Chocolate cyst, known in medicine as Endometriosis, is a disorder that is frequently encountered in women over the age of 30 and more frequently in young women in their reproductive years. It is a cyst that occurs when endometrial cells in a certain amount of menstrual blood that moves in the opposite direction due to unknown reasons stick to sometimes a single egg, sometimes two eggs, sometimes an area close to the anus and sometimes the peritoneum, and it is extremely rare, ranging from 4 cm to 15 cm, accumulates a brown liquid inside and has a probability of 4 to 6 in a thousand for cancerous cells to form. The symptoms of these cysts mostly occur with menstrual cramps. While menstrual cramps, which are frequently encountered during menstrual periods, can be relieved with painkillers, the distinguishing feature of chocolate cysts from menstrual cramps is that their pain is so painful that it cannot be relieved with medication. Severe pains in the waist, back and abdomen, which are not only experienced during menstrual periods but also in daily life, and pains experienced in the legs can also be a sign of this cyst. Other symptoms of a cyst that can bleed in the area where it is located and thus cause pain include subcutaneous bruises on the body, nosebleeds occurring every time along with menstruation, infertility that lasts for a while, severe and disturbing pain during sexual intercourse, and blood in the urine or stool. In contrast to all these severe symptoms, there are also cysts that are attached to somewhere and continue to exist but do not show any symptoms and are found completely by chance.
Stages and Sizes of Chocolate Cysts
Endometriosis cyst, also known as chocolate cyst, is a type of cyst formation known as bleeding in the uterus progressing in the opposite direction and sticking to the ovaries or finding a suitable place outside the uterus, taking advantage of its adhesive structure and continuing there. Some generalizations are made based on the size of this type and the width of the area where it is located, and as a result of these generalizations, endometriosis, known as chocolate cyst, is classified in four stages and sizes.
The cyst, which is minimal in size in the first stage, is limited to mild in the second stage, moderate in the third stage and severe in the last stage. The size of the mass, the darkness of its color, the amount in its location and the intensity of pain are also taken into account in this limitation. While it is determined that the cysts in the first and second stages and sizes are mostly in the abdominal region, attached to the peritoneum, the cysts in the other two stages, which are considered advanced, attract attention with their covering more area and their darkness in color. When the size of the cyst is also calculated, it is also shown that cysts larger than approximately 3 cm are considered in the third stage. The fourth and last stage, which is considered the most severe stage of the disease, is defined as cysts located more in the rectum (close to the anus). These stages can be detected with a success rate of approximately ninety percent, depending on their colors and sizes, in images performed with gynecological ultrasounds without requiring a surgical operation to remove the cyst.
Who is Most Commonly Affected by Chocolate Cysts?
Chocolate cyst is a condition that occurs due to a small deviation of a cycle in the uterus and occurs due to menstrual bleeding, therefore it is not possible to see it in men. Chocolate cyst, which only occurs in women as a uterine disorder, is seen as a disease of our age, where the cause is still not fully known despite today's technology and medical developments and mostly problems affecting reproduction are experienced. It can cause very severe pain, aches and unbearable discomfort that can affect daily life, and it is also possible for the cyst to be found completely by chance without showing any symptoms. In addition, studies have revealed that this disorder can be passed on genetically and when it is seen in first-degree relatives, the risk of the disease increases sevenfold. Chocolate cyst, which is often seen in women who experience extreme pain during sexual intercourse, who experience very frequent pain in the uterine region and who come for check-ups for ovarian cysts, is most commonly seen in young women of reproductive age and who are suitable for pregnancy.
Will Chocolate Cyst Reoccur After Surgery?
Chocolate cyst is a type of cyst that settles outside the uterus and continues its existence by feeding on growth hormones, so although it does not reoccur in some people after being completely cleaned with surgery, it can reoccur in some people. Although nothing can be said for sure about the main reason why this varies from person to person, this situation is proportional to the success of the specialist doctor performing the operation and some unknown factors. Although all visible parts are cleaned with great care during the surgical intervention, the remaining cellular structures that are invisible to the eye can grow again and reoccur by continuing to feed on the hormones secreted in the body. However, although it is not possible to predict whether this situation will occur or not, the risk and the duration of its formation can be minimized with drug therapy to be applied after the operation. The drugs that are deemed appropriate to use after the operation are focused exactly on the growth of the cells and have a structure that prevents bleeding.
What is the Relationship Between Chocolate Cyst and IVF?
Even with today's technology, the cause of chocolate cysts cannot be determined, and therefore, a treatment method that prevents the formation of the cyst or eliminates it cannot be developed. However, after the cysts that can stick to the ovaries and reach a size that prevents reproduction are cleaned, almost half of the patients can have a chance to get pregnant normally, and IVF can be applied to women who cannot get pregnant. Chocolate cysts, which do not damage the ovaries but can prevent normal pregnancy with their adhesive structure on the outside, have been observed as a result of recent studies, as long as they do not cause pain or life-disrupting discomfort to the patient and do not contain cancer cells, even if there is a 4 in a thousand chance, there is no benefit in getting rid of chocolate cysts for IVF.
The fact that all success rates, miscarriage rates and healthy birth rates experienced in IVF are at the same level in patients with chocolate cysts has proven that there is no relationship between chocolate cysts and IVF. In this way, all mothers-to-be who want to get pregnant, who cannot get pregnant for more than a year or who cannot get pregnant due to a disorder in the father's sperm, can be directed to IVF, even if they have a chocolate cyst that does not cause discomfort, IVF can be tried and no risky situation is encountered. Since the rate of a chocolate cyst being found coincidentally without showing any symptoms in addition to severe pain is as high as those detected with complaints, it is not right to force mothers-to-be who have this cyst and mothers-to-be who cannot get pregnant through normal means and for whom IVF treatment is deemed appropriate to undergo an operation in order to receive treatment, and it is recommended that no intervention be performed unless it is necessary, not only for IVF. Despite the risk of damaging healthy ovaries, the safest and healthiest way is to keep the cyst under control and allow it to continue its course in the area where it is located.
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