Chocolate cyst is an encysted structure that occurs within the ovary in the course of a common pathology - endometriosis. how to distinguish both endometriosis from symptoms of chocolate cyst? How to recognize a chocolate cyst and how is it treated?
Chocolate cystmay appear in patients suffering from endometriosis, the essence of which is the uterine tissue - the endometrium, i.e. the epithelium lining the inside of the uterus outside the uterine cavity. The adjacent structures are most often involved, and the process develops in the pelvic region. But it happens that pathological tissue occurs in more distant organs, causing atypical ailments, which makes diagnosis difficult.
The term chocolate is not accidental. It results from the consistency and color of the pathological content resulting from the lesion - it resembles chocolate.
Observations show that the most common outbreaks of endometriosis include the urinary bladder, pelvic pendent apparatus, elements of the gastrointestinal tract and the peritoneum lining the abdominal cavity. Ailments related to endometriosis are justified. The endometrium is undergoing constant changes that are in sync with the menstrual cycle. During menstruation, as a result of the action of appropriate hormones, the epithelium lining the uterine cavity exfoliates - this is the so-called menstrual bleeding. You should be aware that uterine tissue outside its anatomical position is hormonally active, i.e. it undergoes similar changes, including bleeding. Leaking blood causes local inflammation, which causes pain.
Symptoms of the chocolate cyst
It is very difficult to determine which symptoms can be associated with the presence of a cyst and which are a manifestation of endometriosis. The most common complaints reported by patients include:
- pain felt in the pelvic area with a tendency to increase during menstruation
- abnormal bleeding - heavy and / or painful periods or bleeding during the menstrual cycle
- painful intercourse
- very rare - abnormal gastrointestinal or urinary bleeding
The chocolate cyst itselfcan cause discomfort, but most of all during rupture of lesions and evacuation of pathological contents. Then, local irritation of the peritoneum occurs, which is manifested by severe pain, often so severe that it requires urgent surgical intervention.
How to recognize a chocolate cyst
Ultrasound examination with the use of a transvaginal transducer is an indispensable diagnostic tool for the diagnosis of a chocolate cyst. The localization of the pathological content primarily includes the ovaries. In exceptional cases, magnetic resonance imaging is used, but mainly to look for foci of endometriosis, a disease manifested, among others, by these cysts. It should be emphasized that the final diagnosis should be supported by the result of a histopathological examination. The material is collected during a diagnostic laparoscopy, during which specialist optical equipment is inserted through small openings in the abdominal wall, followed by an examination of the abdominal cavity in search of pathologically changed structures, including cysts.
Treatment of the chocolate cyst
The above-mentioned diagnostic laparoscopy does not only fulfill the role of a diagnostic tool. It is an increasingly used form of endometriosis therapy due to the low level of tissue traumatization. In the case of chocolate cysts, it allows for minimally invasive emptying of the pathological contents, which is referred to as enucleation of the cyst. However, a more radical procedure involves removing the entire cyst, including the areola called the pseudocapsule. Unfortunately, endometriosis itself or endometrial cysts have a tendency to recur.
Hormone treatment is a definitely less invasive form of therapy, although it is dedicated mainly to patients with diagnosed endometriosis, but without the manifestation in the form of cysts. The goal of this treatment is to inhibit the growth of the endometrium beyond the physiological location of the uterine tissue. Women feel relieved as symptoms gradually subside. The most commonly used drugs are those from the group of progestogens in combination with a group of preparations with androgenic activity, the classic example of which is danazol used as part of several months of treatment. In addition to targeted treatment, doctors focus on eliminating symptoms. Pain can also be relieved by oral contraceptive therapy.