Endometrial cyst

Endometriosis is an alteration in which the endometrium, the tissue that normally lines the interior of the uterus, grows in other locations outside the uterus.

An endometrial cyst or ovarian endometrioma is one of the ways in which endometriosis presents itself and affects nearly 55% of the patients suffering from it. A cyst located in the ovarium lined with endometrial tissue is filled with blood. It is also known as a "chocolate cyst" for its brown colour.

Endometrial cysts manifest with abdominal pain related to menstruation, pain during sexual intercourse, pain during defecation or urination and sterility.

Diagnosis is done through clinical questioning, gynecological examination and an ultrasound. Sometimes, a tomography or MRI might be needed to ensure a diagnosis. In addition, some markers such as CA125 and HE4 can be studied in blood tests.

Endometriosis treatment depends on the severity of the symptoms, cyst size and reproductive desire. In many cases, hormonal medical treatment with birth control pills may be sufficient, as it prevents the accumulation of blood inside the cyst.

Surgery is usually a second level strategy, since during surgery, healthy tissue may be damaged and the patient's ovarian reserve and fertility may be diminished. However, if the cyst is very large or in cases of severe pain, surgery may be required for its removal (cystectomy). In cases where there is no healthy ovarian tissue in the ovary, complete removal of the ovary may be necessary (oophorectomy).