Chocolate Cyst

Womb (uterus) is located within each month of pregnancy will host the pregnancy is not prepared and when deprived of adequate hormonal support because units (menstruation) in bleeding poured layer of special cells "endometrium" is called. This layer of cells in the body is located just inside the uterus. Of these cells in the body of the uterus take place in an area other than "endometriosis" is called disease. This situation is most common in the ovaries, uterus back in space (Douglas cavity), vagina and intestinal last section between the intestinal tract on the surface of the tube over or around, the bonds holding womb and bladder or abdomen on the membrane surfaces, in surgical wounds, stitched during birth, the precise angle, very rare as the navel, nose can be seen in distant organs such as the membrane. The most common place with 75% ovaries are.

Inner layer of the uterus in the course of the menstrual cycle each month and becomes thicker as a result of a period of time a tissue is taken out of the body bleeding. Outside surface of inner layer of the uterine cervix is placed in a location with a thickening of the menstrual cycle occurs again and again is an effort to remove these tissues with blood. Endometriosis disease where the tissues of the vagina opening to the outside environment, in contrast to the uterus are closed system and bleeding it off into my site (usually in the abdominal cavity or ovarian tissue is into is that in later periods where otherwise known as endometrioma, chocolate cyst, called ovarian cysts causes.) Happens. This internal bleeding which can cause adhesions in the inner regions and the related symptoms occur. This amount is very small amount of internal bleeding is not life-threatening move.

Who is most common in?

Endometriosis as a disease of women in reproductive age are accepted. Without complaint and with no other reason a woman can be identified that are evaluated. 3% of all women-in 5 children have difficulty being detected in 40% of the couples. In one of the first degree relatives of endometriosis in a woman pegged at risk of disease is about 7 times more. Endometriosis is very rare and very late in the menopausal women in the patient is examined. Even been reported in the literature can be seen in men.

Why occurs?

What factors cause is not known exactly where. Explain why the various theories put forward are aimed at. Most accepted view that two genetic predisposition as the women, the abdomen in the specific surfaces or tissue cells undergo structural changes and uterine inner layer is to act as the other the inner layer of the uterus (endometrium) of the fallopian tubes into the abdomen occurs in migrating to this theory that retrograde mesturasyon The theory is called. (The theory is to become more possible and reasonable.)

Specify how to give?

One of the most frequently encountered in patients with endometriosis complain is that it is extremely painful. An increasing order of pain severity is monitored. Focus on the cause of pain in endometriosis secreted by the effect of certain substances called prostaglandin uterine contractions occurring in. However, with the severity of the pain is no relationship between the degree of disease. A mild endometriosis may cause violence, such as severe pain in patients with endometriosis in an ultra-light pieces can be seen even in severe pain may not be any pain. However, earlier onset of labor and the progress continues for more than may indicate stages of the disease. The pain typically begins a few days before one and to the highest level reached with bleeding and bleeding continues throughout. In fact, sometimes this pain may not respond to drugs painkillers. Chronic groin pain than labor units in the endometriosis and low back pain may be. This pain may spread legs towards the.

Endometriosis, can cause pain during sexual intercourse. This situation in most of endometriosis patients with bleeding disorders are common to. However, in the form of premenstrual bleeding common brown staining is typical for endometriosis.

Most of endometriosis patients because of inability to have children can apply for PhD. In general, the complaints of infertility in 10-20% of women have endometriosis at different levels. The relationship between endometriosis and infertility could be is not fully understood. Especially in mild to moderate whether endometriozisin cause infertility is controversial. However, the most commonly accepted theory in space endometriozisin pelvic inflammation caused by some kind of lead to the release of certain substances and materials and have a negative effect on follicle and egg development is that. Peritoneum of these substances secreted in the egg and sperm even, tubal function, and even the fertilized egg is implanted endometriuma been proposed may be of some impact on. Another is just a matter of mild endometriosis does not cause infertility. This is the main cause of infertility in patients with poor sperm quality, such as ovulation disorders or other pathology known unexplained infertility (sterility) as well as in cases of unknown causes are. Only to the table accompanying endometriosis is an additional pathology.

On the other hand a known cause of severe endometriosis is infertility. The resulting adhesions and anatomical reproductive system disorders disrupt the normal function of the fertilization cause problems. Even without adhesions, chocolate cysts by disturbing the normal ovulation can lead to infertility.

Why chocolate cyst: Accumulated blood remains red to brown color as time passed, and black indicates the correct change. Ovarian tissue of blood accumulated in this former Endometrioma are built from and within view of the cyst is reminiscent of the liquid chocolate.

Complaints and findings may appear with endometriosis

- Chronic pelvic pain
- Copies of being painful (dysmenorrhea)
- Infertility
- Ectopic pregnancy
- Painful sexual intercourse (disparonia)
- Low back pain
- Back pain
- Leg pain
- Nausea and vomiting
- Abdominal pain
- Constipation or diarrhea
- Anus pain hit
- Bloody stool
- Makadi bleeding
- Towards the coccyx pain
- Blood in urine
- Burning urination
- Side pain
- Frequently urination
- Copies or bleeding nose bleeding simultaneously in various parts of the body of bleeding and bruising.

How is it diagnosed?

Be seen as poles of the lesions diagnosed Endometriozisin and pathological examination are placed with. So surgery is essential for definitive diagnosis. In the sense of history in patients suspected endometriosis also have infertility problems should be absolutely diagnostic laparoscopy. Peritoneum during laparoscopy, the uterus, Douglas space, inner tubes, such as formation of pelvic endometriosis observing small investigated the presence of focal adhesions is monitored while in severe cases.

The most important diagnostic ultrasonography in the diagnosis of endometriosis at the beginning of the income test. Ultrasonography in the diagnosis of ovarian cysts, but the chocolate had settled, while useful for pelvic endometriosis is insufficient to provide information. Deep in the ovaries can be overlooked, but this had settled endometriomalar laparoscopic ultrasonographic examination with a careful masses can be easily noticed.

Ultrasound examination of the cases heard in the blood endometriomalardan doubt called Ca-125 as a result of a marker at diagnosis is important for support. Originating from the ovaries secreted in some cancers these tumor markers are also increased in the presence of endometriosis, but the blood level does not rise as in malignant diseases.

Phases

Endometriosis disease, where the region, propagation, depth and size are according to the stage. Minimal disease stage 1, stage 2 light, mid-stage 3 and stage 4 represents the severe endometriosis. Created with the stage of disease that has no direct connection between the complaints.

How is it treated?

There is no definitive treatment Endometriozisin permanent. The aim of treatment for the pain and infertility is to eliminate. Medical and surgical treatments can be applied for this purpose. Medical treatment is based on the principle endometriozisin are estrogen-dependent disease. Pregnancy and menopause, endometriosis is preventing the formation of two natural conditions. Hormonal therapy is to mimic the natural state of these two objectives. In both cases the effect of estrogen on the endometrium will disappear in the wrong location had settled in the suppression of endometrial tissue are expected.

Hormonal status during pregnancy to mimic observed when using birth control pills, in order to mimic menepozu called danazol or GnRH analogue drugs are used. Lasting 3-6 months in the treatment of blood estrogen level as in the low levels in natural menopause is. Usually applied once a month in the form of injection of GnRH analogue treatment is very expensive form of treatment. Long-term use of GnRH anaolgları osteoporosis, after menopause such as hot flushes may be seen near the lead to be supplied with medicines that contain estrogen. Called add-back therapy may seem to contrast this to stop. However, the purpose of blood estrogen levels cause endometriosis baskılayacak low and not osteoporosis is to keep a high enough range.

The studies for the pain of endometriosis is applied in medical treatment to be effective, but a positive effect on infertility is not shown. Therefore, in patients admitted with a medical reason for infertility treatment is not recommended.

Should be preferred in patients with severe endometriosis is surgical treatment approaches. Developments in laparoscopic surgical techniques, especially for these patients treated in an effective way allows. For example, chocolate cysts extracted 50% of patients treated within 6 months without having to remain pregnant. Anatomical level of the re-provision and eliminating pain and is extremely important in increasing reproductive potential.

Assisted reproductive techniques:

Treated after surgery because of infertility a woman becomes pregnant within 6 months in self-assisted reproductive techniques are not the next option. If the tubes are open vaccination may be tried. Vaccination in cases where the last alternative in vitro fertilization failed application. This group of patients, especially the large chocolate cyst was removed a reduction in ovarian reserve can be expected. In addition, for some reason unknown, this decrease can be seen in the rate of fertilization in endometriosis patients.