Is surgery required for a 3.8×3.8 cm ovarian cyst?

Ovarian cysts are benign tumors occurring in the ovaries. In general, an ovarian cyst measuring 3.8×3.8 cm without obvious symptoms or related complications may be managed by watchful waiting without immediate surgery. However, if symptoms are significant, the cyst continues to grow, or complications arise, conservative treatment can be attempted first. Surgery should be considered if conservative treatment fails, to prevent complications such as cyst rupture or hemorrhage. Detailed analysis is as follows:

1. General Situation

If an ovarian cyst measures 3.8×3.8 cm and the patient has no obvious discomfort—such as abdominal pain or menstrual irregularities—it is often considered a corpus luteum cyst, which is a physiological type of cyst. These typically appear in the late phase of the menstrual cycle and may gradually shrink or resolve spontaneously with menstrual cycle changes. In such cases, surgical intervention is usually unnecessary. However, regular follow-up examinations are recommended to monitor any changes in the size of the cyst.

2. Special Situations

Although a 3.8×3.8 cm ovarian cyst is not particularly large, if the patient experiences marked symptoms—such as frequent abdominal discomfort, abdominal pain, palpable abdominal mass, or menstrual abnormalities—that significantly affect quality of life and daily activities, medical treatment may be considered first. This may include medications prescribed by a physician, such as Guizhi Fuling Capsules, Shaofu Zhuyu Granules, or Jingangteng Capsules. If drug therapy proves ineffective, surgical options such as laparotomy or laparoscopic surgery may then be considered.

If the cyst continues to enlarge and poses risks such as torsion of the cyst pedicle or rupture, conservative treatment may be insufficient. Surgical intervention is often required in these cases to control disease progression and prevent more serious complications, including ovarian necrosis or intraperitoneal seeding.

Currently, observation is generally recommended initially. If adverse symptoms develop and persist, prompt medical evaluation and further diagnostic tests are advised, followed by development of an individualized treatment plan based on the patient's specific condition. During treatment, adequate rest should be maintained and strenuous physical activity avoided.