What is Endometriosis (Chocolate Cyst)?
The endometrium, which forms the inside of the uterus and provides menstrual bleeding, becomes about 5 mm thick in the period following the menstrual period. The endometrium thickens during the menstrual cycle due to certain hormones in the body and reaches a thickness of 10-15 mm before the menstrual period. If the egg released from the ovaries meets the sperm and is fertilized, the embryo reaches the uterus in about 1 week and begins to develop by attaching to the uterus, which is preparing for pregnancy .
If the egg released from the ovaries is not fertilized by the sperm, the thickened lining of the uterus is expelled through the vagina with menstrual bleeding.
Although the exact cause is unknown, endometrial tissue may be located in a region other than the uterus (ovaries, inner abdomen, uterus). Endometrial tissue repeats this behavior that it exhibits in the uterus every month when it settles in regions other than the uterus. Just like the thickening that occurs in the uterus, thickening occurs in other areas where it is located and is expelled with bleeding. These rashes that should not occur cause adhesions to form between the tissues in the reproductive system and this condition is defined as chocolate cyst (endometriosis).
Chocolate Cyst (Endometriosis) Structure
Chocolate cysts are cysts caused by the positioning of endometrial tissues in the ovaries and the accumulation of bleeding in the ovaries. They are called by this name because the color of the fluid collected in the cystic structure is dark brown and its appearance resembles chocolate.
It can usually be seen in either the right or left ovary, and very rarely in both. Due to their structure, cysts are not malignant or cancerous. These cysts, which are usually seen with a diameter of 4-6 cm, can reach up to 15 cm.
What are the symptoms of chocolate cyst (endometriosis)?
In cases of chocolate cyst, also known as endometrioma, menstrual bleeding may occur with severe pain, and pain may be experienced during sexual intercourse.
Symptoms That May Occur Due to Chocolate Cyst:
Painful menstrual bleeding
Noticing blood in the urine
Diarrhea or constipation
Pain during sexual intercourse
Feeling of pain in the legs
Low back pain
Back Pain
Chronic pain in the groin
Inability to conceive
Bruises occurring anywhere on the body
Blood in stool
Burning sensation while urinating
It can be counted as nosebleeds that may occur during menstrual period.
How Does Chocolate Cyst (Endometriosis) Form?
It is thought that the most common causes of chocolate cyst formation are genetic. Chocolate cysts can be seen in 10% of women in their reproductive years. In 20-40% of women who face infertility problems, the cause is determined to be chocolate cysts.
Chocolate cysts, which occur with symptoms such as intensely painful menstrual bleeding and pain during sexual intercourse, can develop without causing any symptoms in some cases and can be detected incidentally during a gynecological examination.
A definitive diagnosis for chocolate cysts, which are determined by blood tests and ultrasonography, can be made as a result of pathological evaluation. It can usually be easily detected by its appearance in gynecological ultrasound images.
What are the Treatment Options for Chocolate Cyst?
The standard treatment for chocolate cysts is to remove the cyst using open surgery or laparoscopy. However, most physicians may aim to eliminate the cysts by prescribing drug therapy before surgery.
What Are the Chances of Getting Pregnant After Chocolate Cyst Treatment?
In couples with infertility problems, the chance of getting pregnant after chocolate cyst surgery is around 40%. However, there are many factors that affect the pregnancy process. The woman's age, the duration of infertility and different causes that lead to infertility can affect the chance of pregnancy. If the patient is over 35 and the duration of infertility is more than 7-8 years, the chance of spontaneous pregnancy after chocolate cyst surgery decreases even more. Successful pregnancies can be achieved with in vitro fertilization treatment for women who cannot conceive spontaneously within 1 year after chocolate cyst surgery.
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