What Is Chocolate Cyst; In this article, we will share with you all those who are curious about endometriosis, or chocolate cyst, which is a very common disease that directly affects the quality of life of women, but does not come to mind first because it takes a long time to diagnose when it comes to gynecological diseases.
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What is Endometriosis (Chocolate Cyst)?
Endometriosis (chocolate cyst) is a disease that causes women with this disease to live a difficult life. It is mostly asymptomatic, that is, it does not cause any symptoms, but since it often causes “severe pain” in patients with complaints, it deteriorates the living standards of patients. This disease, which can manifest itself in various ways from puberty to menopause, is found in “one out of every 10 women”. Due to the variety of findings and not being specific to the disease, the duration of diagnosis of patients varies between 3 and 10 years.
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How Does Endometriosis (Chocolate Cyst) Occur?
Endometriosis occurs when the cells lining the inner wall of the uterus are replaced by the ovaries and even the muscle tissue of the uterus for various reasons. While the most common symptom of the disease in adolescence is “severe menstrual pain”, it manifests itself with “chronic pelvic (groin) pain”, “pain during sexual intercourse” and “infertility” in women of reproductive age. During menopause, patients with endometriosis have an “increased risk of ovarian cancer” compared to their peers.
When endometriosis affects only the ovaries, it is called “endometrioma” (chocolate cyst), “deep infiltrating endometriosis” (DIE) when it affects the connective tissues of the uterus, bladder, intestines and surrounding tissues in the abdomen, and “adenomyosis” when it affects the uterine wall. Especially in patients with deep infiltrating endometriosis, the variety of findings delays the diagnosis process. Patients apply to clinicians with many findings from bloody urine to chronic constipation, from chest pain to severe menstrual pain.
How is Endometriosis (Chocolate Cyst) Diagnosed?
The most important step in the diagnosis phase is to “recognize and suspect this disease”. The diagnostic step after taking a detailed history is evaluation with transvaginal ultrasonography. In our clinic, thanks to our clinicians specialized in this regard, the diagnoses of the patients are made quickly and the places affected by the disease are mapped. After ultrasonography, Magnetic Resonance examination (MRI) is performed especially in patients diagnosed with deep infiltrating endometriosis and adenomyosis. Thus, the affected area and neighborhood of the lesions can be seen more clearly. Cases with their symptoms are discussed with our radiologist specialized in MRI examination and the mapping of the disease is completed.
Endometriosis (Chocolate Cyst) Treatment
Endometriosis (chocolate cyst) treatment is as difficult as its diagnosis. Painkillers and hormonal treatments (hormone spiral application, birth control pills, etc.) are the most commonly used medical treatments. Although the symptoms are relieved with these treatments, the progression of the disease cannot be prevented. Therefore, regular follow-up of patients is essential.
After surgical treatment, the surgical approach should be the last choice due to the frequent recurrence of the disease. In addition, after each surgery, there is a decrease in ovarian reserve, especially in patients with endometrioma. This causes patients to enter menopause early and indirectly affects their life span. Endometriosis surgery should be performed by specialized surgical teams. While the recurrence time is shortened as a result of incomplete surgeries in which the lesions cannot be completely cleaned, the risk of adhesions and organ damage in the abdomen increases after each surgery.
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Before the surgical treatment is planned, many factors such as the symptoms of the patients, ovarian reserves, child wishes, and the stage of the disease are evaluated in detail and planning is made. Egg/embryo freezing options should also be discussed before surgery to preserve their reproductive potential, especially in patients with reduced ovarian reserve.
