What kind of cyst is called chocolate. What is a chocolate ovarian cyst, its causes, symptoms, diagnosis and treatment. Clinical picture of a chocolate cyst

The reproductive age of a woman is considered vulnerable to many pathological processes of the genital tract. This dependence is explained by hormonal fluctuations that are directly related to the menstrual cycle. An endometrioid ovarian cyst is proof of this.

The appearance of tissue similar in its morphological structure to the tissue of the inner layer of the uterus (endometrium) is called endometriosis. Depending on the localization of endometrioid foci, internal and external endometriosis are distinguished. Internal is characterized by the appearance of endometriotic foci (heterotopia) in the myometrium and is called adenomyosis.

If the lesions find their place on the pelvic organs (intestines, peritoneum, ovaries, rectum) without involving the layers of the uterus in the process, they speak of external endometriosis. Endometrial-like tissue enters the peritoneum through the fallopian tubes along with menstrual blood. Having “chosen” their habitat, alien cells “settle” and begin their development, affecting the organ. Most often, endometrioid tissue “likes” the ovary, an organ involved in the hormonal regulation of the menstrual cycle and actively working in childbearing age.

The incoming endometrioid cells, having attached to the surface of the ovary, are delimited from neighboring areas and build themselves a “capsule house”, which creates a focus comfortable conditions for further growth in the cortical layer of the ovary. Monthly processes that run parallel to the menstrual cycle help old cysts grow and new ones form.

In addition, often external endometriosis is combined with internal. If heterotopias "settled" in the fallopian tube, then there is a risk of ectopic (ectopic) pregnancy. The spread of endometriotic foci in the body of the uterus deprives the fetal egg of the possibility of normal implantation, which often leads to rejection of the embryo.

It is important to contact the antenatal clinic early if pregnancy is suspected, which can be saved if all recommendations and prescriptions are followed. Hormone therapy during gestation and in the postpartum period can help to cope with the disease.

The causes of infertility in endometrioid ovarian cysts are often changes in the ovary itself and hormonal disorders that prevent normal ovulation. However, infertility with endometrioma is not a sentence and pregnancy is possible. Moreover, there is a possibility of its normal course and regression of pathological phenomena in the foci by the end of pregnancy, due to the growth of decidual tissue in the cyst cavity.

Conservative and surgical treatment of endometrioid cysts

Conservative treatment is independently provided in cases of asymptomatic course of the disease with small cysts that do not threaten to rupture. Therapy is reduced to the use of drugs that regulate the hormonal status of the body. Hormonal treatment is the main one, and the rest of the methods are added to it and consist of symptomatic treatment (anesthetic and anti-inflammatory therapy, immunomodulatory and vitamin complex). In cases of endometrioid ovarian cyst, preference should still be given to surgical treatment, and conservative use as auxiliary.

Laparoscopic treatment of an endometrioid cyst is carried out through an endoscope using microinstruments. The course of the operation, displayed on the monitor, allows the doctor to navigate the features of the pathological process and make a decision during the intervention. The outcome of the operation provides the following options:

• removal of only the cyst, if it is sufficient large sizes and well delimited by the capsule from nearby tissues;
• removal of a cyst with economical resection of the ovary, allowing you to save part of the organ;
• complete removal of the organ.

An intraoperative (during the operation - cito!) examination of the cyst walls helps the doctor to come to such a decision. In cases of malignancy (the appearance of malignant cells), the doctor decides to expand the scope of the operation. After the intervention, the extracted material, in order to avoid possible errors, is necessarily sent for a planned histological examination to confirm the diagnosis.

Laparotomy - involves the removal of a cyst, its part or organ by abdominal surgery, which is more traumatic for a woman. Examination of the extracted material is similar to laparoscopy.

With any surgical method of treatment, the postoperative period requires hormonal correction, therefore, the appointment hormonal drugs is mandatory. Physiotherapy treatment in the postoperative period helps to restore organs and prevent the formation of adhesions.

Under the name of the endometrioid (chocolate) ovarian cyst lies a completely unpleasant ailment, because either a cavity in the thickness of the ovary or under it is called a chocolate cyst. outer shells filled with thick dark brown contents.

From the surrounding tissues, the neoplasm is limited to capsules with walls of different thicknesses, and its diameter usually does not exceed 12 cm.

Article outline

Causes of the appearance of an endometrial cyst

As a rule, women and girls of reproductive age, that is, from 12 to 50 years old, learn from their own experience what an endometriotic (chocolate) ovarian cyst is. It can occur in one or both organs at once.

There are many theories trying to explain the reasons for the formation of such cysts, but none of them has yet been supported by solid evidence.

According to one of them, endometrial cysts are formed against the background of retrograde menstruation. This term is called throwing menstrual blood and dead cells of the mucous membrane lining the uterus from the inside (endometrium), into the ovaries. In addition, particles of the endometrium are able to enter the ovaries during a number of procedures:

• operations on the internal genital organs;
• gynecological cleaning (curettage) carried out for one reason or another;
• abortion;
• "cauterization" of cervical erosion.

According to other researchers, an endometriotic cyst is a consequence of a weakened immune system, a hereditary predisposition to its formation, and the presence of endocrine diseases.

Moreover, the relationship between changes in the hormonal background, characteristic of endocrine pathologies, and the inception of a cyst has been confirmed by research.

Therefore, often such neoplasms occur against the background of:

• excessive production of estrogen and prolactin;
• progesterone deficiency;
• disorders of the thyroid gland and adrenal cortex;
• obesity;
• endometriosis;
• use of the IUD over the prescribed period.

In addition, the presence of inflammatory processes in the pelvic organs, in particular, endometritis, oophoritis, etc., contributes to the development of the disease. Also, the factor provoking the occurrence of neoplasm is severe stress.

Stages of development of the chocolate cyst

In the development of an endometrioid cyst, 4 stages are distinguished:

1. The formation of dotted foci of endometriosis in the ovaries.
2. The formation of a cyst at the site of a particular focus, the occurrence of single adhesions in the fallopian tubes and ovary, as well as new endometrioid lesions.
3. An increase in the size of the neoplasm and the number of adhesions.
4. A significant increase in the cyst, as a result of which it affects the work of surrounding organs.

Symptoms of an endometrial ovarian cyst

In each woman, the symptoms of a chocolate (endometrial) ovarian cyst manifest themselves in their own way, which depends on the degree of neglect of the process, the presence of other diseases and the psychological well-being of the patient.

Quite often, the pathology does not manifest itself for a long time and is detected only with a thorough examination of a woman who has asked for help from a gynecologist because of problems with conception. After all one of the main manifestations of an endometrioid cyst is infertility.

If education has grown, a woman may be worried about:

1. acute pains not only in the lower abdomen, but also in the lower back, which usually increase with the onset of menstruation and sexual intercourse;
2. the presence of spotting discharge both before and after the completion of critical days;
3. lengthening the menstrual cycle by 1-7 days;
4. more intense than usual menstruation;
5. weakness, dizziness, bouts of nausea, fever and other signs of intoxication.

If an endometriotic ovarian cyst is not detected in time, it can cause egg degeneration and scarring, which will certainly affect the work of the affected organ and at least lead to persistent infertility, which is quite difficult to eliminate.

If you continue to ignore the disease, the pelvic organs can fuse together with strands of connective tissue, called adhesions. This will entail not only the loss of a woman's reproductive function, but also the occurrence of problems with the intestines and urinary organs, which can be solved only by surgery.

Every woman can avoid such troubles.. To do this, it is enough to undergo a scheduled gynecological examination every year, because in some cases the doctor can diagnose the presence of a cyst by palpation, probing internal organs through the abdominal wall.

To confirm and clarify the diagnosis, ultrasound or MRI is usually prescribed, and only in controversial cases (examination of the uterus and surrounding organs using endoscopic equipment inserted into the abdominal cavity through pinpoint punctures). If the latter method is chosen, the neoplasm can be immediately removed.

Treatment of endometrial (chocolate) cysts

Depending on the size of the detected neoplasm, the nature of the symptoms present, the age of the patient and the presence of the desire to become pregnant, a tactic is being developed for the treatment of an endometriotic ovarian cyst.

Sometimes only drug therapy is prescribed, which consists in taking:

• anti-inflammatory drugs;
• painkillers;
• hormonal drugs;
• vitamin complexes;
• sedatives;
• immunomodulators;
• enzymes.

In other cases, surgical removal of the neoplasm is performed. As a rule, this carried out by laparoscopy, since this operation does not cause great harm body owing to which it has a short recovery period.

Usually, patients are discharged from the hospital on the 3-4th day after the removal of the endometriotic ovarian cyst. In addition, after laparoscopy, there are no large, disfiguring scars on the woman's body.

The only traces of the operation are subtle pinpoint scars, which over the years become almost indistinguishable from normal skin.

Usually, surgical removal of an endometrioid ovarian cyst is indicated if medical therapy fails, large formations with a diameter of more than 5 cm are present, and the risk of their malignancy is confirmed.

As a rule, during the operation, either only the cyst is removed, or a section of the ovary along with the neoplasm is removed. Very rarely, doctors have to completely remove the organ. This is mainly required for .

If it is not possible to perform laparoscopic removal of the cyst for one reason or another, the operation is performed by laparotomy. This method involves making a wide incision on the anterior abdominal wall, which is fraught with a longer recovery and the formation of a long, noticeable scar.

Regardless of the choice of treatment method, women must be examined for the presence of endocrine diseases, and if they are detected, undergo a course of appropriate treatment. Otherwise, a relapse of the disease is possible.

Everything you need to know about the endometriotic ovarian cyst and its treatment

Endometrial cyst and pregnancy, dangers and complications

Since the appearance of such neoplasms often occurs against the background of endometriosis, the existing changes in the uterus and fallopian tubes can lead to the onset of ectopic pregnancy, which, if not diagnosed in time, can cause the death of a woman.

If the violations characteristic of endometriosis are present only in the body of the uterus, then after fertilization, the egg cannot attach to the endometrium, resulting in rejection of the embryo and pregnancy does not occur. This is one of the reasons that married couple deprived of the opportunity to have a child.

In addition, promotes the development of infertility and a strong fusion of the walls of the fallopian tubes between themselves or the uterus with other organs adhesions. This process proceeds gradually, so the chocolate ovarian cyst can be diagnosed for the first time already during pregnancy.

But in this case, to preserve it, it is necessary to conduct hormonal therapy during the entire process of bearing the fetus and in the postpartum period.

Nevertheless, pregnancy is a real chance for a woman to get rid of the pathology, since cases of self-resorption of cysts before childbirth are not uncommon.

But infertility and problems with the intestines or bladder are not the worst consequences of the formation of an endometriotic ovarian cyst. Indeed, when performing heavy physical work or even during sexual intercourse, the capsule of the cyst may rupture, and its contents will leak into the abdominal cavity.

This is fraught with the development of a life-threatening condition - peritonitis. With it, the internal membranes of the abdominal cavity become inflamed, which is accompanied by severe pain in the abdomen.

You should know:

• - is it possible;
• What are;
• during illness.

In such cases, only urgent surgical intervention carried out as soon as possible can save the life of a woman.

Endometrial ovarian cyst is a very dangerous disease. Self-medication is unacceptable, as it can lead to infertility or even lethal outcome. Any medication or other therapeutic measures must be agreed with the doctor.

How is surgery performed during treatment chocolate cyst ovary

Gynecological diseases are now becoming more common. Inflammatory diseases of the uterus and ovaries, various types of cysts and tumors often become the causes of chronic infertility. A certain contribution to this problem is made by sexually transmitted diseases: gonorrhea, syphilis,. Some apart from all the diseases that cause infertility is endometriosis. One of its most frequent manifestations is endometrioid.

Prerequisites for the development of endometrioid cysts

The female reproductive system is thought out and created by nature with amazing originality. The cradle of new life is a small organ called the ovary. There is a large number of immature eggs here. Each of them has an individual dwelling - a follicle. Once a month, one of them has a chance to become the beginning of a new life. The meeting point of the egg and sperm is the fallopian tube. This small organ gently grasps the ovum released from the follicle. After fertilization, the tube will also gently accompany the growing embryo to its home for the next forty weeks - the uterus.

The uterus is a hollow organ that is designed to bear a child. The home for the embryo will be the inner layer of the uterus - the endometrium. Its glands produce mucus in large quantities, facilitating the journey of the fetus through the uterus. Once a month, the endometrium is renewed. The beginning of this process is accompanied by bleeding (menstruation). Ovulation and the menstrual cycle are controlled by two types of biologically active substances - hormones. The first are produced in the central endocrine organ - the pituitary gland: follicle-stimulating and luteinizing. The second produces the ovary - estrogens and progesterone.

An endometrioid ovarian cyst is one of the manifestations of a specific female ailment of endometriosis. The disease most often affects young women who have entered reproductive age (20-40 years). During the period of natural extinction of the childbearing function, the number of cases decreases sharply. Among all gynecological ailments, it occurs in six to eight percent of cases.

Classification

Endometrioid ovarian cysts are divided into several varieties:

Causes and development factors

The endometrioid cyst differs significantly from other benign ovarian formations. The source of the disease is endometrial cells. Normally, it exists exclusively in the inner layer of the uterus. The endometrium is sensitive to the influence of estrogen and progesterone. His cells have an amazing ability to regenerate. Once a month, the endometrium sheds off and grows back.

The causes of endometrioid cysts are still unknown. There are several hypotheses explaining the mechanism of the appearance of endometrial cells in the ovary. In the first case, the possibility of getting menstrual flow not only out through the cervix and vagina, but also into the abdominal cavity through the openings of the fallopian tubes is considered. The second hypothesis explains the occurrence of cysts by a violation of the development of organs and tissues during the period the child is in the womb. As a result, endometrial cells appear outside the uterus in the ovaries. In the third case, the mechanism of transformation into endometrioid cells of normal blood and lymphatic vessels, as well as the peritoneum, a strong membrane that covers the outside of the intestines and other abdominal organs, is considered.

Endometrial cells that have moved to the ovary have many features in common with malignant tumors: the ability to germinate neighboring organs, spread from the uterus through the blood and lymphatic vessels, and give secondary foci of growth. However, there is a serious difference: endometrial cells, wherever they are, appearance and their properties are absolutely similar to each other. Malignant cells are so different from normal cells that it is often difficult to determine their specific source.

Hormonal disorders play a significant role in the formation of endometrioid cysts. Endometrial cells arise in the ovary largely under the influence of an excess of certain hormones:

• follicle-stimulating (FSH), which causes the growth of follicles and the maturation of eggs;
• luteinizing (LH), which causes ovulation;
• estrogen, which promotes the growth of the endometrium;
• prolactin, which plays an important role in the secretion of breast milk;
• male sex hormones produced in the body of every woman in the small endocrine glands of the adrenal glands.

Endometrioid cysts primarily appear in the cortical layer of the ovary among follicles with immature eggs. A common process is characterized by the presence of foci in the center of an organ containing connective tissue and blood vessels. The dimensions of a typical focus are 5-10 millimeters. Inside contains brown mass similar to bloody menstrual flow. Elements tend to merge with each other, forming real cysts, limited by walls of connective tissue (the so-called "chocolate" cysts).

Ovarian cyst - video

Symptoms and signs

In many cases, endometrioid ovarian cysts can be asymptomatic for a long time. A common process leads to the following signs of trouble in the female reproductive system:

• dull aching pain in the lower abdomen, aggravated by sports;
• painful menstrual bleeding;
• painful urination and defecation;
• pain during intercourse;
• inability to conceive and bear a child.

Diagnosis Methods

Diagnosis of endometrioid ovarian cysts is a task for an experienced gynecologist. Suspicion of the presence of cysts is a reason for a full examination. It includes both classical methods and the most modern ones:

Treatment Methods

Treatment of endometrioid cysts is carried out by a gynecologist. Such formations do not disappear on their own. Used depending on the situation drug therapy operations, or a combination of these methods. Tactics is chosen by the doctor individually, taking into account all the features of the disease.

Drug therapy

A number of hormonal drugs are used to treat endometrioid cysts. The specialist aims to create conditions in the body under which the growth of pathological foci is reduced. Hormonal medications block ovulation, cyclical monthly changes in the reproductive system, reduce estrogen levels. A similar state of hormonal levels is characteristic of postmenopause. In the treatment of endometrioid cysts, it is created artificially. However, unlike postmenopause, these changes are reversible. To achieve the effect, drugs are taken for several months.

Hormonal drugs for the treatment of endometrioid cysts - table

With pronounced pain syndrome Non-steroidal anti-inflammatory drugs (NSAIDs) are prescribed:

• Nise;
• Diclofenac;
• Meloxicam;

Drugs for the treatment of endometrioid cysts - photo gallery

Celebrex contains celecoxib as an active agent. Voltaren contains the active ingredient diclofenac Nemestran contains gestrinone Zoladex contains the active ingredient goserelin. Jeanine is used to treat endometrioid ovarian cysts Regulon - combined contraceptive drug Utrozhestan contains progesterone
Nimesulide belongs to the group of painkillers and anti-inflammatory drugs.

Surgical method

Surgical treatment of endometrioid cysts is currently the territory for the use of new medical technologies. Removal of pathological foci from the ovaries occurs using laparoscopy. This method of surgical intervention is characterized by low trauma, the absence of large incisions, and the shortest possible recovery period. Access to the ovary is through several punctures of the anterior abdominal wall. To control the manipulations, an image from a video camera mounted on a special tool is fed to the TV screen. For women of reproductive age, gentle treatment is provided while maintaining healthy ovarian tissue. IN severe cases removal of the uterine appendages (ovary, fallopian tube). After the intervention, there are no large scars on the body. After a short postoperative observation, the patient is discharged home. In the first month it is necessary to limit the level of physical activity. Planning for pregnancy after surgery must be agreed with the attending physician.

An endometrioid ovarian cyst is a serious disease. Folk methods in this case are not used, because they have not proven their effectiveness.

Endometrioid ovarian cyst and pregnancy

Infertility is a real problem for women suffering from endometrioid ovarian cysts. The inability to conceive and bear a child is observed in half of all cases of the disease. The reason is hormonal disorders in conjunction with damage to the follicles containing the eggs. However, in 30–40% of cases, pregnancy is possible. In addition, childbearing, childbirth and breast-feeding change the hormonal background so that the disease has to recede. After the treatment, the chance of becoming pregnant appears in half of the diseased women of reproductive age.

Complications and prognosis

The prognosis for the treatment of endometrioid cysts is determined individually. Hormonal treatment can reduce the size of the foci and stop the pathological process. However, only surgery can completely get rid of them. The most serious complication is the recurrence of the endometrioid cyst. This scenario is observed in almost half of the cases.

Prevention

Prevention of the formation of endometrioid ovarian cysts is an important part of the lifestyle of any woman. The following recommendations must be observed:

• use contraceptives prescribed by a doctor;
• lead healthy lifestyle life;
• consult a doctor for any signs of trouble in the female reproductive system;
• avoid being under the scorching sun, in a hot bath and sauna.

The main reason for the development of a chocolate ovarian cyst, or, as it is also called - endometrioid, is the disease "endometriosis". It is characterized by the fact that areas covered with endometrium, the tissue that forms the inner lining of the uterus, begin to form on the organs of the reproductive system. Hyperplastic changes lead to the fact that the altered foci begin to exfoliate depending on the phase of the menstrual cycle.

The cyst is formed in the form of a capsule, whose inner walls are also covered with endometrium. Due to the accumulation of exfoliated tissues, the capsule increases in size.

Note. The contents of the cyst have a thick consistency and a dark color, from which the name "chocolate" arose.

The following factors can provoke the appearance of such a neoplasm:

• hormonal disorders;
• pathology of the endocrine system;
• diseases of the pelvic organs;
• malfunctions of the immune system;
• trauma;
• previous surgical procedures;
• abortions;
• incorrect reception oral contraceptives;
• constant stress;
• hereditary predisposition.

Characteristic features

Chocolate cyst can for a long time don't show yourself. Usually first warning sign becomes a violation of the menstrual cycle. In the secretion phase, the neoplasm increases in size due to the thickening of the endometrial layer. In this case, discomfort may occur.

In general, the symptoms of a chocolate cyst are:

• discomfort in the lower abdomen, pulling sensations;
• violations of the menstrual cycle, its increased duration;
• pain during or after intercourse;
• abnormal vaginal discharge;
• urination disorders;
• bloating, flatulence;
• constipation;
• intoxication of the body;
• problems with conceiving a child.

Impact on women's health

Important! There is a risk of cyst torsion or rupture. In this case, the woman feels a sharp pain in the abdomen, severe symptoms of inflammation and intoxication develop. Immediate surgical care is required to avoid the development of sepsis and other complications.

Also, a chocolate ovarian cyst can affect pregnancy. This is expressed in the following consequences:

• problems with conception, infertility;
• ectopic pregnancy;
• the risk of developing complications during the period of bearing a child;
• miscarriage.

Diagnostics

To identify the problem, you need to go through a series of studies. The endometrioid cyst has 4 stages of development:

• at the first stage, small inclusions do not cause concern, since they are hardly noticeable;
• at the second stage, the size of the formation increases, it is possible to probe it during a gynecological examination;
• in the third stage, the pathology spreads to the second ovary;
• the fourth stage is characterized by severe endometriosis involving neighboring organs and large bilateral formations that provoke infertility.

Important! Often, an endometrioid cyst is discovered incidentally. Particular attention should be paid to the diagnosis in the presence of other pathologies of the pelvic organs, in particular, endometriosis.

Diagnostics consists in the use of such methods:

• gynecological examination;
• tomography;
• hysteroscopy;
• cytological and histological studies;
• complex blood test;
• laparoscopy.

Treatment Methods

The sooner the treatment of a chocolate ovarian cyst is started, the more chances a woman has to become pregnant and successfully bear a child. Small neoplasms can be tried to be cured through conservative therapy. Its essence lies in the appointment of hormonal drugs to restore balance in the body. It is also important to carry out symptomatic treatment and eliminate other causes that can provoke the disease.

Under the name of the endometrioid (chocolate) ovarian cyst lies a completely unpleasant ailment, because an endometrioid or chocolate cyst is called a cavity in the thickness of the ovary or under its outer shells, filled with thick dark brown contents.

From the surrounding tissues, the neoplasm is limited to capsules with walls of different thicknesses, and its diameter usually does not exceed 12 cm.

Causes of the appearance of an endometrial cyst

As a rule, women and girls of reproductive age, that is, from 12 to 50 years old, learn from their own experience what an endometriotic (chocolate) ovarian cyst is. It can occur in one or both organs at once.

According to one of them, endometrial cysts are formed against the background of retrograde menstruation. This term refers to the reflux of menstrual blood and dead cells of the mucous membrane lining the uterus from the inside (endometrium) into the ovaries. In addition, particles of the endometrium are able to enter the ovaries during a number of procedures:

• operations on the internal genital organs;
• gynecological cleaning (curettage) carried out for one reason or another;
• abortion;
• "cauterization" of cervical erosion.

According to other researchers, an endometriotic cyst is a consequence of a weakened immune system, a hereditary predisposition to its formation, and the presence of endocrine diseases.

Moreover, the relationship between changes in the hormonal background, characteristic of endocrine pathologies, and the inception of a cyst has been confirmed by research.

Therefore, often such neoplasms occur against the background of:

• excessive production of estrogen and prolactin;
• progesterone deficiency;
• disorders of the thyroid gland and adrenal cortex;
• obesity;
• endometriosis;
• use of the IUD over the prescribed period.

In addition, the presence of inflammatory processes in the pelvic organs, in particular, endometritis, oophoritis, etc., contributes to the development of the disease. Also, a factor provoking the occurrence of neoplasm is severe stress.

Stages of development of the chocolate cyst

In the development of an endometrioid cyst, 4 stages are distinguished:

1. The formation of dotted foci of endometriosis in the ovaries.
2. The formation of a cyst at the site of a particular focus, the occurrence of single adhesions in the fallopian tubes and ovary, as well as new endometrioid lesions.
3. An increase in the size of the neoplasm and the number of adhesions.
4. A significant increase in the cyst, as a result of which it affects the work of surrounding organs.

Symptoms of an endometrial ovarian cyst

In each woman, the symptoms of a chocolate (endometrial) ovarian cyst manifest themselves in their own way, which depends on the degree of neglect of the process, the presence of other diseases and the psychological well-being of the patient.

Quite often, the pathology does not manifest itself for a long time and is detected only with a thorough examination of a woman who has asked for help from a gynecologist because of problems with conception. After all, one of the main manifestations of an endometrioid cyst is infertility.

If education has grown, a woman may be worried about:

1. acute pains not only in the lower abdomen, but also in the lower back, which usually increase with the onset of menstruation and sexual intercourse;
2. the presence of spotting discharge both before and after the completion of critical days;
3. lengthening the menstrual cycle by 1-7 days;
4. more intense than usual menstruation;
5. weakness, dizziness, bouts of nausea, fever and other signs of intoxication.

If an endometriotic ovarian cyst is not detected in time, it can cause egg degeneration, the formation of functional cysts and scars, which will certainly affect the work of the affected organ and at least lead to persistent infertility, which is quite difficult to eliminate.

Every woman can avoid such troubles. To do this, it is enough to undergo a scheduled gynecological examination every year, because in some cases the doctor can diagnose the presence of a cyst by palpation, probing the internal organs through the abdominal wall.

To confirm and clarify the diagnosis, ultrasound or MRI is usually prescribed, and only in controversial cases, laparoscopy is performed (examination of the uterus and surrounding organs using endoscopic equipment inserted into the abdominal cavity through pinpoint punctures). If the latter method is chosen, the neoplasm can be immediately removed.

Treatment of endometrial (chocolate) cysts

Depending on the size of the detected neoplasm, the nature of the symptoms present, the age of the patient and the presence of the desire to become pregnant, a tactic is being developed for the treatment of an endometriotic ovarian cyst.

Sometimes only drug therapy is prescribed, which consists in taking:

• anti-inflammatory drugs;
• painkillers;
• hormonal drugs;
• vitamin complexes;
• sedatives;
• immunomodulators;
• enzymes.

In other cases, surgical removal of the neoplasm is performed. As a rule, this is carried out by laparoscopy, since this operation does not cause much harm to the body, due to which it has a short rehabilitation period.

The only traces of the operation are subtle pinpoint scars, which over the years become almost indistinguishable from normal skin.

Usually, surgical removal of an endometrioid ovarian cyst is indicated if medical therapy fails, large formations with a diameter of more than 5 cm are present, and the risk of their malignancy is confirmed.

As a rule, during the operation, either only the cyst is removed, or a section of the ovary along with the neoplasm is removed. Very rarely, doctors have to completely remove the organ. This is mainly required only when cancer cells are detected.

Regardless of the choice of treatment method, women must be examined for the presence of endocrine diseases, and if they are detected, undergo a course of appropriate treatment. Otherwise, a relapse of the disease is possible.

Everything you need to know about the endometriotic ovarian cyst and its treatment

Endometrial cyst and pregnancy, dangers and complications

Since the appearance of such neoplasms often occurs against the background of endometriosis, the existing changes in the uterus and fallopian tubes can lead to the onset of an ectopic pregnancy, which, if not diagnosed in time, can cause the death of a woman.

In addition, promotes the development of infertility and a strong fusion of the walls of the fallopian tubes between themselves or the uterus with other organs adhesions. This process proceeds gradually, so the chocolate ovarian cyst can be diagnosed for the first time already during pregnancy.

But in this case, to preserve it, it is necessary to conduct hormonal therapy during the entire process of bearing the fetus and in the postpartum period.

Nevertheless, pregnancy is a real chance for a woman to get rid of the pathology, since cases of self-resorption of cysts before childbirth are not uncommon.

But infertility and problems with the intestines or bladder are not the worst consequences of the formation of an endometriotic ovarian cyst. After all, when performing heavy physical work or even during sexual contact, the cyst capsule can burst, and its contents will leak into the abdominal cavity.

This is fraught with the development of a life-threatening condition - peritonitis. With it, the internal membranes of the abdominal cavity become inflamed, which is accompanied by severe pain in the abdomen.

You should know:

In such cases, only urgent surgical intervention carried out as soon as possible can save the life of a woman.

Endometrial ovarian cyst is a very dangerous disease. Self-medication is unacceptable, as it can lead to infertility or even death. Any medication or other therapeutic measures must be agreed with the doctor.

How is surgery performed to treat a chocolate ovarian cyst?

And some secrets...

Incredible… You can cure a cyst without surgery!

• This time.
• Without taking hormonal drugs!
• This is two.
• Per month!
• It's three.

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What is a chocolate ovarian cyst, the causes of its development, symptoms, diagnosis and treatment

The materials are published for review and are not a prescription for treatment! We recommend that you contact an endocrinologist at your medical institution!

Due to certain health problems, a woman may develop a so-called chocolate ovarian cyst. This pathology is quite serious, as it can provoke diseases that affect reproductive ability. Modern medicine has methods to deal with the problem.

1. Characteristic features
2. Impact on women's health
3. Diagnostics
4. Treatment Methods

The main reason for the development of a chocolate ovarian cyst, or, as it is also called - endometrioid, is the disease "endometriosis". It is characterized by the fact that areas covered with endometrium, the tissue that forms the inner lining of the uterus, begin to form on the organs of the reproductive system. Hyperplastic changes lead to the fact that the altered foci begin to exfoliate depending on the phase of the menstrual cycle.

This is what endometriosis looks like

The cyst is formed in the form of a capsule, whose inner walls are also covered with endometrium. Due to the accumulation of exfoliated tissues, the capsule increases in size.

Note. The contents of the cyst have a thick consistency and a dark color, from which the name "chocolate" arose.

Chocolate cyst is formed in the area of ​​\u200b\u200bdistribution of foci of endometriosis

The following factors can provoke the appearance of such a neoplasm:

• hormonal disorders;
• pathology of the endocrine system;
• diseases of the pelvic organs;
• malfunctions of the immune system;
• trauma;
• previous surgical procedures;
• abortions;
• incorrect intake of oral contraceptives;
• constant stress;
• hereditary predisposition.

Characteristic features

A chocolate cyst may not manifest itself for a long time. Usually the first alarming sign is a violation of the menstrual cycle. In the secretion phase, the neoplasm increases in size due to the thickening of the endometrial layer. In this case, discomfort may occur.

In general, the symptoms of a chocolate cyst are:

• discomfort in the lower abdomen, pulling sensations;
• violations of the menstrual cycle, its increased duration;
• pain during or after intercourse;
• abnormal vaginal discharge;
• urination disorders;
• bloating, flatulence;
• constipation;
• intoxication of the body;
• problems with conceiving a child.

Mostly abdominal pain manifests itself with the development of complications

Impact on women's health

Important! There is a risk of cyst torsion or rupture. In this case, the woman feels a sharp pain in the abdomen, severe symptoms of inflammation and intoxication develop. Immediate surgical care is required to avoid the development of sepsis and other complications.

Also, a chocolate ovarian cyst can affect pregnancy. This is expressed in the following consequences:

• problems with conception, infertility;
• ectopic pregnancy;
• the risk of developing complications during the period of bearing a child;
• miscarriage.

Due to the disease, the risk of ectopic pregnancy increases

Diagnostics

To identify the problem, you need to go through a series of studies. The endometrioid cyst has 4 stages of development:

• at the first stage, small inclusions do not cause concern, since they are hardly noticeable;
• at the second stage, the size of the formation increases, it is possible to probe it during a gynecological examination;
• in the third stage, the pathology spreads to the second ovary;
• the fourth stage is characterized by severe endometriosis involving neighboring organs and large bilateral formations that provoke infertility.

Endometrial cyst on ultrasound

Important! Often, an endometrioid cyst is discovered incidentally. Particular attention should be paid to the diagnosis in the presence of other pathologies of the pelvic organs, in particular, endometriosis.

Diagnostics consists in the use of such methods:

• gynecological examination;
• tomography;
• hysteroscopy;
• cytological and histological studies;
• complex blood test;
• laparoscopy.

Treatment Methods

The sooner the treatment of a chocolate ovarian cyst is started, the more chances a woman has to become pregnant and successfully bear a child. Small neoplasms can be tried to be cured through conservative therapy. Its essence lies in the appointment of hormonal drugs to restore balance in the body. It is also important to carry out symptomatic treatment and eliminate other causes that can provoke the disease.

In the presence of large cysts and the appearance of unpleasant symptoms, surgical treatment is recommended. In most cases, the operation is performed laparoscopically. There are four options for intervention, depending on the complexity of the situation:

• removal of the cyst with the preservation of the ovary in full;
• removal of the cyst and part of the ovary while maintaining the functions of the organ;
• complete removal of the ovary;
• removal of the ovary and neighboring organs or parts thereof involved in the pathological process.

Cutaway chocolate cyst

The sooner a chocolate cyst is detected and appropriate measures are taken, the more likely it is to preserve women's health and prevent irreversible negative consequences.

pozhelezam.ru

Endometrioid ovarian cyst: causes, treatment, removal surgery

Endometrioid ovarian cyst (chocolate ovarian cyst) is a cavity filled with thick brown contents, bounded by walls of various thicknesses and formed inside the ovary or on its surface. In most cases, the size of this formation does not exceed 12 cm in diameter.

According to medical statistics, most often the pathology under consideration is diagnosed in women of reproductive age (from 12 to 50 years). The main feature of endometrioid ovarian cysts is the violation of the integrity of their walls during menstruation, accompanied by the ingress of their contents into the abdominal cavity. This explains the rich symptoms of this disease and the difficulties in diagnosing it.

Causes of an endometrioid ovarian cyst

Despite the fact that there are currently many theories of the origin of the endometrioid cyst, the exact causes of this disease are still unknown.

There is a hypothesis according to which endometrioid cysts can form during retrograde menstruation, that is, when endometrial cells migrate with the blood and take root in the tissues of the ovaries, fallopian tubes and abdominal cavity. The drift of these cells often occurs during surgical procedures that injure the uterine mucosa, including:

• during gynecological operations;
• with diagnostic curettage;
• with medical abortion;
• with diathermocoagulation of the cervix.

A number of physicians believe that an endometrioid ovarian cyst can form as a result of persistent replacement of the remnants of embryonic tissue, weakening of immune responses, or genetic defects. In addition, it has been proven that there is an inextricable link between the development of this pathology and endocrine disruptions in the body:

• hyperestrogenia and increased prolactin levels;
• a decrease in the level of progesterone;
• dysfunction of the adrenal cortex and thyroid gland.

Provoking factors in the appearance and development of an endometrioid cyst can be:

• long-term use intrauterine devices;
• emotional stress;
• liver dysfunction;
• oophorites;
• obesity;
• endometritis;
• unfavorable environmental conditions.

Symptoms of a chocolate ovarian cyst

The severity of symptoms of a chocolate ovarian cyst depends on the following factors:

• the degree of neglect of the cyst;
• the presence of concomitant diseases;
• psychological state of the patient.

In most cases, the formation of an endometrioid cyst occurs unnoticed by the patient or manifests itself as a violation of her reproductive function (infertility). The development of the disease is accompanied by:

• acute pain in the lumbar region and lower abdomen, aggravated during intercourse or during menstruation;
• profuse menstruation;
• lengthening of the menstrual cycle;
• the appearance of spotting before and after menstruation;
• manifestation of signs of intoxication (weakness, nausea);
• an increase in body temperature.

An increase in the size of an endometrioid cyst can lead to egg degeneration, the appearance of follicular cysts, as well as scars that prevent the normal functioning of the ovary. In the absence of treatment of this pathology, an adhesive process develops in the small pelvis, leading to dysfunction Bladder and intestines.

Diagnostics of the endometrioid ovarian cyst

IN individual cases an endometrioid ovarian cyst can be detected during a gynecological examination: this reveals an inactive, painful formation in the ovary, increasing in size before menstruation. In general, the results of laparoscopy, pelvic ultrasound with Doppler and magnetic resonance imaging are used to make an unmistakable diagnosis.

Doppler ultrasound reveals the absence of blood flow in the cyst membrane. At the same time, the level of the CA-125 tumor marker in the blood may be normal or slightly increased. When diagnosing infertility, hysteroscopy and hysterosalpingography are performed. Laparoscopy is recognized as the most reliable method for diagnosing an endometrioid cyst.

Endometrioid ovarian cyst: treatment

Treatment for an endometrioid cyst may include:

• conservative (non-specific anti-inflammatory, hormonal and analgesic therapy, taking vitamins, enzymes and immunomodulators);
• surgical (organ-preserving removal of the cyst by laparotomy or laparoscopic method);
• combined.

In general, the treatment of cysts should be aimed at eliminating the signs of the disease, as well as preventing its progression. The strategy and tactics of therapy should be chosen taking into account the symptoms, duration and stage of development of the disease, the age of the patient, the presence or absence of problems with conception, as well as concomitant genital and extragenital disorders.

If an endometrioid cyst of a small size is detected, the patient may be prescribed a course of hormonal therapy using:

• low-dose monophasic combined oral contraceptives;
• derivatives of norsteroids;
• prolonged medroxyprogesterone acetate;
• synthetic gonadotropin-releasing hormone agonists;
• androgen derivatives.

Pain caused by an increase in the chocolate ovarian cyst is stopped by taking non-steroidal anti-inflammatory drugs, sedatives and antispasmodics.

With the ineffectiveness of bloodless therapy, with cysts larger than 5 cm, as well as with the risk of malignancy of the formation and other complications, only surgical treatment is indicated. The most common surgical methods are ovarian resection and enucleation of heterotopic formations. Removal of the endometrioid cyst is carried out with pre- and post-operative hormone therapy.

In addition, in the postoperative period, patients are shown physiotherapy aimed at correcting endocrine imbalance, preventing adhesions and infiltration processes, as well as recurrence of cysts.

treatment-symptomy.ru

Chocolate ovarian cyst: symptoms, diagnosis and treatment

The reproductive age of a woman is very vulnerable, in terms of a large number pathological processes that regularly occur in the genitals. This is due to the constant fluctuations in the hormonal background that occur in different phases of the menstrual cycle. Endometrioid, or as it is also called, a chocolate ovarian cyst, is a confirmation of this.

• 1 Reasons
• 2 Symptoms
• 3 Diagnostics
• 4 Treatment

Causes

It is worth noting right away that the reasons for which the development of endometriosis occurs have not yet been fully studied. All existing information today boils down to the fact that there are only assumptions because of what this happens, and factors that increase the risk of developing the disease have been identified:

• The presence of hormonal disorders that lead to problems with the functioning of the ovaries themselves, as well as to disruption of the menstrual cycle;
• The development of thyroid dysfunction, as well as the adrenal cortex;
• The presence of a hereditary predisposition to pathology, which will be indicated by a “family” history, when similar problems are revealed in relatives;
• Long-term use of intrauterine contraceptives;
• problems with the liver;
• Severe stress and prolonged psycho-emotional stress.

Symptoms

At the first stages of its development, such a pathology often has an asymptomatic form, therefore, it is detected by chance when treatment of another disease is required and its examination is carried out. Usually this is infertility. As for the appearance of symptoms and their severity, it directly depends on the stage of the disease, as well as the degree of its spread.

The most common manifestations of such a "chocolate" cyst are the following symptoms:

• Infertility, which appears due to the progression of the adhesive process taking place in the small pelvis;
• Pain in the lower abdomen, which has a pulling character and different intensity, sometimes reaching the level of pain, similar to those present during menstruation;
• Longer menstrual cycle, which also has highlights Brown, which is not typical for normal menstruation;
• Pain that appears during intercourse, greatly interfering with the woman and bringing her considerable inconvenience;

Diagnostics

Even a healthy woman should regularly visit a gynecologist for examination, even if she considers herself completely healthy. This will help identify the disease early stage and start treatment in a timely manner. But if we talk about the targeted detection of such a cyst, then the diagnosis will be reduced to the following studies:

• A gynecological examination is performed, which makes it possible to suspect the presence of education during palpation;
• Ultrasound of the pelvic organs is considered very effective method diagnostics, allowing with a high degree of probability to identify an anomaly in the ovary;
• Cytological diagnostics, which is carried out during the initial examination, will reveal the presence of a pathological process in the organ;
• MRI. A very high-quality diagnostic method, but due to its high price it is not widely used;
• Laparoscopy today is considered the most accurate way to detect ovarian cysts with a chocolate bar, moreover, it makes it possible to extract the necessary material;
• Conducting a histological examination of the taken biopsy allows you to make a final diagnosis, and in the presence of malignancy, identify it.

Treatment

It should be noted right away that treatment with conservative methods is prescribed only if the formation is in an asymptomatic form and does not have big size, as well as prerequisites for mutation into a malignant form. Such therapy is reduced to the use of various drugs that regulate the level of hormones in the body. This is due to the fact that other methods only allow you to deal with the symptoms, and do not eliminate the very cause of the appearance of the pathology. However, the most effective way to eliminate is surgery, while conservative methods will be used as additional ones.

Through the use of an endoscope equipped with micro-instruments, laparoscopic treatment takes place. The image from the device will be broadcast on the screen, on which the surgeon will navigate during the operation.

In total, there are several results of the operation, such as:

• Removal of only a cyst when it has reached a significant size and is easy to separate from nearby tissues;
• Removal of not only the formation, but part of the ovary. An economical resection of the ovary is carried out, which makes it possible to save a certain part of the organ;
• Carrying out a complete excision of the affected ovary.

Have you ever suffered from cyst problems? Judging by the fact that you are now reading this text, the problems are still bothering you. And you know well what is:

• Intense, sudden pain
• Pain due to physical exertion
• Poor and restless sleep
• New sores that do not allow you to live in peace

Perhaps it is more correct to treat not the consequence, but the cause? How to do this as efficiently as possible tells the chief gynecologist of Russia ...

kistaplus.ru

2018 Women's Health Blog.