Ovarian Cyst Removal Surgery in Singapore
Dr. Chang T.C.
Obstetrician & Gynaecologist Singapore
MBBS London, MD London, FRCS Glasgow, FRCOG UK, FAMS
Ovarian cysts are one of the most common gynaecological findings in women of reproductive age. Most are benign, cause no symptoms, and resolve on their own without any treatment. When a cyst does cause symptoms, persists beyond a few months, or has characteristics that require closer review, ovarian cyst surgery, including a cystectomy, may be recommended.
What Are Ovarian Cysts?
Ovarian cysts are sacs filled with fluid that form on the ovaries. They are a normal part of the menstrual cycle for many women and may resolve independently without causing symptoms. However, in some instances, ovarian cysts can grow larger and cause pain and other complications.
What causes ovarian cysts?
Ovarian cysts can develop for various reasons, including hormonal imbalances, endometriosis, or follicle abnormalities during ovulation. Polycystic ovary syndrome (PCOS) is also a common cause of ovarian cysts, where multiple small cysts form on the ovaries due to hormonal disturbances.
Types of ovarian cysts
Ovarian cysts can manifest in various forms, each with distinct characteristics. Common types include:
1
Follicular cysts
These develop when a follicle fails to rupture and release an egg during the menstrual cycle, causing fluid accumulation.
2
Corpus luteum cysts
These form when the follicle ruptures and releases an egg but fails to shrink afterwards, leading to fluid accumulation.
3
Endometriomas
These cysts develop when endometrial tissue grows within the ovaries, often due to endometriosis. They are sometimes called chocolate cysts because of the dark, old blood they contain.
4
Dermoid cysts
These cysts contain tissue such as hair, skin, and even teeth, originating from embryonic cells. They are typically benign.
5
Cystadenomas
Cystadenomas develop from ovarian tissue and can be filled with mucus or fluid. They can grow quite large but are usually benign.
Symptoms of ovarian cysts
Many ovarian cysts cause no symptoms at all and are found incidentally during a routine pelvic scan. When symptoms do occur, they may include:
Pelvic pain
The most common symptom associated with ovarian cysts is pelvic pain. The pain may occur on one pelvis side and can radiate to the lower back or thighs.
Bloating
Bloating or feeling fullness in the lower abdomen may be due to a cyst pressing on surrounding organs.
Changes in menstrual cycle
Ovarian cysts can cause irregularities in the menstrual cycle, including heavier or lighter bleeding than usual and spotting between periods.
Pain during intercourse
Large ovarian cysts may cause discomfort or pain during sexual intercourse, especially if they put pressure on the pelvic organs.
Urinary symptoms
Ovarian cysts that press on the bladder may cause more frequent urination or difficulty emptying the bladder.
Painful bowel movements
Large cysts can exert pressure on the rectum, causing pain or discomfort during bowel movements.
How Are Ovarian Cysts Diagnosed?
A pelvic examination is typically the first step, allowing Dr Chang to check for any tenderness or irregularity. Your menstrual and medical history will also be reviewed, as cycle patterns and symptoms help guide the assessment.
A pelvic ultrasound is the primary imaging tool used to confirm an ovarian cyst. A transvaginal ultrasound (TVU), where a small probe is gently inserted into the vagina, provides a closer and clearer view of the ovaries than an abdominal scan and is often preferred for diagnosis.
Blood tests may also be arranged. One of these is the CA-125 tumour marker test, which measures a protein that can be elevated in ovarian cancer. It is important to understand that a raised CA-125 does not automatically mean cancer. Levels can also be elevated in benign conditions such as endometriosis, fibroids, or even during menstruation. Dr Chang will interpret the result in the context of your full clinical picture.
For cysts that appear more complex on ultrasound, a CT scan or MRI may be recommended to provide further detail on the cyst’s structure and its relationship to surrounding organs.
Can ovarian cysts lead to cancer?
Most ovarian cysts are benign and do not become cancerous. Some types, including dermoid cysts and cystadenomas, carry a small risk of malignant change over time, which is why regular monitoring is recommended rather than assuming all cysts can be left indefinitely. The risk of malignancy is generally higher in post-menopausal women and in cysts that are large, complex, or contain solid components on imaging.
Regular follow-up with Dr Chang allows any concerning changes to be identified early.
Non-Surgical Treatment for Ovarian Cysts in Singapore
Watchful Waiting and Monitoring
For small, simple, asymptomatic cysts, Dr Chang may recommend a period of watchful waiting rather than immediate intervention. This typically involves a repeat ultrasound after a set interval, often six to twelve weeks, to confirm the cyst is shrinking or has resolved on its own. Most functional cysts follow this course. If the cyst persists, grows, or develops new features, the management plan is reviewed and escalated if needed.
Medication and Hormonal Management
When Is Ovarian Cyst Surgery Needed?
Ovarian Cyst Removal (Cystectomy)
When surgery is recommended, the most common procedure is an ovarian cystectomy. A cystectomy removes the cyst while preserving the healthy ovarian tissue around it, which means the ovary itself remains in place. This distinguishes it from an oophorectomy, where the entire ovary is removed.
Cystectomy is most often performed for benign cysts and aims to relieve symptoms while keeping the ovary and its function intact. It is the approach Dr Chang uses for most women undergoing ovarian cyst removal in Singapore.
Laparoscopic vs Laparotomy
Dr Chang will recommend the surgical approach based on the size, type, and complexity of your cyst. For most benign ovarian cysts, a laparoscopic approach is used. Open surgery is reserved for specific situations.
Laparoscopic Ovarian Cyst Surgery
Laparoscopic ovarian cyst removal involves making small incisions in the abdomen through which a laparoscope (a thin, flexible tube with a camera and light) and fine surgical instruments are inserted. Dr Chang uses the laparoscope to view the cyst and surrounding structures and carefully removes the cyst from the ovary. Laparoscopic cystectomy is associated with a shorter recovery, less postoperative discomfort, and a reduced risk of complications compared to open surgery. Many women are able to go home the same day or after a short stay.
Open Ovarian Cyst Surgery (Laparotomy)
A laparotomy uses a larger incision along the lower abdomen to access the ovaries directly. It is reserved for cysts that are very large, complex, or where there is a concern about malignancy that cannot be fully assessed through keyhole surgery. Recovery from a laparotomy takes longer than laparoscopic surgery. Patients typically stay in hospital for two to four days and can expect a recovery period of several weeks before returning to normal activity.
Laparoscopic vs Open Surgery at a glance:
| Laparoscopic | Open (Laparotomy) | |
| Incisions | Small keyhole incisions | Single larger incision |
| Hospital stay | Same day or one night | Two to four days |
| Recovery | One to two weeks | Several weeks |
| Discomfort | Generally mild | Generally more |
| Typical use | Most benign cysts | Large, complex, or suspected-cancerous cysts |
What to expect during the procedure
Knowing what to expect before your surgery can help ease any anxiety. A laparoscopic cystectomy is performed under general anaesthesia (where you are fully asleep).
The abdomen is gently inflated with carbon dioxide gas to create space for the camera and instruments. Dr Chang then makes two to three small incisions, through which the laparoscope and fine surgical tools are inserted.
The cyst wall is carefully separated from the healthy ovarian tissue, taking care to protect the ovary’s blood supply. The cyst is then placed inside a protective bag and removed through one of the small incisions to prevent any contents from spilling.
The incisions are closed with dissolvable stitches or surgical glue. A typical laparoscopic cystectomy takes approximately one to two hours, depending on the size and complexity of the cyst.
Recovery after ovarian cyst removal
Recovery after a laparoscopic cystectomy is generally straightforward. Most women are able to go home the same day or the following morning and can return to light activities within one to two weeks. Strenuous exercise, heavy lifting, and sexual intercourse are typically advised against for two to four weeks, depending on how you feel.
It is normal to experience some pelvic discomfort, mild bloating, or light spotting in the days after surgery. You may also notice shoulder tip pain in the first day or two after a laparoscopic procedure. This is caused by residual carbon dioxide gas used during the operation irritating the diaphragm, and it resolves on its own within a day or two. It is not a sign that anything has gone wrong.
After open surgery (laparotomy), recovery takes longer. A hospital stay of two to four days is usual, with a return to normal activities over several weeks.
Dr Chang’s team will provide specific post-operative guidance and advise you on when to return for a follow-up scan. For more detail on what to expect, you may also find our guide on recovering from ovarian cyst surgery helpful.
Risks and possible complications
Every surgical procedure carries some degree of risk, and ovarian cyst removal is no exception. With minimally invasive techniques, serious complications are uncommon, though it is important to be aware of the following:
- Infection
- Bleeding
- Damage to surrounding structures, including the bladder or bowel
- Adverse reactions to anaesthesia
- Blood clots, including deep vein thrombosis (DVT), a general risk associated with any procedure requiring general anaesthesia and reduced mobility during recovery
- Cyst recurrence, particularly with endometriomas
Dr Chang will discuss these risks with you in full before surgery, taking steps to reduce the likelihood of complications.
Fertility and ovary preservation
For women of reproductive age, preserving fertility is an important consideration when treating ovarian cysts. A cystectomy is designed to remove the cyst while keeping the healthy ovarian tissue intact, which in most cases means fertility and hormone production are not significantly affected.
The impact on fertility can vary depending on the type of cyst and the extent of surgery. Removing an endometrioma (chocolate cyst) can affect ovarian reserve (the quantity and quality of remaining eggs, measured by the AMH blood test) more than removing other cyst types. Surgery on both ovaries at the same time carries a greater impact on reserve than surgery on one side only..
Dr Chang takes an individualised approach and will discuss these considerations with you based on your specific situation.
Cystectomy vs Oophorectomy: Which Is Right for You?
When surgery is needed for an ovarian cyst, the procedure performed is not always the same. Understanding the difference between a cystectomy and an oophorectomy can help you have a more informed conversation with Dr Chang.
A cystectomy removes the cyst only, leaving the ovary intact. It is the approach used for most benign cysts in women who wish to preserve their ovarian function and fertility.
An oophorectomy removes the entire ovary, sometimes together with the fallopian tube. It may be recommended for very large or recurrent cysts where preserving the ovary is not feasible, for suspected malignancy, or in post-menopausal women where ovary preservation is less of a priority.
| Cystectomy | Oophorectomy | |
| What is removed | Cyst only | Entire ovary (sometimes with fallopian tube) |
| Ovary preserved? | Yes | No |
| Effect on fertility | Minimal in most cases | Reduces egg reserve; bilateral removal causes menopause |
| Hormone production | Maintained | Affected if both ovaries removed |
| Typical use | Benign cysts, fertility preservation | Large, recurrent, or suspicious cysts; post-menopausal women |
When should you see an ovarian cyst specialist?
Consult Dr Chang if you experience the following:
- Severe or sudden onset of pelvic pain
- Fever or signs of infection
- Difficulty breathing
- Sudden changes in urinary or bowel habits
- Unexplained weight loss
- Family history of ovarian cancer
Additionally, if you have a history of ovarian cysts or are at higher risk due to conditions like PCOS, regular check-ups are recommended to monitor for any changes.
Cost of Ovarian Cyst Removal Surgery in Singapore
The cost of ovarian cyst removal surgery in Singapore will vary depending on the type of procedure, whether you are treated in a private or restructured hospital, and your individual clinical needs.
The figures below are general guides only. Dr Chang will provide a detailed cost estimate during your consultation based on your specific situation.
| Procedure | TOSP Code | Indicative Cost Range (Private) | MediSave Limit | MediShield Life Limit |
| Laparoscopic Cystectomy (simple, day surgery) | SI700L / SI812O | ~S$9,600 to $14,500 | ~S$1,920 to $2,380 | |
| Laparoscopic Cystectomy (complex or bilateral) | SI812O | ~S$15,100 to S$21,500 | $2,380 | $2,310 |
Oophorectomy / Salpingo-Oophorectomy | SI806O | ~S$22,000 to S$31,000 | $2,380 | $2,310 |
Frequently Asked Questions on Ovarian Cyst Removal Surgery
What is the cost of ovarian cyst removal surgery in Singapore?
The cost of ovarian cyst removal surgery in Singapore depends on the type of procedure, the hospital, and your individual clinical needs. Ovarian cyst removal is a claimable surgical procedure, and MediSave, MediShield Life, and Integrated Shield Plans can offset part of the cost. Your final out-of-pocket amount will depend on your ward class, hospital, and plan.
Which surgery is used for ovarian cysts?
The choice of surgical approach depends on the size and type of cyst, your overall health, and your reproductive goals. Laparoscopic (keyhole) surgery is used for most benign cysts, while open surgery (laparotomy) may be needed for larger, more complex, or suspected-cancerous cysts.
What size of ovarian cyst is dangerous?
While there is no definitive size threshold for determining the risk of ovarian cysts, large cysts (over 5 centimetres) or those that cause symptoms such as persistent pain or bloating may warrant further evaluation and treatment.
Can ovarian cysts resolve on their own?
Many ovarian cysts resolve independently without treatment, especially if they are small and asymptomatic. However, larger cysts or those causing symptoms may require medical intervention or surgical removal.
How long does it take to recover from ovarian cyst removal surgery?
Most women recover from laparoscopic (keyhole) ovarian cyst removal within one to two weeks and are able to go home the same day or after a short stay. Recovery from open surgery (laparotomy) typically takes several weeks, with a hospital stay of two to four days.
What is the difference between a cystectomy and an oophorectomy?
A cystectomy removes only the cyst and preserves the ovary, whereas an oophorectomy removes the entire ovary. The choice depends on the cyst’s size, nature, and whether you wish to preserve fertility.
Can I use MediSave or MediShield Life for ovarian cyst surgery in Singapore?
Yes. Ovarian cyst removal is a claimable surgical procedure in Singapore. MediSave, MediShield Life, and Integrated Shield Plans can be used to offset part of the cost, with your final out-of-pocket amount depending on your ward class, hospital, and plan. Dr Chang’s clinic can advise on what applies to your situation.
Will ovarian cyst removal affect my ability to get pregnant?
In most cases, a cystectomy does not reduce fertility because the surgeon preserves the healthy ovarian tissue. However, removing endometriomas or operating on both ovaries can affect ovarian reserve. Dr Chang will discuss the likely impact on your fertility based on your specific cyst and circumstances.