Uzm. Dr. Ertan Özen
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- 36+years exp.
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Gynaecological Procedures
Ovarian or paraovarian cyst removal
When an ovarian or paraovarian cyst needs removal and when monitoring is enough, how keyhole cystectomy preserves the ovary, how it differs from removing the ovary, approximate costs in Turkey against the UK, US and Germany, recovery milestones, effects on fertility, risks and how to choose a gynaecology hospital.
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Prof. Dr. Zehra Neşe Kavak
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Ovarian or paraovarian cyst removal in Turkey: what it is
Ovarian or paraovarian cyst removal is an operation to take out a fluid-filled sac that has formed on the ovary (ovarian cyst) or beside it in the tissue of the broad ligament (paraovarian cyst, sometimes called a paratubal cyst). Most cysts are harmless and many ovarian cysts disappear without treatment, so surgery is reserved for cysts that are large, painful, growing, persistent or that look suspicious on scan. In most women the cyst alone is removed through small keyhole incisions and the ovary is left in place. Gynaecology departments in Turkey perform this routinely, mainly by laparoscopy.
This guide explains when removal is advised, how the surgery is done, what it costs compared with the UK, US and Germany, how long recovery takes and what the risks are. Related care is listed in our overview of gynaecology treatments in Turkey.
Does my ovarian or paraovarian cyst need to be removed?
Not always. Functional cysts, which form during the normal monthly cycle, usually shrink within a few menstrual cycles, and the NHS advises monitoring with repeat ultrasound when a cyst is small and causes no problems. Surgery is usually discussed when a cyst is larger than about 5 cm and does not shrink, causes ongoing pain or pressure, has solid parts or other suspicious features on ultrasound, or has caused twisting of the ovary (torsion) or bleeding. After menopause, any ovarian cyst is assessed more carefully, often with a blood test called CA-125 and a risk score.
The type of cyst matters. Endometriomas (cysts caused by endometriosis), dermoid cysts (mature teratomas) and cystadenomas do not go away on their own. Paraovarian cysts arise next to the ovary rather than in it, are generally benign and can grow large enough to cause torsion of the tube and ovary, which is a reason for removal.
How is the cyst diagnosed before surgery?
The starting point is a pelvic ultrasound, often transvaginal (see intravaginal ultrasonography), which shows the size, wall, contents and position of the cyst. A blood test for CA-125 and sometimes other markers is used in women with features that need closer assessment. MRI is added when the picture is unclear, for example to separate an endometrioma from a dermoid. Hospitals in Turkey can usually complete these tests in one or two days, and sending recent scan reports in advance allows the surgeon to give a first opinion before you travel.
How does laparoscopic cyst removal work, step by step?
Keyhole surgery is done under general anaesthesia and usually takes 30 to 90 minutes. The surgeon makes three or four small incisions in the abdomen, inflates it gently with gas, inserts a camera and fine instruments, and identifies the cyst. In ovarian cystectomy, the cyst wall is peeled away from the ovary, which is repaired with fine stitches or left to close, and the cyst is placed in a bag and removed so that its contents do not spill. For a paraovarian cyst, the sac is separated from the broad ligament, and the ovary and tube are usually left untouched. Tissue is sent for pathology. Open surgery with a lower abdominal incision is kept for very large cysts or those that look suspicious.
The operation in more detail, including how the surgeon protects the healthy ovary, is described in our guide to laparoscopic ovarian cystectomy.
Cyst removal, monitoring or removing the ovary: how do they compare?
The options differ in how much tissue is taken and how long recovery is. In some cases, such as a large endometrioma in a woman who has completed her family, or a suspicious mass, the surgeon may suggest removing the ovary (laparoscopic oophorectomy). Where fertility matters, removing only the cyst is the usual aim.
| Option | Best suited to | Typical limits |
|---|---|---|
| Watchful waiting with repeat scans | Small, simple cysts without symptoms | Cyst may persist or cause symptoms |
| Keyhole cystectomy (ovary kept) | Persistent, large or symptomatic benign cysts; women planning pregnancy | Cyst can recur; some loss of ovarian tissue is possible |
| Open cystectomy | Very large cysts or suspicious masses | Larger scar, longer recovery |
| Oophorectomy (ovary removed) | Suspicious masses, torsion with damaged ovary, completed family | Ovarian function lost on that side |
Needle drainage of a cyst is possible in selected cases but is not often advised for ovarian cysts because fluid often returns and the contents cannot be tested properly.
Ovarian or paraovarian cyst removal cost in Turkey compared with the UK, US and Germany
The figures below are approximate ranges for a keyhole operation, not hospital quotes. They depend on the size and type of cyst, whether surgery is keyhole or open, how long you stay in hospital, whether the ovary is preserved and what tests are included. The ovarian or paraovarian cyst removal price is confirmed by each hospital in a written quote.
| Country | Approximate cost range |
|---|---|
| Turkey | €1,800 – €5,500 |
| United Kingdom | €3,500 – €9,000 |
| United States | €7,000 – €20,000 |
| Germany | €3,500 – €8,000 |
A package normally includes the pre-operative tests, the surgeon and anaesthetist, one or two nights in hospital, pathology of the removed tissue, medication, a follow-up check and transfers. Ask whether pathology is included and what happens if the operation needs to be converted to open surgery.
Who is a good candidate, and who is not?
Candidates are women with a cyst that is persistent, large, painful, growing or has features that need a tissue diagnosis, and who are fit for general anaesthesia. Surgery is not advised for a small simple cyst that is likely to settle, and urgent local care is needed instead of travel if there is sudden severe pain, vomiting or fainting, which can mean torsion or rupture. Pregnancy changes the plan, since cysts found in pregnancy are usually monitored and operated on in the second trimester only if necessary. A suspicious mass needs a gynaecological oncology opinion before any operation to avoid spillage.
How long is recovery after ovarian or paraovarian cyst removal?
After keyhole surgery, most women leave hospital the next day. Shoulder-tip pain and bloating from the gas settle in two to three days, and the small wounds heal within one to two weeks. Many return to desk work after about a week and to exercise after two to four weeks, while open surgery needs four to six weeks. The surgeon will advise when you may fly, usually after a check on day three to five. Walking from the first day and drinking plenty of fluids reduce clot risk. The ovarian or paraovarian cyst removal recovery is quicker when the ovary is preserved.
A typical trip is four to six nights in Turkey, which leaves time for a pathology preview and a wound check.
Will cyst removal affect my periods or fertility?
Periods continue as normal after cyst removal because the uterus and the remaining ovarian tissue keep working. Removing a cyst from the ovary can lower the number of eggs (ovarian reserve) to a small degree, particularly after surgery for endometriomas or when both ovaries are operated on, so women planning pregnancy should discuss egg freezing or a fertility assessment before surgery. Removing a paraovarian cyst does not normally affect the ovary. Most women who want children can conceive after cyst removal, and the surgeon should explain the specific effect in your case.
What are the risks of ovarian or paraovarian cyst removal?
As with any operation under general anaesthesia, there are risks. Specific to this surgery are bleeding, infection, injury to nearby organs such as bowel, bladder or ureter, spillage of cyst contents, adhesions, reduction of ovarian reserve and a chance the cyst returns, notably endometriomas. Rarely, the operation has to be changed to open surgery. The Royal College of Obstetricians and Gynaecologists (RCOG) and the NHS publish patient information on these risks. Ask your surgeon how often they perform the operation and what the pathology result will mean for follow-up.
How to choose a gynaecology surgeon and hospital in Turkey
Choose a gynaecologist with training in minimally invasive surgery in a licensed hospital with an anaesthetist and an intensive-care unit, who agrees a plan after reviewing your scans. Red flags include a price with no scan review, promises that the cyst will never return, no pathology report, pressure to remove the ovary without a reason and no plan for aftercare at home. Read how our process works and send your reports through the free quote page. If scans also show fibroids, see hysteroscopic myomectomy.
Questions to ask the hospital
- Which type of cyst do my scans show, and does it need surgery now?
- Can the ovary be kept?
- Is the operation keyhole, and when would it become open?
- Is pathology included, and who explains the result?
- How long should I stay before flying home?
Conditions treated with Ovarian or Paraovarian Cyst Removal
Hospitals with Gynaecology in Turkey
Frequently asked questions
An ovarian cyst forms on the ovary and a paraovarian cyst forms beside it in the broad ligament. Most are benign, many ovarian cysts disappear on their own, and surgery is reserved for cysts that are large, persistent, painful or suspicious.
Usually when it is larger than about 5 cm and does not shrink, causes ongoing pain, has suspicious features on ultrasound or has caused torsion or bleeding. Small simple cysts are usually monitored with repeat scans.
Approximate ranges are €1,800 to €5,500 in Turkey, against about €3,500 to €9,000 in the UK. The price depends on cyst type, keyhole or open surgery and length of stay; the hospital confirms its price in a written quote.
You are asleep during keyhole surgery. Afterwards expect soreness at the incisions and shoulder-tip pain from the gas for two to three days, usually controlled with simple painkillers.
After keyhole surgery most women go home the next day, return to desk work after about a week and exercise after two to four weeks. Open surgery needs four to six weeks.
In most cases the cyst alone is removed and the ovary is kept. Removing the ovary is considered for suspicious masses, a badly damaged ovary after torsion or when the family is complete.
Most women can conceive afterwards, but removing a cyst from the ovary can reduce ovarian reserve slightly, especially with endometriomas. Discuss a fertility assessment or egg freezing with the surgeon beforehand.
Yes, some cysts recur, particularly endometriomas. Follow-up scans and treatment of the underlying condition lower the chance, and the surgeon should explain the likelihood for your cyst type.
An ovarian cyst grows from ovarian tissue, while a paraovarian cyst grows beside the ovary and does not involve it. Paraovarian cysts can usually be removed with the ovary left untouched.
Four to six nights is typical after keyhole surgery, which allows for the operation, an overnight stay, pathology advice and a wound check before you fly. Open surgery may need a longer stay.
Patient stories