It is the location of the lining of the uterus (endometrium) in the non-uterine organs, which is seen in 1 out of every 10 women in the reproductive age. Cysts that develop when these cells invade the ovary are called endometrioma or chocolate cyst. Endometriosis is most commonly seen in the ovaries (ovaries) at a rate of 65-70%. In addition, the most common tissues where endometriosis is located are: Fallopian tubes, the peritoneum tissue around the intestine and uterus.
Some women with endometriosis have no complaints, while others may experience severe pain and problems such as inability to conceive. There are many treatment options for endometriosis. The treatment of endometriosis should be personalized according to the characteristics of the patient.
Causes of Endometriosis (Chocolate Cyst)
The exact cause of the disease of endometriosis is not known, there are 4 theories that illuminate this issue;
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The endometrial tissue shed from the uterus during menstrual bleeding every month passes through the tubes and settles into the abdomen
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The tissue that is expelled from the body with menstrual bleeding settles in any part of the body due to abnormalities in the immune system and growth
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Genetic congenital disorders
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It is the spread of endometrial tissue from the uterus to the abdomen as a result of lymph and blood flow.
What are the Symptoms of Chocolate Cyst?
The most common condition among the symptoms of endometriosis (chocolate cyst disease) is pelvic (lower abdomen) pain. Pain can manifest itself in different ways. It can start before the menstrual period or can be seen during the menstrual period. There may be severe pain, especially during sexual intercourse. Patients with bowel and bladder involvement may experience severe pain while urinating and during large toileting.
Patients with endometriosis may also have difficulty conceiving. Endometriosis does not harm the pregnancy. Most of the time, complaints of endometriosis decrease during pregnancy.
How is Endometriosis Diagnosed?
Diagnosis of endometriosis (chocolate cyst disease); First of all, the presence of symptoms and problems related to the disease (pain during menstruation, pain during sexual intercourse, infertility, painful urination and defecation, rectal blood It starts with the physician's suspicion of endometriosis depending on the disease.
EXAMINATION; Detection of endometriotic lesions in the vagina and cervix in the pelvic examination, especially during the menstrual period. In the examination of the uterus and ovaries; detection of ovarian cyst, inability to move the uterus during examination due to adhesions to neighboring tissues. Presence of pain in the vaginal wall and cervix during examination.
IMAGING (ULTRASOUND, MRI); detection of the presence of chocolate cyst in the ovaries, detection of endometriotic lesions in the rectum and bladder (urinary bag) wall, detection of lesions in the inner lining of the abdomen. Definitive diagnosis is possible by examining the tissue taken in pathology.
Treatment of Endometriosis (Chocolate Cyst Disease)
The stage and severity of endometriosis disease affect the treatment approach. Two important factors determining the treatment are pain and inability to conceive. There are 2 basic approaches in the treatment of endometriosis: medical treatment (use of medication) and surgical treatment.
In Which Situations Surgical Treatment Is Not Considered In The Foreground?
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In those who do not have children,
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Adolescents
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People with very low ovarian reserve
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Double-sided chocolate in those with cysts
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In patients who have had previous repetitive operations
The aim of the surgery is to remove endometriosis and scar tissue.
Treatment of Infertility Due to Endometriosis
The first thing to do in women with infertility problems is to evaluate the couple in detail in terms of infertility and to evaluate basic infertility. It is the application of the tests used (HSG, sperm analysis, ovulation detection, basal hormone tests).
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