Chocolate Cyst Treatment Istanbul

What is Chocolate Cyst?

A chocolate cyst is the presence of the endometrial tissue, which grows and sheds during the menstrual cycle, found on the ovaries. It causes symptoms such as pain due to the bleeding that occurs in the ovaries every menstrual period. If the endometrial tissue is found in other areas (such as the intestinal wall or the abdominal lining),it is referred to as endometriosis.

What Causes Chocolate Cyst?

There are several reasons for the formation of chocolate cysts and endometriosis. The most widely accepted cause is the retrograde flow of menstrual blood. It is thought that cells from the endometrium drop into the ovaries and abdominal cavity through the fallopian tubes and implant in these areas. Another possible cause is genetic predisposition, as family history is commonly observed.

What Are the Symptoms of Chocolate Cyst?

• Abdominal pain, lower back pain, and pelvic pain.
• In advanced/severe cases, persistent and debilitating pain due to sciatic nerve or other nerve involvement.
• Irregular menstrual periods.
• Severe menstrual cramps (dysmenorrhea) that cannot be controlled with painkillers.
• Infertility or difficulty conceiving.
• Painful intercourse (dyspareunia).
• Blood in the stool or urine (in severe cases).

Endometriosis symptoms vary depending on the affected area.

How Is Chocolate Cyst Treated?

Being a chronic condition, several treatments are available for chocolate cysts. Pain relievers are used to control the pain. Birth control pills may help reduce cyst growth.

Hormonal therapy creates a temporary menopause-like environment, helping to shrink the chocolate cyst. Laparoscopic surgery is used to remove the chocolate cyst, clear adhesions, and treat any nerve involvement or deep endometriosis surgically.

Chocolate Cyst Surgery

Laparoscopic or minimally invasive surgery is generally preferred for chocolate cysts. The two main reasons are:

1. High patient comfort and a shorter hospital stay.
2. Endometriosis often invades narrow areas with close proximity to blood vessels and nerves, making laparoscopy more effective for visibility and accessibility compared to open surgery.

In cases where laparoscopy is not feasible, open surgery can be performed.

Is Chocolate Cyst Surgery Risky?

The risks of chocolate cyst surgery are similar to those of laparoscopic surgery in general, including bleeding, infection, and the possibility of converting to open surgery. However, potential risks are shared with the patient after a thorough examination.

How Long Does Chocolate Cyst Surgery Take?

The duration of the surgery depends on the severity of the cyst or endometriosis. It may take around an hour for mild or moderate cases, but the duration can increase for severe cases of endometriosis.

What Should Be Considered After Chocolate Cyst Surgery?

Post-surgery care for chocolate cyst surgery follows general post-operative instructions, without specific restrictions.

Does Chocolate Cyst Prevent Pregnancy?

Chocolate cysts can reduce ovarian function and cause inflammation in the area, preventing the embryo from attaching to the uterine wall. Thus, it may delay conception. However, chocolate cyst surgery in IVF patients should be performed after egg retrieval.

When Should Chocolate Cyst Surgery Be Done in IVF Patients?

In IVF patients, chocolate cyst surgery should be performed after egg retrieval (OPU). Endometriosis surgery carries a slight risk of reducing ovarian blood flow, but it is known that chocolate cysts hinder embryo implantation. Therefore, surgery should be done after egg collection.

Is Chocolate Cyst Dangerous? Does It Cause Cancer?

Chocolate cysts have a low risk of acute bleeding, but they can affect the function of organs they compress. Adhesions, pain, and pressure are the main concerns. While cancerous cell changes are rare, the risk of confusing chocolate cysts with cancerous masses exists, and blood tests should be used to monitor this.

Can Chocolate Cysts Occur in Virgins?

Chocolate cysts are not related to the hymen and can occur in virgins after puberty.

Can a Chocolate Cyst Rupture, and What Should Be Done if It Does?

Rupture is rare but can occur in large cysts. If it happens, there may be active bleeding, and the cyst contents may spill into the abdomen, requiring emergency surgery.

Can Chocolate Cysts Be Expelled with Menstrual Bleeding?

Chocolate cysts are located inside the abdomen and cannot be expelled through vaginal menstrual flow.

What Happens If Chocolate Cyst Is Left Untreated?

If left untreated, a chocolate cyst can grow larger. Adhesions and pressure may cause increased pain, painful intercourse, and infertility. Therefore, chocolate cysts larger than 4 cm should be treated with laparoscopic surgery.

Does Chocolate Cyst Prevent Conception?

The presence of a chocolate cyst can hinder conception, particularly if the cyst is larger than 4 cm. IVF may be required in such cases. Regular monitoring and attempts to conceive before the cyst grows larger than 4 cm are recommended.

At What Age Do Chocolate Cysts Appear?

Chocolate cysts typically occur in patients aged 20-25 years, as they are associated with the menstrual cycle and require the accumulation of blood and adhesions in the area.

Can Chocolate Cyst Recur?

Chocolate cysts are a chronic condition. As long as menstruation continues, there is a risk of recurrence. However, the risk decreases after menopause when menstruation ceases.