How big is an ovarian cyst that requires surgery?

Ovarian cyst is a disease that many women have. If the ovarian cyst is very small, no treatment is required. If the ovarian cyst is large, treatment is required. How big an ovarian cyst should be to require surgery? If the ovarian cyst is larger than 5 cm, it needs treatment. There are two methods to treat ovarian cysts, one is drug treatment and the other is surgical treatment. Let's learn about the details.

1. How big is the ovarian cyst that requires surgery?

How big an ovarian cyst needs surgery? Generally 5 cm. Generally, cysts smaller than 5 cm are considered physiological cysts and do not require surgical treatment. Only ultrasound follow-up every 3 months is required. Most physiological cysts will shrink or disappear on their own, but they may grow again on the other ovary or the same ovary. For cysts with a diameter greater than 5 cm, surgical treatment is recommended mainly because of the possible complications of rupture, infection, torsion, etc.

Many patients believe that surgical removal is only necessary when the cyst grows to a certain size. However, in addition to the size of the cyst, other conditions of the patient must also be considered, such as whether the cyst has ruptured, whether the patient has an infection or has more serious symptoms.

2. Treatment of ovarian cysts

When treating ovarian cysts, the patient's age, whether the cyst has worsened, and the location, volume, size, growth rate of the cyst should be considered. At the same time, whether the reproductive function can be retained and the patient's own subjective wishes should also be considered. The vast majority of ovarian cysts are benign, so surgical treatment should not be performed blindly. The treatment of ovarian cysts is as follows:

1. Treatment of benign cysts

(1) General treatment

If it is a simple cyst, without septa, intracystic papillae, calcification and other complex features, it is basically benign and can be observed conservatively. The cyst will usually be smaller or gone when you check it out again 4-8 weeks later. If the cyst does not disappear, but ultrasound shows that it is still a simple cyst, you can still continue to observe closely. If physiological ovarian cysts are accompanied by endocrine symptoms such as menstrual disorders, oral medications can be used to alleviate the symptoms. However, for pathological cysts, no oral medications with clear therapeutic effects have been found so far.

(2) Surgical treatment

Ovarian cystectomy is often performed on young patients, especially premenopausal patients, while preserving normal ovarian tissue as much as possible.

Salpingo-oophorectomy: For older women (over 45 years old) or postmenopausal women, unilateral or bilateral salpingo-oophorectomy can be performed.

2. Treatment of malignant cysts

For cysts that are considered malignant or have unclear diagnosis, the resected material should be sent for pathological examination after surgery to determine the nature of the cyst under a microscope before considering the next step of treatment. If an ovarian cyst shows complications such as torsion, rupture, bleeding, or infection, emergency surgery should be performed.

Most patients are already in the late stage of the disease when they seek medical treatment, so during treatment, every effort should be made to remove the primary cyst and visible pelvic and abdominal metastases. Currently, a blanket-style removal of the uterus and tumor along with the pelvic peritoneum is often used, such as omentectomy, partial intestinal resection, partial bladder resection, and ureter resection. Consideration should also be given to placing a catheter in the peritoneal cavity to facilitate postoperative intraperitoneal injection of chemotherapy drugs.