Wang Jianmei Director of Reproductive Medicine and Family Planning Department of the Second Hospital of Tianjin Medical University
Recently, a new medical vocabulary "chocolate cyst" was accompanied by the TV series "Love" and rushed on the hot search.In the play, the heroine Liang You’an suffered from chocolate cysts.Many audiences said that for the first time, I heard that the name was so "sweet".
Wang Jianmei, director of the Department of Reproductive Medicine and Family Planning of Tianjin Medical University Second Hospital, said: "Chocolate cysts are not ‘sweet’, which is more common among women’s groups. Nearly 80%occur in the age of childbearing, and it has a great impact on women’s fertility., And it is easy to relapse after treatment, which seriously affects the physical and mental health of women. "
Symptoms such as dysmenorrhea, menstrual disorders and other symptoms
"Chocolate cysts are cysts formed by ectopic endometrium to ovarian." Wang Jianmei explained this disease to the Science and Technology Daily reporter with an metaphor of an image.The uterus is like a house, and the endometrium is like the wall in the house.After puberty, before menopause, the ovaries are excreted and estrogen hormone is secreted every month. The wall skin in the house will be prepared thickly for embryo bed under the action of hormones.If there is no pregnancy that month, the wall skin will be exfoliated into menstrual flow, and the wall skin will grow again next month, and it will start.If the wall skin is not only on the surface of the wall, but also runs to the wall or outside the house, it is the endometrium.After the endometrium is ectopic to the ovaries, as the endometrium in the uterus is exfoliated every time, the ectopic endometrium is also exfoliated by bleeding.Ovarian endometriosis cyst.During surgery, you will find the old blood -like liquid chocolate in the cyst, so there is this title -chocolate cyst.
The incidence of endometriosis is high, and the incidence of women in childcare accounts for 15%-20%, of which chocolate cysts account for 70%-80%.In addition to ectopic endometrium to the ovaries, it can also reach multiple places, such as fallopian tubes, peritoneums, intestines, etc. Patients will have symptoms such as dysmenorrhea, menstrual disorders, and sexual intercourse pain.Of course, there are no symptoms of patients, just like the heroine Liang Youan in the play, but the menstrual cycle is a bit disordered, and problems are found during physical examination.
"Regardless of whether there is any symptoms, the effects of chocolate cysts on fertility are very great. 25%-35%of infertility is related to endometriosis. Repeated bleeding of the ectopic endometrium can cause changes in the fallopian tube and ovarian structure, resulting in the fallopian tubeCovering, pelvic tissue adhesion, and also secrete inflammatory substances, causing the quality of eggs and embryos to decrease, resulting in infertility and abortion. "Wang Jianmei said.
Can’t completely solve the problem with pregnancy
In the play, the doctor suggested that if Liang Youan gets married, he will become pregnant as soon as possible, and he will not come to menstruation for a long time. When you suspend new bleeding, the cyst will slowly shrink.
Can there be a chocolate cyst for giving birth?In this regard, Wang Jianmei said that this disease is closely related to female hormones, so any measures that reduce or stop menstruation, including gonadotropin to release hormone analogs, contraceptive pills, contraceptives, internal birthpasses, physiological pregnancy, physiological pregnancyMenpoopopathy, surgical resection ovarian, etc., all have the effects of treating or delaying the progress of the disease in chocolate cysts.
"But pregnancy does not change the fact that the endometrium is already different. The recurrence of chocolate cysts depends on women’s ovarian function. As long as the ovarian function is still there, it may recur. Therefore, after giving birth, chocolate cysts are still very very very very goodThe probability of recurrence. "Wang Jianmei said.
If the patient’s ovarian function is good, the unilateral chocolate cyst is less than 4 cm, the severity dysmenorrhea is unobstructed, and the fallopian tube is unobstructed. You can try to get pregnant. Pay attention to monitoring ovarian reserves during pregnancy.It should not be too long to wait for the natural conception. If the ovarian function has fallen significantly, it is recommended to consult to auxiliary reproduction as soon as possible.Pay attention to the monitoring of progesterone in the early stages of pregnancy, and there are no special precautions in the middle and late pregnancy.
If the patient’s chocolate cyst diameter exceeds 4 cm, the tubal is blocked or water accumulation, severe dysmenorrhea, or bilateral ovarian has chocolate cysts and has a large diameter, and should be pregnant after surgery.
Wang Jianmei said that surgical therapy is suitable for patients with symptoms such as cysts greater than 4 cm or accompanied by symptoms such as infertility and pain. The lesions can be removed by laparoscopic minimally invasive surgery, and ovarian resection can also be performed without fertility requirements.If you have fertility requirements, age is more than equal to 35 years of age or ovarian dysfunction, an auxiliary reproduction should be performed as soon as possible after surgery.
However, it should be noted that the probability of recurrence of chocolate cysts is very high, and it is difficult to completely cure even surgery.Therefore, patients with chocolate cysts must not be careless after surgery, but also need to be treated with drugs for auxiliary treatment to prevent cysts from recur.
People are not very clear about the cause of chocolate cysts, so there is no clear prevention method.However, Wang Jianmei also gave suggestions: "After adolescence, women should maintain a good lifestyle, diet and exercise reasonably, pay attention to menstrual period, postpartum health care and sexual hygiene, efficient contraception, reduce unwilling pregnancy and abortion." (Chen Xi)
Source: Science and Technology Daily