An ovarian cyst is a fluid-filled sac in the ovary. They are very common and, in most cases, benign. Finding a cyst does not mean surgery is needed: management depends on its features, your symptoms and how it evolves.
When watchful waiting is enough
Many cysts are functional: they appear with the cycle and resolve on their own within one or two periods. In those cases the best approach is usually to monitor with a follow-up ultrasound, without surgery. Small, simple, symptom-free cysts usually fall in this group.
When surgery is considered
- The cyst persists or grows on follow-up.
- It is large or causes pain or pressure.
- There is a complication such as torsion (twisting of the ovary) or rupture.
- It has features that warrant study on ultrasound.
- It is an endometrioma (an endometriosis cyst) causing pain or affecting fertility.
When surgery is needed, I perform it by minimally invasive surgery (laparoscopy) and, in most benign cases, with cystectomy preserving the ovary: the cyst is removed and healthy tissue is kept.
Frequently asked questions
Do all ovarian cysts need surgery?
No. Many are functional and resolve on their own; they are monitored with ultrasound. Surgery is considered when they persist, grow, cause symptoms or need study.
Can the ovary be preserved?
In most benign cases yes: laparoscopic cystectomy removes the cyst while preserving the ovary.
Is an ovarian cyst cancer?
The vast majority are benign, especially in reproductive age. Some features lead to closer study; evaluation helps clarify it.
Does a cyst affect pregnancy?
Many do not. Some, such as endometriomas, can have an effect; they are assessed case by case.