ENDOMETRIOSIS (CHOCOLATE CYST) CAUSES, SYMPTOMS AND TREATMENT
What is Endometriosis (Chocolate Cyst)?
Endometriosis seen in most women is a serious disease. These cysts are formed when the tissue in the uterus called the endometrium settles outside the uterine cavity. The name of the disease is also known as chocolate cyst, since these tissues can grow into cysts and their contents are chocolate-coloured.
What Are The Causes Of Endometriosis (Chocolate Cyst)?
The exact cause of endometriosis is still unknown today. It is estimated that genetic factors play a role in the formation of chocolate cyst. If your mother or relatives had endometriosis, you’re more likely to have it too. Many women are unaware that they have endometriosis because the disease can sometimes show no symptoms. Sometimes women think these pains are low back pain and menstrual pain. In addition, endometriosis can cause cystic structures to form, so if you have any doubts, you should see a gynaecologist as soon as possible.
What Are The Symptoms Of Endometriosis (Chocolate Cyst)?
Endometriosis symptoms cause different symptoms for everyone. Endometriosis may not show any symptoms in some people. However, it can cause severe pain in some patients. The most important symptoms of a chocolate cyst are chronic fatigue, painful sexual intercourse, severe menstrual pain, gas and bloating in the stomach. Also, another common symptom of the disorder is depression. Sexual reluctance and chronic fatigue can lead to depression. Also, infertility is one of the most important symptoms. Women who cannot have children for a long time go to the doctor and it is learned that the reason for this is chocolate cysts.
How Is Endometriosis (Chocolate Cyst) Diagnosed?
The definitive diagnosis of the disease is made by direct observation of the lesions and pathological examination of the tissues taken from them. Surgery is essential in the definitive diagnosis of this disease. If a chocolate cyst is suspected and infertility is associated with it, diagnostic laparoscopy should be performed. With this, all pelvic formations in the patient are monitored, small lesions are investigated, and adhesions in severe findings are investigated. Ultrasonography is one of the most important tests for the diagnosis of chocolate cyst. However, while this examination is effective in lesions in the ovaries, it is not effective in lesions in the pelvic region. In addition, cysts located deep in the ovaries may be overlooked in laparoscopy, and these can be determined by careful ultrasound examination. As Istanbul Gyno, We are working with advanced medical equipments. If you have any doubts, you can always contact with us.
How Are Endometriosis (Chocolate Cyst) Treated?
There is no definitive treatment for the disease. Treatments for cysts are aimed at relieving pain and eliminating infertility in women. Medical and surgical treatments are used to achieve this. The principle of medical treatments is based on the fact that the disease is dependent on estrogen. Menopause and pregnancy are natural conditions that will prevent the formation of chocolate cysts in women. For this reason, this natural state is imitated in medical treatments. By removing the estrogen effect on the chocolate cyst, it is tried to suppress the endometrial tissue located where it should not be. Birth control pills are used to mimic the situation in pregnancy, danazol or GnRH analogue drugs are used to mimic menopause. By continuing the treatment for 3-6 months, the estrogen level in the blood is reduced to the low level of menopause. GnRH analog therapy is a costly treatment administered with once-a-month injections. Since its long-term use will cause symptoms such as osteoporosis and hot flashes, it can be applied together with estrogen drugs. Although this practice is thought to be contradictory, the aim here is to keep the estrogen level in the high enough range to suppress the chocolate cyst and prevent osteoporosis. It has been observed that these medical treatments can relieve pain in patients, but are not effective on infertility. Therefore, medical treatment is not recommended for patients with infertility. Surgical treatment is preferred in cases of severe endometriosis. This treatment is applied by laparoscopic technique. Generally, up to 50% of patients treated in this way can conceive naturally within 6 months. It is an effective method both in relieving pain and increasing the reproductive potential of women. In women who cannot conceive, successful results can be obtained with IVF treatment.
Frequently Asked Questions About Endometriosis (Chocolate Cyst)
Can Chocolate Cysts Cause Cancer?
Most of the chocolate cysts are benign cysts. The rate of cancerization is 0.1-0.5%. This risk does not require surgery for every woman with a chocolate cyst.
Who Should Consider IVF Treatment After Treatment?
In vitro fertilization should be considered if the patient has not been able to conceive within 1 year after the operation, if the patient is over 38 years old, and if the spouse of the woman with chocolate cyst has a sperm problem. As Istanbul Gyno, We have high success rate in IVF, which is 86 percent. You can contact with our experienced gynecologists.
Can chocolate cysts reappear after surgical treatment?
The risk of recurrence of endometriosis after laparoscopic surgery (excluding uterine removal surgery and patients close to menopause) is around 20-40% within 5 years. Some studies reveal that while normal vaginal delivery reduces the risk of recurrence of endometriosis, cesarean section increases the risk of recurrence.
Does Chocolate Cyst Cause Infertility?
Chocolate cysts adhere very tightly to the surrounding tissues. These adhesions can also result in infertility and pain. Also, reductions in ovarian function can result in infertility.
Chocolate cysts are more common in whom?
Endometriosis, which is considered a disease of women of reproductive age, can develop in any woman even without showing any symptoms. When all of the women in the society are evaluated, the disease is effective at a rate of 3-5%, and it is effective at a rate of 40% in women who have difficulty in having children. Women with a first-degree relative with endometriosis are at 7 times more risk in this regard. The disease may rarely be effective in women who have gone through menopause and in young women. It has been found to very rarely affect men.
Should Chocolate Cyst Surgery Be Open or Closed (Laparoscopic)?
Laparoscopic or robotic surgery should be preferred in chocolate cyst surgery. Open surgery is not preferred. With laparoscopic surgery, the ovaries and uterus can be protected better and postoperative adhesions are less. Open surgery can be recommended by surgeons who do not have experience in laparoscopic surgery, using previous surgeries or dense adhesions as an excuse. However, adhesions or previous surgeries do not prevent laparoscopic surgery and these surgeries can be easily performed by experienced gynecologist. As Istanbul Gyno, We are here with the best gynecologists for you. You can always contact with us.