Where an ovarian cyst is small and causing few symptoms, provided the blood tests and scan show no cause for concern, it may well be reasonable to wait for the cyst to disappear without treatment. In many such cases, a follow up scan in 8-12 weeks will show that the cyst has gone.
For larger cysts or where there are more significant symptoms, a decision on the best treatment will usually depend on whether the tests show any significant risk of the cyst being malignant. For most, this will not be the case, and there is a wide range of possible surgery options. Laparoscopic (keyhole) surgery is often the best choice and it may be possible to remove the cyst in this way, leaving the normal ovary behind (laparoscopic ovarian cystectomy). Sometimes the cyst cannot be separated from the ovary, which therefore has to be removed completely (laparoscopic oophorectomy).
Where the ovarian cyst is very large, where there are potential difficulties for a laparoscopic approach, or where the cyst shows possible signs of malignancy, then surgical treatment would be recommended via an abdominal incision. The type of incision used will depend upon the precise circumstances and is very much an individual matter. You will, of course, be able to discuss this aspect in detail with your surgeon before surgery.
