Chocolate cysts of endometria

[Mandi79]

Hi, I have been diagnosed with complex cyst  - chocolate cysts of endometria I think they called it. I got extreme pelvic pain in Aug 2007 but I was on vacation and just thought its abdominal pain from bad eating. I took Tylenol and it went away. I got my period 2 days after and figured it was because of that. Then in Oct 2007, I got some pain but it went away. Then in December 2007, I got extreme pelvic pain again. Went to Emergency and they diagnosed me with ovarian cysts. Ultra sound showed a 5.6 cm by 4.4 cm cyst on the right side. I went to gynaecologist who said he recommends surgery and possible removal of an ovary, but because i'm only 28 and don't have children, i wanted to wait it out as I dont want to risk removing the ovary. I then started to get pain on the left side around Feb 2008, so I decided to get another ultra sound done. This time it was transvaginal and it showed a 6 cm mass on the LEFT side with nothing on the right side...

I am confused because the pain now is happening in the lower pelvis but this month appears to be on the right side....it feels like the entire area is off and on in pain. I am feeling a bit fatigued and bloated for 1-2 months at least. I work out every day but gained 5 pounds which didn't make sense to me, but the cysts/mass must be causing my weight gain.

What I would like to know is can I wait it out or should I go for surgery?i am waiting to get a CAT scan to confirm exactly where the problem is. Can you remove the cysts and leave the ovary intact? if the ovaries are damaged, can i wait to have children before removing them or should I have them removed?

[Mandi79]

Hi,

I decided to get a hold of my latest report. This is as of 26th Feb 2008

Pelvic transvarginal exam, was co-related with Ultrasound done January 10 2008

Uterus - 6.5cm by 3.8 cm by 6.1 cm - normal

Endometrium – normal 1.1 cm

Right ovary – normal 0.9 cm by 1.3 cm by 0.7 cm
Left overy – abnormal septated complex mass with low level echoes 6.4 cm x 4.4 cm..

Cul-de-sac – free fluid seen. (( What does this mean??))

Uterus is anteverted normal . Endometrium is 1.1 cm in thickness. Right adnexae and right ovary are normal.

There is some free fluid seen in cul-de-sac. In the left Adnaxae, there is a septated complex mass measuring 6.4cm x 4.4 cm with low level echoes lumen. The echoes are uniform and the margins of this complex cystic mass are suggestive of endometrioma or a chocolate cyst of endometriosis.

When co-related with ultrasound examinations, the very first one done on 12 dec 2007 demonstrated the mass to be on the right side which has resolved.

The second exam done 10 jan 2008 demonstrated this very same mass in the left adnaxe and I believe this is an endometrioma or chocolate cyst of endometriosis and a follow up US in 6-8 weeks is recommended.


--- I dont understand how the right one just disappeared as it was over 5 cm in thickness when I first got my Ultra sound done....could it be something else they THOUGHT is a cyst? I'm having pain on the entire lower abdomen for the past 2-3 days, which lessens with Advil...but its not just happening on the left side where the complex cyst is supposed to be. I asked my doctor to do a CA125 test but she refused that its not needed. Should I still ask her for it?

[Mandi79]

hi there

thanks so much for your reply. the gynaecologist did say that based on my history of painful heavy periods, I most likely have endometriosis as well as complex cysts. What do you mean by functional cysts? i'm used to reading simple vs. complex cysts...

I am on prescription medicine for my periods pain but wierdly since the last 2-3 months when I was confirmed with the cysts, i haven't had to take that medicine! anyways, they have recommended a laparoscopy for me. i guess they would remove the endometriosis as well if they find it..because the doctor said the condition results in infertility in 60-80% of women and they never find it until you start trying.

[Nursemommy34]

The way your cysts are coming and going sounds like they are functional cysts,but that usually doesnt apply to chocolate cysts.  I would ask doc if they could have missed some spots of endometriosis..this often follows the hormonal commands made by the ovaries, and each little patch of blood vessels will act like a mensing uterus during menses...cramps/pain and all.
I wouldn't wait on the surgery.  At least a laparoscopy so they can confirm the types of cells in your cysts, and look around for endometriosis.
Ask doctor if he thinks its possible to remove the cysts leaving the ovaries intact.  Usually they do leave the ovaries, unless they suspect abnormal cell presence, or if your cyst has caused twisting of the ovary, thus causing it's nutrient and oxygen supply to be cut off which leads to tissue necrosis.
Just be firm with your expectations of doctor, but do not deny yourself a propper diagnosis.  Get it over with so you can get on with your life.
Nursemommy34