Do I need surgery for ovarian cysts?

For women, when they reach a certain age, they need to have regular gynecological examinations, and ovarian cysts are a problem that many women find during the examinations. But do ovarian cysts require surgery? In fact, whether or not ovarian cysts need treatment depends on their size. If they are within a certain range, they do not need to be eliminated. Most of them are physiological and will disappear on their own. However, if the ovarian cysts are too large or too numerous, the possibility of disease development should be considered and surgery must be performed to eliminate them.

How big is an ovarian cyst that requires surgery?

1. Diameter greater than 5CM:

Generally, cysts smaller than 5CM are considered physiological and require follow-up ultrasound examinations every 3 months. Most of them will shrink or disappear on their own. You can simply use medicine [Nang.Zhongfufang Shantie] to regulate the condition, and then follow up closely. If a cyst with a diameter greater than 5CM is purely cystic, it is actually not very harmful. The main possible complications are rupture, infection, torsion, etc., so surgical treatment is recommended.

2. Ovarian chocolate cyst:

Generally, B-ultrasound will show that there are dense light spots inside the cystic tumor. If the patient also has infertility or severe dysmenorrhea, surgical treatment will be performed. If there are no above problems, gynecological examination can also be followed up. If the diameter grows to more than 5CM or ruptures, becomes infected, or is suspected of becoming malignant, surgical treatment will be required.

3. There are solid areas inside the cyst:

Considering the possibility of malignancy, surgical treatment is required. Surgical treatment of ovarian cysts

1. Ovarian cystectomy: Most of these patients have no menstrual disorders, and some even have complicated pregnancy. If the tumor is more obvious on one side, a salpingo-oophorectomy on the affected side can be performed.

2. Salpingo-oophorectomy: Unilateral ovarian cyst occurs in older patients (over 45 years old), while bilateral ovarian cysts usually require unilateral or bilateral oophorectomy. Patients who are not fit for surgery due to general condition or have severe inflammation often undergo total hysterectomy. It is worth noting that for the surgical treatment of larger ovarian cysts, the size of the incision should be ignored and complete resection is appropriate to avoid rupturing the patient's pulse and allowing the contents to spill into the abdominal cavity or incision. During the operation, attention should be paid to the patient's pulse, breathing, and blood pressure changes. When necessary, infusion or blood transfusion, oxygen supply should be accelerated. Early detection of acute gastric dilatation, paralytic intestinal obstruction, and the resulting water and electrolyte imbalance and blood chemistry changes should also be prevented.

3. Adnexectomy and total hysterectomy: For unilateral or bilateral ovarian cysts that occur in women who are near menopause or menopause, and the patient's general condition is not adequate for the procedure, bilateral adnexectomy and total hysterectomy are appropriate, but this will seriously affect endocrine disorders.

Surgical treatment of malignant ovarian cysts:

Most patients are in the late stage when they seek medical treatment, so every effort should be made to remove the primary cyst and any visible pelvic and abdominal metastases. Because malignant ovarian cysts are often adhered or infiltrated with the uterus and adnexa, and are closely attached to the pelvic peritoneum, the uterus and tumor are often removed in one piece, such as by rolling carpet or dumpling-like removal of the greater omentum, partial intestinal resection, partial bladder and ureter resection. For ovarian malignant tumors complicated with ascites, regardless of whether they are completely removed or not, it is advisable to place a catheter in the abdominal cavity to facilitate postoperative intraperitoneal injection of anticancer drugs or radioactive colloidal gold or colloidal phosphorus.

Surgical treatment of complications of ovarian cysts:

1. Ovarian cyst pedicle torsion requires emergency surgery after diagnosis. Analgesics should be injected intramuscularly first. Regardless of the patient's age, it is appropriate to perform an oophorectomy on the affected side.

2. Rupture of ovarian cyst should be treated by laparotomy as soon as possible, because the contents of the cyst overflow into the abdominal cavity, whether it is benign or malignant, there is a possibility of implantation, so the abdominal cavity and incision should be thoroughly lavaged.

3. Ovarian cysts complicated with infection: If anti-infection drugs are used for a period of time, but the body moisture does not decrease or the local symptoms become more severe, laparotomy should be performed to remove the tumor to eliminate the infection focus, and the symptoms can often subside quickly.

4. Ovarian cysts and peritoneum have extensive adhesions. This is often seen in patients with giant ovarian cysts that are misdiagnosed as massive ascites, who have undergone repeated abdominal paracentesis or ovarian cyst infection.