A histopathological examination of the removed lesions is always carried out, this is a highly specialised examination with appropriate staining which allows the nature of the lesion to be examined in great detail.

The operation, either by laparoscopy or by laparotomy, is performed under general anaesthesia, the patient is asleep and does not feel pain.

Surgical treatment of an ovarian cyst usually leads to complete removal of the ovarian cyst and thus complete recovery. Surgery is the only method that allows the nature of the lesion to be determined unambiguously, which also allows the malignant nature of the lesion to be excluded in case of doubt and the precise postoperative management to be determined.

Unfortunately, the surgical procedure is associated with the possibility of complications, but these are rare. Those are, among others:

damage to adjacent abdominal organs (ureter, bladder, intestines, blood vessels in the abdominal cavity)
postoperative intestinal obstruction
intraoperative and postoperative bleeding, formation of abdominal haematoma
infectious complications (peritonitis, cystitis, postoperative wound infection)
thromboembolic complications (e.g. thrombophlebitis in the lower limbs)
the formation of adhesions in the abdominal cavity
anaesthetic complications

What is the recovery time after surgery?

The recovery time after surgery to remove an ovarian tumour is usually short.

If the operation was performed laparoscopically, the scope of the surgery was limited to removal of the cyst or removal of the cyst with the appendages, the patient is discharged home the next day after the operation. Pain levels are low, requiring short-term pain medication at home. Mostly the return to normal function takes place up to 2 weeks after laparoscopy, you should refrain from intense physical effort for 4 weeks after surgery.

If the procedure was performed by laparotomy, then the patient spends about 48 hours in the hospital after the surgery. The pain is of moderate intensity. Most often, the return to normal functioning takes place within 1-2 months. Do not carry any weight for 3 months after the operation.

Preparation for surgery:

Before the operation, a gynaecological and anaesthetic qualification is carried out, where the necessary tests are ordered along with a timetable for their completion. These are mainly blood tests. An electrocardiogram and chest X-ray may also be required.

You should report to the surgery on an empty stomach (that is, do not eat or drink for at least 8 hours). Drugs taken regularly should be swallowed in the morning with a small amount of still water.