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Endometriosis | Endometriotic Cyst | Chocolate Cysts | Dr Tehmina Rehman | #tehminasclinic Dr Tehmina talks about endometriosis in general. Its causes, and effects Its treatment options She talks about endometriotic cysts , also called chocolate cysts And some of its effects on fertility. #endometriosis #endometriosiscyst #tehminasclinic #drtehminarehman #gynaecologist Endometriosis is a common diagnosis How is it diagnosed? A common factor is pain in periods And the pain keeps increasing in the periods Then we get ultrasound done Often we find a cyst In the ovary Its not in the uterus And the cyst shows blood on ultrasound So painful periods and cyst with blood on ultrasound Mean a high chance of this being endometriosis Some people have very painful periods But they are not endometriosis As the pain pattern is different Sometimes people have pain like endometriosis But we find no cyst on scan In such patients whose pain is getting un manageable Or she has other added problems Like not conceiving Then we do diagnostic laparascopy Were we put in a pencil like camera Into the abdomen Through the umblicuc No big cut And we see what is happening Sometimes endometriosis does not make cysts But makes patches inside And these patches donot show on ultrasound And we have to do laparascopy to diagnose Why does it happen Some family tendency has been seen Maybe a genetic role What happens in endometriosis? The blood that is formed in the uterus Which goes out during periods That blood For some reason not really known at this time That blood collect outside the uterus Sometimes it makes cysts And other times it is spattered around Causing injury Injury causes fibrosis and scarring When endometriosis is severe Injury and scarring can be so bad That things can not work properly So what can be done for endometriosis? It all depends age, symptoms And how it is situated We can offer medical treatment option Where we stop periods for a time There are tablets, injections And also side effects But if we stop periods for a time Then the the new blood That would feed the endometriosis Is stopped And the cysts may reduce in size And endometriosis may quieten down It works at times And at others it does not Should they be operated I am not really in favour Unless its in skilled hands And they can remove the cyst intact Or with minimal spillage If the cyst gets ruptured And the fluid and cells get spilled Then the endometriosis that was only in the cyst Gets spilled and spread all over So surgery should be by skilled surgeon And try to remove the cyst intact The patches around are also burned After the surgery we stop the periods for a few months So that any remaining cells get killed off This usually helps Diagnosing endometriosis is hard at times If you go to different consultants You may get different opinions And they may all be right to an extent Everyone is a product of education And experience So we may differ in our advice But the methods I have outlined Where you go stepwise Things move better Endometriosis affects fertility Some infertile ladies may have a endometriotic cyst Should it be removed? Yes It is a good idea But endometriosis works at microscopic level too It does not let the tubes, eggs etc. work well So my advice is that in case of cyst It should be removed laparoscopically And then IVF So that everything affected by endometriosis is by passed So that you can have at least one baby And then you can keep trying naturally if you wish Because endometriosis is known for Not being removed completely and it just keeps damaging And if you wait too much Then the damage may be so that we cannot even get eggs for ivf So if you have been diagnosed with endometriosis Go to an experienced doctor Who knows when surgery should not be done And if the surgery is not done right Then it can actualy make things worse Thankyou