Got pcos, 20+cysts on each ovary all at least 5cm in size. lots of pain in abdo and back. what size of the cysts is required for surgery? how urgent?

Surgical indications: Indications vary.If the medical management of PCOS is not successful, then and only then indications for ovarian surgery will usually be considered based on your symptoms (severity of pelvic-abdominal pains, suspected torsion or hemorrhage...) , reliability of sonographic evaluation (suspicion of ovarian neoplasm...) "Size of the cysts"alone may not be a reliable or clear criteria for surgery.