Endometriosis Treatment in Ankara, Turkey

What Is Endometriosis (Chocolate Cyst)?

Endometriosis is a condition in which endometrial glandular tissue, which normally lines the inner wall of the uterus, is found outside the uterine cavity.
A chocolate cyst, also known as an ovarian endometrioma, is a cyst formed as a result of endometriosis involving the ovaries and contains old, dark, chocolate-colored blood.

What Causes Endometriosis (Chocolate Cyst)?

The exact cause of endometriosis is not fully understood; however, several theories have been proposed. These include environmental toxins, genetic predisposition, retrograde menstruation (backward flow of menstrual blood into the ovaries),and the implantation of endometrial cells onto the ovarian tissue.

What Are the Symptoms of Endometriosis (Chocolate Cyst)?

• The most common symptom is painful menstruation (dysmenorrhea)
• Pain during sexual intercourse (dyspareunia)
• Infertility
• Irregular menstrual bleeding

How Is Endometriosis (Chocolate Cyst) Treated?

Treatment of ovarian endometriomas depends on the patient’s symptoms and the size of the cyst. Surgical treatment may negatively affect ovarian reserve; therefore, if surgery is not absolutely necessary, it may be postponed until after pregnancy.

If there is no immediate desire for pregnancy, hormonal medications may be prescribed to suppress endometriosis.

However, surgery is recommended in cases where menstrual pain or pain during intercourse does not respond to hormonal suppression therapy, and in severe cases where deep infiltrating endometriosis is suspected. Lifestyle modifications such as reducing animal-based food consumption, regular exercise, and supportive treatments are also recommended.

Endometriosis Surgery Ankara, Turkey

Endometriosis surgery can be performed using either a laparoscopic (minimally invasive) or open laparotomic approach. Laparoscopy is the preferred method due to shorter hospital stay and faster recovery.

Is Endometriosis (Chocolate Cyst) Surgery Risky?

In cases of deep infiltrating endometriosis, where endometriotic nodules involve surrounding organs, organ injury may occur during removal of these nodules. If extensive intra-abdominal adhesions due to endometriosis are present, injury to adjacent organs may occur during cyst removal.

How Long Does Endometriosis (Chocolate Cyst) Surgery Take?

The duration of surgery depends on the presence of intra-abdominal adhesions, the size of the cyst, prior surgical history, and the patient’s body mass index.
In patients without adhesions or previous surgeries, the procedure may take approximately 1–1.5 hours, whereas in cases of deep infiltrative endometriosis, surgery may be prolonged and resemble oncologic procedures.

What Should Be Considered After Endometriosis (Chocolate Cyst) Surgery?

Postoperatively, proper wound care is essential. Prescribed antibiotics and painkillers should be taken as directed, and heavy lifting should be avoided.
In unmarried patients, suppressive hormonal therapy may be prescribed to prevent recurrence of ovarian endometrioma.

Does Endometriosis (Chocolate Cyst) Prevent Pregnancy?

Endometriosis alone does not necessarily prevent pregnancy. However, it may cause infertility by leading to extensive intra-abdominal adhesions, disrupting the relationship between the fallopian tubes and ovaries, or blocking the tubal openings.

Studies have shown that endometriosis may slightly reduce embryo quality and negatively affect implantation. Nevertheless, with appropriate treatment approaches, successful pregnancy outcomes can be achieved in patients with endometriosis.

Is Endometriosis (Ovarian Endometrioma) Dangerous?

Endometriosis-related ovarian endometriomas may sometimes rupture, causing severe pain and requiring emergency surgery. If the cyst is very large, it may lead to ovarian torsion by twisting around its own axis. There are scientific publications indicating that ovarian cancer may develop on the background of long-standing endometriosis over the years. Therefore, in patients who have completed their fertility plans, removal of ovarian endometriomas measuring 4 cm or larger is recommended.

Can Endometriosis Occur in Virgins?

Yes, endometriosis can occur in virgins. The most common symptom in this group is severe menstrual pain. Hormonal therapy is generally recommended to suppress cyst growth over time and to reduce menstrual pain.

Can an Endometriotic Cyst Rupture? What Happens If It Does?

Ovarian endometriomas can rupture, similar to other ovarian cysts. When the cyst contents spill into the abdominal cavity, it may cause severe pelvic pain and signs of an acute abdomen, including tenderness in the abdomen and groin, and surgery may be required for treatment.

What Should Be Done If an Endometriotic Cyst Ruptures?

Patients with a known history of endometriosis who experience acute pelvic pain should urgently consult a gynecologist. After clinical examination, treatment planning is based on blood test results, vital signs, and ultrasound findings.

Does Endometriosis Resolve With Menstruation?

Endometriotic cysts do not resolve with menstrual bleeding. They may persist for years and generally tend to enlarge over time. Oral contraceptives do not completely eliminate these cysts; however, hormonal suppression may reduce their size to some extent.

Can Patients With Endometriosis Get Pregnant?

Patients with endometriosis can become pregnant. However, the time to conception depends on the severity of the disease. If the patient is young and endometriosis has not disrupted the anatomical relationship between the fallopian tubes and ovaries, pregnancy may be achieved in a shorter time.
Even the presence of endometriosis alone may lead to unexplained infertility by negatively affecting embryo quality and implantation, making conception more difficult.

Where Is Endometriosis-Related Pain Felt?

Pain associated with endometriosis is usually felt in the pelvic or groin region, especially during menstruation. In cases of deep infiltrating endometriosis, the location of pain may vary depending on the site of endometriotic nodules.

Does Endometriosis Cause Weight Gain?

Endometriosis does not cause weight gain.

At What Ages Is Endometriosis Seen?

Endometriosis may be seen starting from the years following the onset of menstruation.

Is Endometriosis Benign?

Endometriosis-related ovarian endometriomas are benign cysts containing old, dark blood. However, it has been reported that malignancy may develop on the background of some endometriomas over many years. Therefore, close follow-up is essential, and especially in postmenopausal patients, cysts larger than 4 cm should be surgically removed.

Does Endometriosis Recur?

Even after surgical removal, endometriosis may recur if suppressive hormonal therapy is not administered, as the underlying disease mechanism continues to persist.