FAQs related to ovarian cyst surgery: recurrence and fertility

Written by: Mr Mahantesh Karoshi
Published:
Edited by: Robert Smith

Ovarian cysts are quite common, and usually, they are harmless. However, sometimes they will need to be removed if they’re causing symptoms of if there are concerns they could be malignant.

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We found out some of the answers to your FAQs related to ovarian cyst surgery from Mr Mahantesh Karoshi, a leading London women’s health expert and consultant gynaecologist.
 

I am left with one tube and ovary following torted ovarian cyst surgery, what are my options?

Minority of young women develop benign cysts in their ovaries and some may end up having an ovarian cyst accident such as torsion requiring emergency removal of the ovary. This can cause a girl to end up with one tube and ovary.

If this is the case, we would have to look at the options, if any, to preserve the remaining ovary.
 

What are the chances that a patient will get another cyst that needs treatment?

There is a 40% risk of recurrence. Evidence also shows that the larger the cyst, greater the risk of recurrence.
 

Should I be having regular scans of the remaining ovary to monitor for recurrence?

The answer to this is ‘yes’, but, there is not much scientific evidence based publications as we have in menopausal women with ovarian cysts.
 

Is there an impact on my future fertility now that I only have one ovary left?

In the long term ‘yes’. Several studies have shown that women who had undergone unilateral removal of their ovaries responded less well to ovarian stimulation.

 

Is there something I can do to completely stop this from happening again?

Oral contraceptive pills are considered to reduce the risk of recurrence of ovarian cysts.

 

I was told that progestogen only pills can make cysts in the ovary, is this true?

Yes, that’s correct.

 

What is the best thing I can do to preserve my future fertility?

Freezing of eggs is a good option.
 

To prevent recurrent torsion (not the cysts), patient can undergo laparoscopic shortening of the ovarian ligament

Figure 1 - Before laparoscopic shortening of the ovarian ligament
Figure 1 - Before laparoscopic shortening of the ovarian ligament

 

Figure 2- After laparoscopic shortening of the ovarian ligament

 

For an evaluation of ovarian cysts or for more guidance related to female reproductive health issues, you may like to book an appointment with a leading consultant gynaecologist such as Mr Mahantesh Karoshi . Visit his Top Doctors profile today for more information on appointment availability.

 

Sources

1. BMJ Best practice guidelines
 

2. Bonilla-Musoles F, Ballester MJ, Simon C, et al. Is avoidance of surgery possible in patients with perimenopausal ovarian tumors using transvaginal ultrasound and duplex color Doppler sonography? J Ultrasound Med. 1993 Jan
 

3. Hartley, J., Akhtar, M. and Edi-Osagie, E., 2018. Oophoropexy for recurrent ovarian torsion. Case reports in obstetrics and gynecology, 2018.
 

4.Lass, Amir. (1999). The fertility potential of women with a single ovary. Human reproduction update. 5. 546-50. 10.1093/humupd/5.5.546.
 

5. Cramer, D.W., Xu, H. and Barlow, B.L. (1995) Does ‘incessant’ ovulationincrease risk for early menopause? Am. J. Obstet. Gynecol., 172,568–573.
 

6. MacKenna, A., Fabres, C., Alam, V. and Morales, V., 2000. Clinical management of functional ovarian cysts: a prospective and randomized study. Human reproduction, 15(12), pp.2567-2569.
 

7. Grimes, D.A., Jones, L.B., Lopez, L.M. and Schulz, K.F., 2011. Oral contraceptives for functional ovarian cysts. Cochrane Database of Systematic Reviews, (9).

By Mr Mahantesh Karoshi
Obstetrics & gynaecology

Mr Mahantesh Karoshi is a London-based women’s health expert and consultant gynaecologist, with a special interest in ovarian cysts, heavy menstrual bleeding, infertility, fibroids, and adenomyosis. He is currently one of the most highly-rated gynaecologists in London with a very good reputation amongst his patients and peers.

Mr Karoshi's work is recognised internationally, having volunteered in Ethiopia’s Gimbie Hospital, and later receiving the Bernhard Baron Travelling Fellowship from the Royal College of Obstetricians and Gynaecologists which led to his work in the University of Buenos Aires. Here he worked on the techniques needed to surgically manage morbidly adherent placental disorders - a serious condition that can occur in women with multiple caesarean sections.

He believes in an open doctor-patient relationship, being sure to include the patient and educating them so that they understand their condition better and they can be directly involved in their care and management at every stage. Aside from his clinical work, he is actively involved in research, which together with his experience, has given him the opportunity to publish the first stand-alone textbook on postpartum haemorrhage which was launched by HRH Princess Anne.

At the core of Mr Karoshi's practice is a high standard of professionalism where patients are involved in their treatment and where the latest techniques and advancements are used to provide an extremely high level of care.

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