What is a Chocolate Cyst?
Chocolate cyst is the involvement of endometriosis in the ovary. In the ovary, contains a thick liquid inside They are cystic growths. This liquid is called chocolate cyst because it is chocolate colored. The medical name for chocolate cyst is endometrioma. In the presence of endometrioma, most of the time the ovary adheres to the surrounding organs, namely the tube, uterus and intestines. Chocolate cyst can be detected in women who come for infertility, or those who come with endometriosis complaints, namely pelvic pain, menstrual pain (dysmenorrhea), pain in intercourse (dyspareunia) It can be seen on ultrasound performed in patients with strong
Why Chocolate Cyst Causes?
The most expressed mechanism is the reverse flow of menstrual blood in the uterus, towards the abdomen and ovaries builds up on it. However, the exact cause is still unknown. Menstrual tissues adhered to ovary, cysts over time, bleed into and chocolate-colored fluid accumulation occurs. Because of the accumulated blood, the cyst fluid contains a high level of iron.
What are the Symptoms of a Chocolate Cyst?
Small cysts may not cause any symptoms, they are detected by chance on ultrasound they can be. Pain is the most common condition in chocolate cyst. Menstrual pain (dysmenorrhea), abdominal and groin pain (chronic pelvic pain), pain during intercourse (dyspareunia) are a symptom of cyst. Infertility is another condition. In the presence of cyst, ovarian function may be disrupted, ovulation power may decrease, tube clogging may be seen due to the adhesion between the tubes. The Cyst fluid can sometimes leak into the abdomen, in this case severe, sudden pain like appendicitis can occur. It has also been observed that some patients had accidental appendicitis surgery.
How is a Chocolate Cyst Diagnosed?
The first step in diagnosis was ultrasound r. Chocolate cyst has an easily understandable ultrasonographic image. If there is any doubt in the diagnosis, it should be supported with MRI. The main diagnosis is made by examining the cyst part under the microscope, this is possible with the cyst capsule removed by surgery. Since not every patient will be operated on, they are sometimes followed up without a definitive diagnosis, only with the patient's complaints and ultrasound measurements. Chocolate cyst can be confused with other cysts, especially with temporary ovulation cysts called hemorrhagic cysts that bleed into it. Hemorrhagic cyst disappears spontaneously in the following 1-2 months, but chocolate cyst does not disappear, it may even grow.
Does a chocolate cyst cause infertility? Why does chocolate cyst prevent pregnancy?
In the presence of chocolate cyst, there may be adhesions between ovaries and tubes, uterus and intestines. Due to adhesions, there may be clogging in the tubes, which is infertility. It has been stated that chocolate cyst weakens the ovarian pool, reduces ovulation power and prevents the baby from sticking to the womb by chemical means. It is not known exactly how he caused infertility .
Why does a chocolate cyst cause pain?
Chocolate cyst can adhere to the surrounding organs, tube, uterus and intestines, these adhesions and stretching may cause pain. Also, in the presence of chocolate cyst , there are endometriosis foci in the peritoneum. These foci may bleed into the abdomen, albeit very slightly, in each period. This can cause pain, too. Studies have shown that women with endometriosis and chocolate cyst are over-stimulated in the pain center of the brain and feel pain more than other women. Pain during sexual intercourse is caused by uterine movements stretching the adhesions and activating endometriosis foci.
Is chocolate cyst excreted by menstruation?
Chocolate cyst is not expelled by menstruation, does not disappear. The capsule of the cyst is quite thick, so the diameter of the cyst usually stays the same or even grows. Other cysts may disappear one month later, but chocolate cyst does not.
What are the harms of chocolate cyst? Will the chocolate cyst burst?
Chocolate cyst may damage ovarian function and reduce ovulation power in the presence of a chocolate cyst. By making intra-abdominal adhesions, pain and infertility may occur. The capsule surrounding the chocolate cyst is quite thick, so it is not uncommon for chocolate cyst to burst, but leakage from the cyst fluid into the abdomen may occur. In this case, there may be very severe sudden pain. There may be a fire with it. In case of sudden, stabbing pain, fever, nausea, vomiting, it is necessary to apply to the emergency room.
Chocolate Cyst Treatment Ankara
Chocolate cyst treatment means two types of treatment: medication and surgical treatment.
● Chocolate cyst Medicine Treatment: Medicine can be tried in patients with chocolate cysts smaller than 2-3 cm, without pain or infertility problems. Birth control pill, drugs containing progestin hormone and medicated spiral are among these treatments.
● Chocolate Cyst Surgical Treatment: The main thing in chocolate cyst treatment is surgical treatment. In the patient with pain and in cases where the cyst is larger than 4 cm in diameter, the cyst must be surgically removed.
Chocolate cyst surgery,
● It is necessary to completely remove the cyst. In cases where only the cyst fluid is drained, 60-80% may recur within 2 years. Removing a Chocolate cyst is more difficult than other cyst surgeries due to adhesion. It is very important that it is performed by an experienced surgeon. During the surgery, it is very important not to damage the ovaries and to protect the remaining ovarian tissue.
● In the treatment of chocolate cyst, ovary can also be removed. This method is used if the cyst has completely engulfed the ovary, if there is no healthy tissue left between the cyst and the ovary, if the patient does not expect a child, if it will be more beneficial to remove the ovary rather than removing the cyst used. Ovarian removal operation is more suitable for women close to menopause.
Chocolate Cyst and CA 125
CA 125 is one of the indicators of inflammation in the body. Chocolate cyst and endometriosis tissues in the peritoneum cause Ca 125 height. This height is an expected result anyway, there is no need to worry right away, the average value is 100 IU/ml. In Chocolate cyst follow-ups and in the postoperative period, CA 125 is also checked. If the CA 125 value increases rapidly in the presence of chocolate cyst after menopause, there may be a risk of the cyst becoming cancerous.
Does Chocolate Cyst Recur? Why does the chocolate cyst recur?
Chocolate cyst If it is not completely removed, 80% will recur. Chocolate cyst is completely removed, if an effective surgery is applied, it can recur at a rate of 30%.
Why does a chocolate cyst recur? The answer to the question is estrogen, the female hormone. Estrogen secreted from the ovaries , estrogen, endometriosis > keeps their focus alive, thus causing cyst to form again on the ovary.
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