Post-Operative Concerns After Laparoscopic Chocolate Cyst Surgery

Postoperative care for chocolate cysts?

I underwent laparoscopic surgery for bilateral chocolate cysts (4 cm on the left side and 7 cm on the right side) in the emergency department on April 20.
Postoperatively, I received a menopause injection around noon on April 22.
Later that afternoon, around 4 PM, I experienced bleeding that lasted approximately 6-7 days.
On May 11, I had my menstrual period, which was around the usual time for my pre-surgery cycle.
I received another menopause injection on May 18.
Recently (late May to early June), I noticed that the right ovary feels more prominent than the left (due to weighing 38.39 kg, I often felt a bulge on the right side even before the surgery).
When I place my hand on it, I sometimes feel a sensation of gas movement (similar to the feeling of a balloon deflating in bursts).
Currently, due to the outbreak of the pandemic, I have not been able to visit the hospital, so I am uncertain whether this is benign or malignant.

1.
Is this condition a side effect of the menopause injection or the surgery?
2.
Is this situation normal?
3.
How long after surgery can I engage in sexual activity?
4.
Are there any precautions I should take after receiving the menopause injection?

Ms. Chen, 10~19 year old female. Ask Date: 2021/06/06

Dr. Huang Yuande reply Obstetrics and Gynecology

1.
It may be a phenomenon of postoperative adhesions.

2.
It is a common symptom, especially within six months after surgery.

3.
After one month, gentle activities should be able to begin.

4.
No, regular follow-up visits are necessary.
The likelihood of malignancy in a chocolate cyst is very low.

Reply Date: 2021/06/06

More Info

After undergoing laparoscopic surgery for bilateral chocolate cysts, it is understandable to have concerns regarding post-operative symptoms and recovery. Here are some insights based on your questions and the typical medical knowledge surrounding this type of surgery.

1. Is the current situation a side effect of the menopause injection or a post-operative effect?
The symptoms you are experiencing, such as the sensation of fullness or gas movement in the right ovary, could be attributed to a few factors. After surgery, it is common for patients to experience some degree of swelling or changes in the texture of the ovaries as they heal. The menopause injection (often a GnRH agonist) can also lead to side effects such as changes in ovarian function, which may contribute to your symptoms. However, it is essential to differentiate between normal post-operative changes and potential complications, such as adhesions or fluid accumulation.

2. Is this situation normal?
It is not uncommon for patients to experience various sensations in the pelvic region after surgery, especially within the first few months. The feeling of gas movement could be related to normal bowel activity or the healing process of the surgical site. However, if the sensation is accompanied by significant pain, discomfort, or any unusual changes, it is advisable to consult your healthcare provider for further evaluation.

3. How long after surgery can sexual activity resume?
Generally, it is recommended to wait at least four to six weeks after laparoscopic surgery before resuming sexual activity. This allows adequate time for healing and reduces the risk of complications. However, it is crucial to listen to your body and consult with your surgeon or healthcare provider for personalized advice based on your recovery progress.

4. What should be noted after receiving the menopause injection post-surgery?
After receiving a menopause injection, it is essential to monitor for any side effects, such as hot flashes, mood changes, or bone density loss, especially if the treatment is prolonged. Regular follow-ups with your healthcare provider are important to assess the effectiveness of the treatment and to manage any side effects. Additionally, you should be aware of any signs of complications from the surgery, such as severe pain, fever, or unusual discharge, and seek medical attention if these occur.

In conclusion, while some post-operative symptoms can be normal, it is crucial to maintain open communication with your healthcare provider. Regular follow-ups and monitoring will help ensure that any potential complications are addressed promptly. If you have concerns about the sensations you are experiencing or if they worsen, do not hesitate to reach out to your doctor for further evaluation. Your health and peace of mind are paramount, especially after undergoing a significant surgical procedure.

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