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Endometriotic Cystectomy

What is Endometriotic Cystectomy?

Endometriotic cystectomy is a surgical procedure performed to remove endometriomas, commonly known as chocolate cysts, which are fluid-filled cysts formed on the ovaries due to endometriosis. Endometriosis is a condition where tissue similar to the lining of the uterus grows outside it, causing pain and fertility issues. Cystectomy involves carefully excising the cyst while preserving as much healthy ovarian tissue as possible to maintain hormonal function and fertility.Endometriotic cystectomy is a crucial treatment for women suffering from endometriomas, particularly when they cause pain or infertility.
Endometriotic Cystectomy

Symptoms of Endometriotic Cysts

Women with endometriotic cysts may experience:

  • Severe pelvic pain, especially during periods
  • Painful intercourse (dyspareunia)
  • Painful bowel movements or urination
  • Irregular or heavy menstrual bleeding
  • Infertility or difficulty conceiving
  • Abdominal bloating and discomfort
  • Fatigue

These symptoms often worsen over time and significantly affect daily activities and emotional wellbeing.

Procedure / Treatment

Endometriotic cystectomy is usually performed through laparoscopy (keyhole surgery). The procedure includes:

  1. General anesthesia is administered.
  2. Small incisions are made in the abdomen to insert a laparoscope (camera) and surgical instruments.
  3. The surgeon carefully separates and removes the endometriotic cyst from the ovary without damaging healthy tissue.
  4. Bleeding is controlled, and the ovary is reconstructed if required.
  5. The incisions are closed with sutures or surgical glue.

Hospital stay is usually short (same day or 1 day), and recovery takes around 2–4 weeks, depending on individual health.

Prevention

Currently, there is no definitive prevention for endometriotic cysts as their exact cause is unknown. However, management strategies include:

  • Hormonal therapy such as oral contraceptives, progestins, or GnRH agonists to suppress endometriosis progression.
  • Regular gynecological checkups to detect cysts early.
  • Maintaining a healthy lifestyle, balanced diet, and exercise to reduce inflammation and hormonal imbalances.

Benefits of Endometriotic Cystectomy

  • Pain relief from chronic pelvic pain and period cramps.
  • Improved fertility by restoring normal ovarian anatomy and function.
  • Better quality of life due to reduced symptoms.
  • Prevention of cyst rupture or further enlargement causing complications.
  • Helps in accurate diagnosis by histopathology confirmation of endometriosis.

Types of Endometriotic Cystectomy Procedures

  1. Laparoscopic Cystectomy

    • Minimally invasive

    • Less postoperative pain

    • Faster recovery and minimal scarring

  2. Open (Laparotomy) Cystectomy

    • Rarely required for very large or complicated cysts

    • Longer hospital stay and recovery

  3. Robotic-Assisted Cystectomy

    • Advanced precision in cyst removal

    • Reduced risk of ovarian damage

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