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WHAT IS A CHOCOLATE CYST? WHAT IS THE TREATMENT IN TURKEY?
The condition in which the tissue called the endometrium that lines the inside of the uterus settles in the organs outside the uterus is called ‘Endometriosis’. Endometriosis most often seen in ovaries, which then becomes the name ‘Endometrioma’, that is, a chocolate cyst.
Endometriosis can also be seen in the peritoneal membrane, tubes, vagina, intestines, bladder, ureter, umbilicus (belly button), old operation suture sites, lungs, diaphragm, spinal canal, brain, eye, breast tissue, heart, arms and hands, spleen, which line the inside of the abdomen, except for the ovaries.
We still do not clearly know the cause, but genetic and immunological factors play a role in its development.
It is observed in one out of every 10 women of reproductive age (15-49 years). In women with infertility problems, it is observed at a rate of 30-40%.
Women with endometriosis may have complaints such as painful menstruation, painful sexual intercourse (pain hitting the groin and breech), infertility (infertility), constipation, indigestion, bloating, abdominal pain, discomfort in the pelvis, ie, lower abdominal discomfort, menstrual irregularity, premenstrual spotting, frequent urination, bloody urine, side pain. Sometimes there are no complaints.
Chocolate cysts, which we call endometriomas in the ovary, and sometimes endometriotic nodules in the intestine, rectum, bladder can be displayed on ultrasound. MRI, which is advanced imaging methods, is especially useful in cases where endometriosis, which we call deep endometriosis, involves deep pelvic tissues. The definitive diagnosis of endometriosis is made by performing a tissue biopsy with open or closed surgery.
Two important determining factors in treatment are pain and infertility (desire for children).
There are 2 basic approaches to treatment.
Medical treatment: The aim is to suppress endometriosis lesions, reduce inflammation, stop the progression of endometriosis lesions. In drug treatment, there are painkillers, birth control pills, progesterone-containing drugs and intrauterine systems (spiral), monthly or 3-month-old needles that we call GnRH analogues, aromatase inhibitors.
Surgical treatment: The aim is to remove ovarian cysts in a way that causes minimal damage to the remaining ovarian tissue, burn the foci of endometriosis in the peritoneum with a cautery, remove deep endometriosis nodules and ensure normal anatomy. Surgery at an early age should be avoided unless it is very necessary, because symptoms return within a year in half of women after surgery, and re-operation is required in half of cases within 5 years after surgery.
The treatment of endometriosis in an infertile woman is controversial. It is appropriate to perform surgery on women over the age of 35 who have children.
In infertile women with endometrioma on their ovaries, surgery may be recommended first if the size of the cyst is 5 cm and above. But during this surgery, careful surgery should be performed to create minimal damage to the remaining ovarian tissue, otherwise the ovarian capacity, which we call the ovarian reserve, may decrease. The chance of spontaneous conception is highest within 6 months following surgery in MedicalPark Istanbul and Antalya hospitals.
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Turkey Medicals Co-ordinator, “Surgery should be considered as a last resort in the adolescent group, surgery should be avoided if the size of the cysts is not large in cases with endometrioma on both ovaries and there is no child prompt yet.” it was said.
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Turkey's world-renowned organ transplant specialist. Dr. Demirbaş has 104 international publications and 102 national publications.
Physician's Resume:
Born on August 7, 1963 in Çorum, Prof. Dr. Alper Demirbaş has been continuing his work as the President of MedicalPark Antalya Hospital Organ Transplantation Center since 2008.
Prof. who performed the first tissue incompatible kidney transplant in Turkey, the first blood type incompatible kidney transplant, the first kidney-pancreas transplant program and the first cadaveric donor and live donor liver transplant in Antalya. Dr. As of August 2016, Alper Demirbaş has performed 4900 kidney transplants, 500 liver transplants and 95 pancreas transplants.
In addition to being the chairman of 6 national congresses, he has also been an invited speaker at 12 international and 65 national scientific congresses. Dr. Alper Demirbaş was married and the father of 1 girl and 1 boy.
Awards:
Eczacibasi Medical Award of 2002, Akdeniz University Service Award of 2005, Izder Medical Man of the Year Award of 2006, BÖHAK Medical Man of the Year Award of 2007, Sabah Mediterranean Newspaper Scientist of the Year Award of 2007, ANTIKAD Scientist of the Year Award of 2009, Social Ethics Association Award of 2010, Işık University Medical Man of the Year Award of 2015, VTV Antalya's Brand Value Award of 2015.
Certificates:
Doctor of Medicine Degree Hacettepe University Faculty of Medicine Ankara, General Surgeon Ministry of Health Turkey EKFMG (0-477-343-8), University of Miami School of Medicine Member of Multiple Organ Transplant, ASTS Multiorgan Transplant Scholarship. Lecturer at Kyoto University. Lecturer at University of Essen, Research assistant at the University of Cambridge .
Professional Members:
American Society of Transplant Surgeons, American Transplantation Society Nominated, Middle East and Southern Africa Council Transplantation Society 2007, International Liver Transplantation Association, Turkish Transplantation Association, Turkish Society of Surgery, Turkish Hepatobiliary Surgery Association.
Disclaimer:
Our website contents consist of articles approved by our Web and Medical Editorial Board with the contributions of our physicians. Our contents are prepared only for informational purposes for public benefit. Be sure to consult your doctor for diagnosis and treatment.