Ovarian Cystectomy in Singapore: When Is Surgery Needed?

Being told you have an ovarian cyst can leave you wondering, especially if surgery has been suggested. You may wonder whether removal is necessary, whether your ovary can be preserved and what treatment could mean for a future pregnancy. 

This article explains when ovarian cystectomy may be recommended, how the surgical approaches compare, and the possible effects on fertility. It also covers recovery, costs, and care options in Singapore.

What is ovarian cystectomy?

An ovarian cystectomy is surgery to remove an ovarian cyst while preserving as much healthy ovarian tissue as possible. Ovarian cysts are fluid-filled sacs that develop on or inside your ovaries. Many are harmless and resolve on their own, but persistent, painful, or concerning cysts may need to be removed.

Unlike an oophorectomy, which removes one or both ovaries, an ovarian cystectomy aims to keep the affected ovary intact. This can help preserve ovarian function and fertility potential.

The procedure is commonly performed through laparoscopic (keyhole) surgery, which uses small abdominal incisions and a camera to guide the surgeon. However, open surgery may be needed for certain cases, such as when a cyst is very large or there is concern about cancer.

Does an ovarian cyst always need surgery?

No, not every ovarian cyst needs surgery. Many ovarian cysts resolve on their own within a few months, particularly functional cysts that develop during the menstrual cycle. Your gynaecologist may recommend monitoring the cyst with follow-up ultrasound scans rather than immediate surgery.

Your gynaecologist may recommend an ovarian cystectomy if your cyst:

• Persists or continues to grow after several menstrual cycles.
• Causes ongoing pelvic pain, discomfort, or pressure.

If the cyst looks unusual on an ultrasound scan, your gynaecologist may recommend further tests or specialist assessment before deciding whether surgery is needed. The decision also depends on your age, whether you have been through menopause, and the cyst’s size and appearance.

If surgery is recommended, your gynaecologist will discuss whether they can remove just the cyst. When cancer is suspected, removing the affected ovary or performing a more extensive operation may be necessary instead of cystectomy.

Which types of ovarian cysts may need removal?

Your scan report often suggests the likely type of ovarian cyst, which can help guide the next steps. Functional cysts that develop during your menstrual cycle usually resolve on their own. However, these three types are less likely to disappear, but not all need surgery. Your gynaecologist may recommend monitoring or removal depending on the cyst’s size, symptoms and scan findings.

• Dermoid cysts are benign growths that can contain tissues such as hair, fat or teeth. They do not usually shrink on their own. Your gynaecologist may recommend removal if they grow, cause symptoms or increase the risk of the ovary twisting, known as ovarian torsion.
• Endometriomas (chocolate cysts) develop due to endometriosis and contain old blood. Whether to remove them depends on your symptoms, pregnancy plans and any previous ovarian surgery. Removal can affect healthy ovarian tissue and reduce ovarian reserve (the remaining supply of eggs) so your gynaecologist will weigh the potential benefits against these risks.
• Cystadenomas are usually benign growths filled with watery or mucus-like fluid. They can grow large, so your gynaecologist may recommend removal depending on their size, symptoms and appearance on the scan.

Laparoscopic vs open ovarian cystectomy

Most ovarian cysts are removed with keyhole surgery. Which procedure your gynaecologist recommends depends mainly on the size and appearance of your cyst and on whether you’ve been through menopause. Here’s how the two compare.

Is ovarian cystectomy suitable for you? 

If you need surgery, the next question is whether your surgeon can remove just the cyst and leave your ovary in place. That’s the aim of ovarian cystectomy, which may be suitable if:

• You haven’t been through menopause
• Your scan suggests the cyst is benign
• There’s enough healthy ovarian tissue around the cyst to keep
• You want to preserve ovarian function, including the possibility of pregnancy.
• You’re well enough for surgery and a general anaesthetic

Your gynecologist may recommend removing the affected ovary entirely if cancer is suspected, or if the cyst is so large that it has replaced most of the healthy ovarian tissue. 

Furthermore, if you have been through menopause and require surgery, they will typically recommend removing both ovaries and fallopian tubes rather than just the cyst to reduce the risk of future disease. Occasionally, a planned cystectomy becomes an ovary removal during the operation, for example if there’s heavy bleeding. It’s worth asking your gynaecologist about this beforehand.

Can ovarian cystectomy affect your fertility?

Ovarian cystectomy can reduce ovarian reserve (the remaining supply of eggs) if healthy ovarian tissue is removed or damaged during surgery. However, this does not necessarily mean you will have difficulty getting pregnant.

Some research shows partial recovery in anti-Müllerian hormone (AMH) levels, a marker of ovarian reserve, over the months after surgery. This does not mean that lost eggs are replaced, and recovery varies depending on the cyst type and individual circumstances.

The effect on ovarian reserve is generally greater when removing endometriomas (chocolate cysts) caused by endometriosis, especially when surgery involves both ovaries. Surgery can also leave scar tissue in the pelvis, which may affect fertility.

If you hope to get pregnant, discuss your pregnancy plans with your gynaecologist before surgery. Ask whether an AMH blood test could help assess your ovarian reserve and whether egg freezing is worth considering. AMH does not provide an exact egg count, measure egg quality or reliably predict your chance of conceiving naturally on its own.

Which specialist performs ovarian cyst surgery?

Ovarian cyst surgery is usually carried out by an obstetrician and gynaecologist (O&G specialist), the same kind of doctor you’d see for most problems affecting the womb and ovaries. 

Depending on your age, your scan and your plans for pregnancy, other specialists may also be part of your care.

Recovery after ovarian cystectomy and when to see a doctor

For the first few days, it’s normal to have some tummy discomfort, bloating and tiredness. After keyhole surgery, you may also feel pain in your shoulder tip, caused by the gas used during surgery irritating the diaphragm (the muscle beneath your lungs). Light vaginal bleeding for a day or two is also common, which usually tapers off within days to a couple of weeks.

You can look after yourself at home by:

• Take short, gentle walks from the first day, and rest when you need to.
• Take pain relief as prescribed.
• Don’t drive for at least 24 hours after a general anaesthetic, or while your painkillers make you drowsy.
• You can usually shower after 24 hours, gently drying your wounds afterwards. Follow your discharge instructions about when you can have a bath.
• Hold off on heavy lifting, vigorous exercise and sex until your surgeon says you’re ready.
• Many people return to desk work around two weeks after keyhole surgery. Jobs that involve lifting may need longer.

When should you see a doctor?

Contact your healthcare team if you have:

• A fever or chills
• Tummy pain that keeps getting worse instead of better, or a swollen tummy
• Heavy vaginal bleeding (soaking a pad every one to two hours) or a bad-smelling discharge
• Redness, swelling, pus or increasing pain around your wounds
• Vomiting that won’t stop, or trouble keeping fluids down
• Burning when you pass urine, or being unable to pass urine

Seek urgent medical assessment if you have pain, swelling or redness in one calf. Seek emergency help immediately for chest pain, shortness of breath or coughing up blood.

Risks and possible complications

Laparoscopic ovarian cystectomy is generally safe when performed by an experienced gynaecologist. However, as with any surgery, potential risks and complications may occur, including:

• Bleeding and infection during or after surgery
• Injury to nearby organs, such as the bowel, bladder, or ureters
• Adhesion formation, where scar tissue develops in the pelvis and may affect fertility
• Reduced ovarian reserve if healthy ovarian tissue is removed or damaged during surgery

When a second opinion may help

If your ovarian cyst surgery is planned and your gynaecologist says it is safe to wait, there may be time to seek another specialist’s view before you go ahead. Asking for a second opinion is a reasonable step, and it doesn’t mean you doubt your gynaecologist. It can confirm the plan, give you more options, or simply help you feel settled about your decision.

A second opinion tends to be most useful in these situations:

• Your scan result was unclear. A review by a doctor who specialises in gynaecological ultrasound can help, and expert scans have been shown to reduce unnecessary surgery.
• You’ve been advised to remove your whole ovary for a cyst that looks benign. Keeping the ovary is usually the aim before menopause, so it helps to understand why removal is suggested.
• You’re hoping to get pregnant or planning IVF. A fertility specialist can help you weigh up the timing of surgery and its effect on your egg reserve.
• You’ve had ovarian surgery before, or the cyst has come back. Each operation on the same ovary can lower your egg reserve further.
• You’ve been offered open surgery for a cyst that looks benign. Many large benign cysts can now be removed with keyhole surgery.

How much does ovarian cystectomy cost in Singapore?

The cost of an ovarian cystectomy depends on the size and number of cysts, whether you stay overnight, the hospital you choose and your ward class. The Ministry of Health (MOH) classifies ovarian cystectomy under three Table of Surgical Procedures (TOSP) codes, based on how complex the operation is:

• SI811O: Ovarian cystectomy, simple, one ovary (Table 3B)
• SI812O: Ovarian cystectomy, complex on one ovary or simple on both, for example a single cyst over 5cm, cysts under 5cm on both ovaries, or scar tissue (Table 4A)
• SI813O: Ovarian cystectomy, complex on both ovaries, with cysts over 5cm on each side (Table 4C)

MOH does not currently publish typical hospital bills for these codes. It does publish fee benchmarks for private hospitals and clinics, which show a reasonable range for doctors’ fees in a routine case:

These ranges include GST and apply to private hospitals and clinics only. They cover doctors’ fees alone. Hospital charges such as the operating theatre, ward stay, medication, and tests are billed on top.

At public hospitals, Singapore Citizens and Permanent Residents can receive government subsidies in Ward B2 and Ward C, which lowers the bill. Choosing Ward B1 or A means you’ll be charged as a private patient without these subsidies. 

Depending on your eligibility, the following may help reduce your out-of-pocket costs:

• MediSave: For an inpatient stay, you may use up to SGD 1,130 per day for the first two days and SGD 400 per day after that. For day surgery, the limit is up to SGD 830 per day. On top of this, there’s a separate surgical withdrawal limit of SGD 1,740 for Table 3B, SGD 2,380 for Table 4A and SGD 2,540 for Table 4C.
• MediShield Life: For admissions from 1 June 2026, the normal ward claim limit is SGD 830 per day, with an additional SGD 800 per day for the first two days of an inpatient stay. The surgical claim limit is SGD 1,740 for Table 3B, SGD 2,310 for Table 4A and SGD 2,460 for Table 4C. A deductible and co-insurance apply. Bills in Ward B1, Ward A or a private hospital, and bills for Permanent Residents, are pro-rated before your claim is calculated.
• Integrated Shield Plan (IP): An IP adds private insurance coverage on top of MediShield Life and may help cover higher-class wards in public hospitals or treatment in a private hospital. A deductible and co-insurance still apply, and whether your specialist is on your insurer’s panel can affect how much you can claim.

How Health in Asia can help

Tell our Care Team about your symptoms, what your scan showed, whether you’re planning a pregnancy, and any treatment recommended so far. Scan reports and images, blood test results, details of any previous ovarian surgery and your insurance details all help the team understand what you need.

The Care Team can help with:

• A shortlist of one to three specialists matched to your condition and preferences, with the reasons explained
• Checking your insurance considerations, including your insurer’s panel eligibility, likely coverage and whether pre-authorisation applies
• Estimated out-of-pocket costs explained before you book
• Appointment booking and care coordination
• Arranging a second opinion if you’re unsure about the diagnosis, whether your ovary can be kept, the recommended surgical approach, or the need for surgery

The matching costs you nothing, and the specialist’s fee is the same as booking directly.