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How can chocolate ovarian cysts be removed?

Q: I am a 27 years old female diagnosed with two chocolate cysts in both the ovaries, measuring 5 cm each. The doctor has also diagnosed me with endometriosis. I am currently taking Danazole. Is surgery inevitable for removing the cysts?

A:Yes, laparoscopic treatment of the chocolate cysts and any other endometriosis will definitely be required and if extensive, then even an open surgical procedure may become a possibility depending on surgical expertise of the surgeon involved, and disease extent. Chocolate cysts do not get better with medications and always need surgical removal. You have not written if fertility is an issue in your case. If you wish to have children, then also treatment is necessary to improve chances of conception. Post surgery, Danazol or Gonadotropin-releasing hormone (GnRH) analogues, or progesterone therapy may be needed for some time, depending upon extent of the disease seen at the time of laparoscopy/ surgery. This could vary from three to six months. The follow up after the procedure would be required, till pain relief/ conception is achieved, as the case maybe.

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