Chocolate cysts, medically called ovarian endometriosis cysts, are a type of endometriosis. Under normal circumstances, the endometrium should grow in the uterine cavity and be excreted during the menstrual cycle. When these endometrial tissue "escapes" to grow into the ovaries, ectopic cysts will form.
,,,.Over time, the old blood accumulation in the cyst becomes thick and dark brown, shaped like chocolate liquid, hence the name "chocolate cyst".
Chocolate cyst is a hormone-dependent disease that occurs most frequently in women of childbearing age.
,.In recent years, the incidence of endometriosis, including ovarian chocolate cysts, has shown a significant upward trend. Among women of childbearing age, about 10%-12% suffer from endometriosis, of which ovarian chocolate cysts account for as high as 30%-40%.
,:,.In addition, genetic factors are also one of the important causes. Studies have shown that patients 'first-degree relatives (mothers, daughters and biological sisters) have seven times the risk of developing the disease compared to those without a family history.
The clinical manifestations of chocolate cysts are diverse. In many cases, there may be no obvious discomfort and are only accidentally discovered during physical examination.
,,.However, most people experience periodic pain, known as dysmenorrhea, that usually starts before menstruation and lasts throughout the menstrual period or even disappears a few days after menstruation.
The degree of pain is not necessarily proportional to the size of the cyst. Sometimes, even a small cyst can cause unbearable pain. On the other hand, as the size of the cyst increases, the symptoms of pain may become less noticeable.
,,,.Pain in sexual intercourse is also common, especially when cysts cause local adhesions and retroversion fixation.
,,40%.This is related to ovulation disorders caused by abnormal ovarian function, poor corpus luteum formation, and pelvic adhesions that affect fallopian tube function.
The diagnosis of chocolate cyst requires combining clinical manifestations, gynecological examination and imaging examination.
The diagnosis of chocolate cysts requires a combination of clinical symptoms, gynecological examinations, and imaging tests.Ultrasound is the first choice method to clarify the location, size and shape of cysts;CT and MRI are also of great significance in diagnosis and disease judgment. Laparoscopy and biopsy are the "gold standard" for the diagnosis of the disease.
,,,.In general, when cysts are less than 4 cm in diameter, medication can be considered, such as oral contraceptives, dinogest or injection of gonadotropin releasing hormone agonist (GnRH-a).
≥4,,.Currently, laparoscopic surgery is most recommended, including:
Surgerythat preserves fertility function: Remove the lesion but preserve the uterus and at least part of the ovaries. It is mainly suitable for young patients with childbearing requirements
Surgeryto preserve ovarian function: Remove the lesion and uterus, and preserve part of the ovaries. It is suitable for patients under the age of 45 with obvious symptoms and no fertility requirements
Radical surgery: Removal of the lesion, uterus and bilateral appendages, suitable for critically ill patients over 45 years old.
The preventive effect of chocolate cysts is limited, but some measures can be taken to address the related causes.
,.Timely diagnosis and treatment of diseases that may cause menstrual blood retention, such as reproductive tract malformations, cervical adhesions or vaginal strictures, can help prevent menstrual blood backflow.
,,,,.Early postoperative activity can help reduce complications such as intra-abdominal adhesions.
,,,.Even with surgical resection, the recurrence rate after surgery that preserves fertility is still as high as about 40%.
,,.Regular gynecological examinations to detect and treat the disease in a timely manner are important measures to ensure women's reproductive health.