Mechanism and cause
The lining of the uterus gets shed every month with periods. This can grow outside the uterus and cause bleeding insider the abdomen, which gets collected to form cysts called chocolate cyst. It also causes organs like bladder and bowel to stick to uterus, tubes and ovaries. This can cause block in tubes, leading to infertility.
Examination of pelvis may be painful. Scan (USS) might show that the anatomy is distorted (retroverted) and ovaries sticking to uterus. There may be cysts in the ovary (chocolate cysts) and sometimes the ovaries appear sticking to each other (kissing ovaries) on the scan.
Early stages may be treated with progesterone pills
1. Combined pills (contraceptive pills)
2. Gonadotrophin agonists are (eg.luprolide acctate)
Used as depot preparations, which are taken as monthly injections for 6 month.
Best method of treatment is laparoscopic cauterization of the lesions and chocolate cystectomy, if cysts are present
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