When the size of the cyst exceeds 8 cm (or the mixed technique is not possible), the CEC proposes 2-step surgical procedure 3 months apart.
The first operation involves of making a large opening in the cyst to drain its contents, which can sometimes be thick in terms of consistency (chocolate liquid). Ovarian blockage is then maintained for a period of 3 months, after which a second operation is performed. During these 3 months of treatment, the cyst will certainly reform, but it will be much smaller than at the start and therefore suitable for vaporization(14, 16).
This two stage technique has proved its worth in maintaining ovarian function and is beneficial despite requiring two surgical steps. We have often been asked whether it is possible to empty cysts in another way to avoid undergoing two operations. The issue here is twofold as it is necessary to drain the cyst completely, since its contents are often very thick and therefore difficult to empty by simple puncture and make a wide enough opening. These two procedures are essential to the success of the treatment and preservation of ovarian function.
The 2 procedures are therefore essential for the success of the procedure and the preservation of ovarian function.