Chocolate cysts are prone to recurrence, how to prevent them correctly?

Chocolate cyst is a common gynecological disease, but unlike malignant cysts, it is a benign lesion and a type of endometriosis. However, this disease also has its special features, which are specifically manifested in the recurrence of chocolate cysts. So, how can we prevent the recurrence of chocolate cysts?

1. Get immediate treatment

Surgery should be performed immediately after diagnosis, as the discharged cystic fluid may cause pelvic adhesions, infertility, or re-dissemination and implantation of ectopic endometrium.

2. Flush and absorb cyst fluid

Young nulliparous women can have the cyst excision surgery after suctioning and thoroughly flushing the cyst fluid that has overflowed into the pelvic cavity. This can preserve normal ovarian tissue as much as possible, which is helpful for maintaining ovarian and endocrine functions and increasing the chances of pregnancy in the future.

3. Removal of the appendages

For older patients who already have children with normal contralateral ovaries and unaffected uteri, adnexectomy on the affected side may be considered to avoid future recurrence.

4. Perform cystectomy whenever possible

In principle, cystectomy should be performed if both ovaries are affected. If the cyst is tightly adhered to the surrounding tissues and forced removal may damage the internal organs, anhydrous alcohol can be applied to the cyst cavity to cause necrosis of the epithelial layer in the cyst cavity to prevent future recurrence. Postoperative medication is still recommended.

5. Clean the abdominal cavity

For patients with ruptured ovarian chocolate cyst, surgery should be performed to thoroughly clean the abdominal cavity, remove the lesion as much as possible, and loosen adhesions.

6. Postoperative medication

It is generally advisable to take medications for the treatment of endometriosis after surgery to prevent lesions or cystic fluid that are not detectable by the naked eye from contaminating the abdominal cavity and causing new dissemination and implantation of lesions.