What are the treatments for ovarian chocolate cysts?

Chocolate cysts are a special pathological type of endometriosis. Generally speaking, if the diameter of a chocolate cyst exceeds 2 cm, it is almost impossible to completely remove it with drugs. At most, drugs can only control the cyst from further development, or slightly shrink the cyst or relieve symptoms. For patients with large lesions and no significant improvement with drug treatment, surgical treatment should be performed in a timely manner.

1. Abdominal surgery: It is a classic treatment method. Conservative surgery or radical surgery is performed according to the patient's age, the size of the lesion and fertility. Conservative surgery preserves the uterus and normal ovaries, preserves the patient's fertility, but also leaves the hidden danger of recurrence. If the cyst is removed, the surgery should first use a thick needle or electric puncture to absorb the cyst fluid, or repeatedly flush with saline to prevent the cyst contents from overflowing widely, contaminating the pelvic cavity, and causing iatrogenic spread and implantation.

2. Laparoscopic surgery: At present, its application is becoming more and more widespread, which shows that it is more valuable than laparotomy. With the improvement of laparoscopic equipment and the improvement of operator skills, laparoscopy can not only complete various laparotomy operations, but also has little interference with patients and fast postoperative recovery. The surgical principles are the same as those of laparotomy. In order to make laparoscopic surgery easier to operate, sometimes the drugs leuprorelin or goserelin are used for a period of time before the operation. The cysts are reduced, the cyst walls are thinned, and the pelvic adhesions are reduced before the operation.

3. Puncture and inject drugs under the guidance of B-ultrasound: With the improvement of B-ultrasound equipment accuracy and the development of various interventional treatments in recent years, chocolate cyst puncture is performed in the abdomen or vagina, the cyst fluid is extracted, repeatedly rinsed with saline, and then anhydrous alcohol or other corrosive agents are injected to make the cyst wall cells lose their growth activity, degenerate, necrotize and secrete functions. Due to the atrophy, shedding and absorption of the cyst wall cells, the cyst can shrink, be punctured repeatedly, and even disappear completely.

After surgery, the drug leuprorelin or goserelin should be used for a period of time to consolidate the effect. Patients who have not given birth are encouraged to become pregnant as soon as possible.