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Endometriosis

(Chocolate Cyst)

Endometriosis (Chocolate Cyst) negatively affects the daily life of approximately two million women in Turkey. It is seen in 10 - 17% of women of childbearing age. It is seen in 30% of women diagnosed with infertility.

Chocolate Cyst is a disease whose diagnosis is often delayed.

We have successfully freed our dear patient Ms. Elif from chocolate cysts (endometriomas) that had spread to her ovaries, uterus, ureters, rectum, and the sacrouterine region, causing these areas to stick together — truly one of the most challenging types of cysts we encounter.

It was a long and intricate surgery, one that required immense precision and care, but we completed it successfully. I’m here with Ms. Elif, filled with joy, pride, and gratitude after another complex operation brought to a positive outcome.

To all my patients suffering from this condition: Don’t be afraid — let us do the worrying!
(Just kidding, of course.) Rest assured, we will always continue to stand by you and do our very best.

Here we are once again with another young and energetic patient — dear Günel. Getting to this point with her wasn’t easy. Thanks to our minimally invasive surgical technique, we were able to free her from multiple large chocolate cysts that had covered both her right and left ovaries.

Now, all of that is behind us, and my dear patient has turned a brand-new page in her life.

Wishing you a long, healthy, and fulfilling life, dear Günel — may your future be filled with success and happiness.

Here we are with my dear patient Ms. Seçil — performing surgery on such a cheerful woman and seeing her recover so quickly has been a great joy for us.

Through laparoscopic surgery, we removed endometrioma cysts from both her right and left ovaries. Her sigmoid colon (the section of the large intestine closest to the rectum and anus) was adhered to her ovaries, and we carefully released these adhesions, cleaned the deep endometriosis lesions, and restored both ovaries to their normal, healthy position.

We accomplished a lot during this operation — but the best part of all is seeing our patient’s smiling face shine even brighter.
That’s what makes us happiest of all.

Another patient of mine who smiles again thanks to closed, that is, laparoscopic surgery. Mrs. Funda, who quickly returned to her health, work, home, and husband and felt as if she had never had an operation.

She applied to our clinic from Gaziantep. For about 15 years, she had many tests, various hormone treatments, surgeries, and applied to many doctors due to her deep chocolate cyst disease, but unfortunately she could not get results, on the contrary, the side effects of these treatments caused her to experience more difficult processes. . We performed deep endometriosis surgery on our patient with the closed surgical technique, we eliminated all the problems that cause pain without overlooking even the smallest details, we eliminated the deep foci that spread to the urinary tract and intestine one by one. Now our patient is extremely healthy, she has recovered, today we have dressed her and removed his stitches.

Dear Simge, after long researches, she found us and came to our clinic from Cyprus There were adenomyotic area, rectovaginal nodule, endometriotic cysts, fibroids and adhesions. We cleaned all of them one by one with the closed surgical method and regained our patient's health.

We cleaned the endometriosis foci and adhesions in our patient's ovaries with closed surgery, freed her tubes and bowel involvement, and finished her surgery by doing a lot of work.

We successfully completed a deep chocolate cyst surgery closed with the laparoscopic method. If you ask my patient, yes, she is extremely well, healthy and of course, I am very happy that he got rid of her endometriosis, which causes all the uterus and ovaries to stick together, with closed surgery, and that we preserved her ovaries. We patiently managed this difficult surgery that we performed with my team, and we restored my patient's health.

My dear patient applied to us with the complaint of chocolate cyst, we performed deep endometriosis surgery with laparoscopy for our patient. Because of these cysts, every area including lymph nodes, appendix and ureters was stuck together.

With laparoscopy, that is, closed surgery technique, called hydrosalpenx; We cleaned the fluid in the tubes, removed the endometriosis cyst in the right ovary, performed a magnificent surgery and preserved the uterus & ovaries of our patient and left them immaculate.

We performed the operation of our patient with the closed surgical technique; We collected all the fibroids that settled in her uterus, we cleaned the endometriosis foci and adhesions in her ovaries, we released her tubes and intestinal involvement, we left a clean uterus and 2 ovaries to our patient.

We performed deep endometriosis surgery with the closed surgical technique. For our patient, preoperatively; Although it was quite difficult due to the stress and pain factor, the aftermath went very well. Together we watched the surgery video, which is the ritual of our clinic, which is the most enjoyable and most interesting part because it makes us very happy to show my patients what we did during their surgery, to let them see what we saved them from, so they say goodbye to us with a reborn feeling, painless, bleeding and relaxed.

With laparoscopic surgery, we opened all adhesions extending to the back of the uterus and intestines, removed the foci of adenomyosis one by one, cleaned all the fibroids that settled in the uterus, freed their ovaries, they were also in a disastrous condition and we had struggled a lot to bring them back to normal. We dressed her stitches, and we bid farewell to our patient, who had regained her health, from our clinic, wishing her luck in 2022.

Our young patient, precious Irmak; She applied to our clinic from Croatia. For about 3 years, she had many tests, various hormone treatments were given to her due to her deep chocolate cyst disease, she applied to many doctors because of his persistent pain, but unfortunately he could not get results, on the contrary, the side effects of these treatments caused her to experience more difficult processes. We performed deep endometriosis surgery on our patient with the closed surgical technique, we eliminated all the problems that cause pain without overlooking even the smallest details, we eliminated the deep foci that spread to the urinary tract and intestine one by one. Our patient is very, very well.

Sometimes more words are not needed! My dear patient wrote down her heart for us.

"Hello I'm Burcu

To briefly describe our path that crossed with my doctor Fatih, our adventure started with a cyst definition two years ago. I applied to many different physicians in Aydın. The pain that did not go away began to affect my daily life. I learned much later that it was endometriosis, not a cyst. A lot of medication, antibiotics and more... Then a doctor said, "You should go to Fatih Şendağ". I had open surgery before, I thought everything was over with the diagnosis of endometriosis, but it had just begun. I came to my doctor Fatih, he explained me in such a positive, comforting and explanatory way that I understood the process in the first examination. I was going to have closed surgery, but my fear was too much due to previous experiences. But I got through this very easily. It's not like I was afraid. My doctor, nurses, everyone was very helpful. I am writing from my control one week after the operation, neither pain nor pain, thankfully, nothing is left. The reason I ran away from the doctors I went to first was fear and pain, it is very important to be able to trust, I trust Fatih Şendağ with my eyes closed and I thank his team and him for everything.

Burcu Korkmaz"

Don't look at her standing so calm next to me, she came to our clinic with an incredible panic last week, when I saw her so stressed and upset, I quickly took an ultrasound and did her examination. During the examination, we noticed chocolate cysts covering the right and left ovaries, deep endometriosis foci covering the rectum and located in the rectovaginal area, and the adhesions caused by these. Of course, all of these impaired our patient's quality of life, caused severe pain and most importantly made my patient feel psychologically helpless. We cleaned all the masses one by one with the laparoscopic method, removed the cysts, freed the ovaries from deep endometriosis foci, opened the adhesions, in short, we accomplished a lot. Ms. Suzan is doing wonderfully well now. Enjoyable, healthy, happy...

It has been only 6 days since our patient Merve performed her surgery. She was with us today, getting rid of the huge chocolate cysts that we removed with the laparoscopic method, we saw her regain her health and morale.

Ms. Nursen left our clinic today feeling extremely healthy, relieved of her pain caused by deep chocolate cysts, her fears are over, the state of panic is gone and she was born again. womb; It was the size of the uterus of a 4-month pregnant patient due to fibroids. Both her ovaries, rectum and uterus were stuck together in a mass. Of course, these had a reflection on the patient. It was causing unbearable pain. All these problems were solved with a single operation, moreover, with the closed technique. We wish our patient healthy, happy and peaceful days.

Our patient, Ayşe, applied to us with a request for a child. I couldn't believe my eyes when I had the first ultrasound examination. Everything that could happen to a uterus and an ovary was present in the image. Many large and small fibroids, chocolate cysts, fluid accumulation in the tubes called hydrosalpenx, adhesions.... We had to start from somewhere and we were ready to do whatever it took without wasting time. First of all, we secured ourselves by accumulating embryos with the in vitro fertilization pooling method (pool technique) due to the low ovarian reserve. Then, with the laparoscopic surgery method, we cleaned the fibroids, cysts, adenomyosis and all adhesions in the uterus and ovaries one by one, down to the smallest detail, and saved the tubes from the fluid in them. Finally, we cleaned the fibroid masses that settled in the uterine cavity with the hysteroscopy procedure we performed before completing the operation, checked the area where we will transfer the baby (endometrium layer) and finished our operation. Of course, we never lost our hope and excitement as we approached the happy ending step by step. Before embryo transfer, we rested the uterus and ovaries for 3 months and applied suppression treatment, and now it's time to reunite our patient with her baby. The positive result after a successful embryo transfer, the happy mother-to-be and the reflection of all this on the face. Yes, the paper held by our patient; First photo of your baby.

We performed the operation of dear Gülistan last week. Again, we successfully completed the surgery of a deep chocolate cyst, which is not easy at all, closed with the laparoscopic method.

If you ask my patient yes, she is extremely well, healthy and of course I am very happy that she got rid of his endometriosis, which causes the sticking of all the uterus and ovaries to each other, with closed surgery, and I am very happy because we protected her ovaries.

M.G

Living with endometriosis was incredibly difficult — only those who experience it can truly understand. Reaching Prof. Dr. Fatih Şendağ was one of the greatest blessings of my life. Before finding him, I had visited so many hospitals and doctors. Medication no longer helped, and my pain had become unbearable. I had reached a point where I couldn’t enjoy life anymore.

It was through my previous doctor’s recommendation that I found Fatih Hoca. The moment I walked through his door, I felt a strong belief that I would get better — and that’s exactly what happened. Everything went beautifully. He told me that this disease could be treated, and I trusted him completely.

Since my case involved deeply infiltrating endometriosis, surgery was my only option. Thankfully, I was able to have a laparoscopic operation that preserved my fertility — just as I had hoped. Having undergone open surgery before, I knew how tough recovery could be, but this time it was surprisingly easy; I recovered within a week.

I now realize that meeting Fatih Hoca was the turning point that ended all my pain. I owe him an enormous thank you.

Aycan Aydoğan

I had been struggling with ovarian cysts for many years and went through a lot of difficulties because of them. Prof. Dr. Fatih Şendağ performed my third surgery, and now I truly feel so much better. I was able to return to my daily life quickly and without any problems.

From the very beginning, he gave me such confidence that I agreed to undergo surgery for the third time without hesitation.

I’m very grateful to him — I’m so glad our paths crossed.

Sevda Kaymaz

My name is Sevda Kaymaz. On June 27, 2023, I underwent surgery for fibroids and cysts. In total, 10 fibroids, a chocolate cyst, and a dermoid cyst were removed. The operation lasted 6.5 hours and was very successful. I stayed in the hospital for just one day. At first, I had some pain, but it soon decreased with medication. The nurses were very attentive, and I had complete trust in Prof. Dr. Fatih Şendağ from the start.

It’s now been a week since my surgery, and by the third day, I was already starting to return to normal life. Tomorrow, I’ll even be able to drive and go back to work. My recovery process has been incredibly fast.

I would like to express my heartfelt thanks to Prof. Dr. Fatih Şendağ, his team, his assistant Selda Hanım, and all the nurses at Kent Hospital.
Wishing all patients reading this a speedy recovery.

Zehra Akbulut

My acquaintance with Prof. Dr. Fatih Şendağ began after my symptoms recurred following my first endometriosis surgery. Although I was confident in his medical expertise, I was quite anxious about having to undergo a second surgery within a year due to the progression of my condition. With his accurate diagnosis and guidance, we planned and completed the surgery within just one week.

If this had been my first operation, I might not have been able to write with such certainty — but I truly did not expect such a comfortable recovery. To give specific examples: even the laparoscopy incisions were smaller, I stopped taking painkillers on the second day, and by the fourth day, I was traveling by car on vacation. I didn’t experience any movement restrictions.

My two biggest fears before surgery were the use of surgical drains and gas pain, but he did not use any drains, and I did not experience shoulder pain from gas either.

I completed this process with gratitude and relief, having lost only four days of my vacation, and I’m filled with joy at being free of the disease and having gone through this journey under the care of such a skilled doctor.

I sincerely hope there will be more professionals as competent and compassionate as him.

Elif Turan Küçükbursa

When I had my routine annual check-up, a large endometriosis was detected, so I started looking for a good doctor. After being examined by three other doctors, I reached Prof. Dr. Fatih Şendağ. From the very first examination, he gave me confidence. He clearly explained how the disease would progress, the alternative options, and the best treatment method for me.

For me, clarity and a definite solution were important. Prof. Dr. Fatih Şendağ truly made me feel confident about this. I had no hesitation about undergoing endometriosis surgery. Both before and after the operation, the process went very smoothly.

I would like to thank Prof. Dr. Fatih Şendağ, always kind and smiling Ms. Selda, and the clinic for their care. :)

Serpil Işık Yıldırım

I am a nurse, and I have been struggling with chocolate cysts (endometriosis) since 2017. I was very afraid of surgery, especially since I had already undergone one operation before and had two C-section deliveries.

Every doctor I visited told me that the adhesions were too severe and that they couldn’t perform the surgery. Then, at Balıkesir City Hospital, my gynecologist Dr. Erol Özdaş recommended Prof. Dr. Fatih Şendağ. After doing my own research, I decided that he was truly the best option — and I chose to have the surgery with him.

I’m so glad I did. The surgery and the recovery process were both excellent.
Many thanks to Dr. Fatih Şendağ for his skill and care.

Nuriye Güldane Aksu

I had been suffering from pelvic pain for over a year. Even though I visited several doctors, I was told that I didn’t have a cyst and that my pain was due to other issues. For at least 20 days each month, I experienced severe pelvic and body pain — until I met the doctor who finally noticed what others had missed.

Through his guidance, I found Prof. Dr. Fatih Şendağ. I spoke with his assistant, Ms. Selda, and soon after, I was given a quick appointment for both consultation and surgery — and that decision changed my life.

I was very pleased with the care and attention shown by Dr. Şendağ and his entire team. The postoperative pain was so minimal compared to what I had been enduring before that within 6 hours, I was able to get up and walk, and one week later, most of my pain was gone.

As someone who enjoys walking for hours, I truly believe that pain-free, better days are ahead of me.

Thank you, Prof. Dr. Fatih Şendağ, and your wonderful team.

Suzan Dikmen

I went to my doctor with severe menstrual pain. I was experiencing intense abdominal pain and tenderness. When I came to Prof. Dr. Fatih Şendağ, I was diagnosed with a chocolate cyst (endometrioma). Before the surgery, I was extremely anxious and afraid — the idea of undergoing surgery terrified me.

However, Dr. Şendağ and Ms. Selda’s warm and sincere approach completely calmed me down. I had the surgery, and I recovered very quickly. I was up and walking the same day, and within three days, I had returned to my normal life.

My pelvic pain, tenderness, and other symptoms were completely gone. It wasn’t scary at all, unlike what I had imagined.

Many thanks to Prof. Dr. Fatih Şendağ and his team for everything.

Pelin Yurtseverler

I first met Prof. Dr. Fatih Şendağ in 2016, and once again, he saved my life. The chocolate cyst I had was completely ruining my quality of life, but through a successful surgery, he helped me regain my health.

I am deeply grateful to him — and to Ms. Gülsem — for everything. You are truly so precious to me. Thanks to you, I recovered; thanks to you, I became a mother.

I hope that other women who are going through similar problems will reach you as soon as possible.

Özlem Demir

Dear Prof. Dr. Fatih Şendağ, We met when you started following up on my long-term treatment. You performed my first surgery 13 years ago. As an endometriosis patient, I met this disease, which I don’t even like to name, when I was 19 years old. Years later, we found you, and I trusted you.

On April 29, 2021, we decided to remove my uterus and ovaries, and I would like to thank you and your entire team. I am very lucky that you were by my side during this difficult process — and throughout all the stages of it.

I would also like to thank Ms. Selda. Now, you are my daughter’s doctor too, and she is as lucky as I am.

Thank you very much for everything.

Irmak Erol

My name is Irmak Erol, and I’m 28 years old. Three years ago, I was diagnosed with endometriosis. Over time, both the discomfort caused by endometriosis and the side effects of the hormone medications I was taking led me to start searching for solutions.

When I learned about the possibility of undergoing laparoscopic surgery performed by Prof. Dr. Fatih Şendağ, I decided to go ahead with the operation. The surgery process was very smooth — I woke up with four small bandages on my abdomen, started walking on the second day, and after one week, my mobility had significantly improved.

Dr. Şendağ informed me that the surgery had been very successful — in addition to removing the known cyst on my left ovary, he had also cleared endometriosis tissue from my urinary tract and previously affected intestinal areas.

Endometriosis had greatly affected my daily life in a negative way, and I truly believe this surgery was a turning point for me.
I’m deeply thankful to Prof. Dr. Fatih Şendağ for giving me my comfort and health back.

Müge Keser Işıkyakar

It’s a wonderful thing to be able to trust someone outside your own family. No one else could have saved me from this illness. I truly believe you have superpowers. Thank you for everything. Here’s to many more years together.

Meryem Dindar

After being diagnosed with endometriosis, I found Prof. Dr. Fatih Şendağ through my own doctor’s recommendation. When I looked into his background, I saw his successful surgeries and strong academic career.

Without even feeling the need to look for another doctor, I underwent surgery with complete trust, and I am extremely satisfied with my treatment.

I feel truly lucky to have found him.

Merve Barbar

I am Merve Barbar. After a long and exhausting journey, my path finally crossed with Prof. Dr. Fatih Şendağ. I went into the surgery with great fear, yet just one week afterward, I can feel how healing has spread throughout my entire body — my recovery has been remarkably fast.

Words can’t fully express it, but deep inside, there’s an overwhelming sense of “I’m so glad” that I chose this path. Women suffering from deep endometriosis can undoubtedly trust Prof. Dr. Fatih Şendağ.

With his countless experiences, he gave me hope, joy, morale, motivation, and most importantly, healing at every step.
My endless thanks to Prof. Dr. Fatih Şendağ and his dedicated team.

Gülistan Baytar

I came to Dr. Fatih Şendağ as a patient who had been diagnosed with chocolate cysts (endometriosis) three years ago and had been suffering from pain every month. During my very first examination, he noticed things that had been missed in previous ultrasounds, despite me having had many done before. His attention to detail, expertise, and passion for his work immediately increased my confidence. I felt truly lucky to be there that day.

All the necessary tests were conducted before the surgery, and we went through the entire operation process quickly and safely. Throughout this journey, Dr. Şendağ and his team were always by my side, providing constant support.

I am deeply grateful to Dr. Fatih Şendağ and his entire team for giving me the chance to live without pain and helping me look toward the future with hope.

I’m so glad I met you.
So glad I’m here.

Ekin Bezirganoğlu

Words aren’t enough to express my gratitude — so glad you exist!
With love, your singer who truly appreciates you…

Ebru Savut

I had heard many great reviews about Dr. Fatih Şendağ, which is why I decided to consult him. After listening to his detailed explanation, I was convinced to undergo laparoscopic uterine surgery, and within just a week, I had my operation.

My recovery process was smooth and fast, and Ms. Selda followed up with me closely throughout the entire journey, showing great care and attention. I am deeply grateful to my dear doctor Prof. Dr. Fatih Şendağ, as well as to the entire surgical team and Ms. Selda for their dedication.

This is a highly specialized procedure that requires exceptional precision, detail, and skill, and I truly couldn’t have entrusted it to anyone else. Dr. Şendağ even showed me the video recording of my surgery, and I was truly impressed.

I entered the operation room anxious and uncertain, but after the surgery, I felt as though I had been reborn.
With all my heart, I am deeply thankful to Dr. Fatih Şendağ.

Ebru Kurt

Hello, I’m E.K. A few months ago, during a routine check-up, I learned that there was a large mass in my uterus. Naturally, I was anxious and scared. I needed surgery and wanted to make sure I chose the best possible doctor. As a healthcare professional, I had many doctor friends who could perform this surgery, but somehow I couldn’t feel fully confident — something was always missing.

After extensive research, I came across Dr. Fatih Şendağ. I immediately traveled to İzmir for a consultation. What had once been a frightening and life-altering diagnosis suddenly became manageable thanks to Dr. Şendağ’s confidence and clear explanations. At that moment, I decided that I would have the surgery as soon as possible — and that Dr. Fatih Şendağ would be my surgeon.

Dr. Şendağ and his assistant, Ms. Selda, are incredibly skilled professionals. Ms. Selda was exceptionally kind and patient; she answered all my questions so thoroughly that I felt as if I had known her for years — like a close friend who truly wanted the best for me.

To anyone experiencing similar issues, my advice is simple: you don’t need to look any further. The very best in this field are Dr. Fatih Şendağ and his nurse, Ms. Selda.

Thank you for everything — I’m so grateful that our paths crossed.
With love,
Ebru

Demet Dadalı

I’m Demet, 42 years old. I had a chocolate cyst (endometrioma) that had been diagnosed 10 years ago. I visited many doctors in Malatya, Adıyaman, Hatay, and Diyarbakır, but all of them told me that they couldn’t perform the surgery. As my pain worsened, my doctor Uğur Değer at Diyarbakır Medical Park Hospital said that only Dr. Fatih Şendağ could perform this operation and referred me here.

I had previously undergone one IVF and one insemination attempt, and my fallopian tubes were removed by surgery two years ago. In March of this year, Dr. Fatih Şendağ performed my surgery. It was a very challenging operation — the cysts were attached to my intestines, bladder, and almost the entire abdominal cavity. The surgery lasted five hours, and it was a complete success.

I have now come for my follow-up appointment and had the chance to watch my surgery together with Dr. Şendağ. I truly believe it was a highly professional and skillful operation.

To all women who have chocolate cysts and are struggling with infertility, I sincerely recommend that you reach out to Dr. Fatih Şendağ without losing time.

Damla Özdoğan

In 2021, I was diagnosed with a 6 cm endometrioma. At just 24 years old, I didn’t want to undergo ovarian surgery. After a full year of searching for the right doctor, a friend of mine from Hatay told me about a highly skilled doctor in İzmir — Prof. Dr. Fatih Şendağ. She said, “He’s unmatched in laparoscopy and experience.”

A year later, with my cyst having grown to 8 cm, I decided to trust Dr. Fatih Şendağ. He was the doctor who informed me the most, listened to my concerns, and earned my full trust. After the surgery, the 8 cm endometrioma in my left ovary was completely gone, and my ovaries were preserved and healthy. I was finally free from the cyst and the pain it caused — and I still had my ovaries intact.

From now on, Prof. Dr. Fatih Şendağ is the only gynecologist I will ever go to, and I recommend him wholeheartedly to everyone. He is so humble that he even personally checked my dressings after surgery.

I would like to sincerely thank both Ms. Selda and Prof. Dr. Fatih Şendağ for their dedication, kindness, and patience.
I hope to meet them again soon with good and happy news.

Buket Özbaş

Dear Doctor,

May your healing hands — the ones that helped me overcome an anxious period with ease and restored my health through your incredible knowledge and skill — bring wellness to many others for a lifetime.

And my dear Ms. Selda, thank you so much for your care and attention throughout the entire process.

With heartfelt gratitude,
Wishing you many healthy days ahead…

Bilge Sevtekin

Dear Doctor,

After the age of 40, I learned about a condition called endometriosis — and the moment I did, I was overcome with panic, fear, depression, and countless questions.

Being a naturally meticulous person, I ended up visiting ten different doctors, only to realize that many of them knew less about the condition than I did.

I’m truly grateful for my cautious nature, because it eventually led me to Prof. Dr. Fatih Şendağ. Thank you, dear doctor, for patiently listening to my two-page-long notes and questions about my illness and for answering each one with care and clarity.

But above all, my deepest gratitude is for my surgery — it was truly life-changing.

Thank you for everything.
I’m so glad you exist.
May your hands never know hardship.

With love and gratitude…

Ayşen Uygur

My name is Ayşen Uygur, I am 25 years old.

Around mid-September, I suddenly started experiencing groin pain. The pain was so severe that I took painkillers every time it began, but after realizing it didn’t go away for days, I decided to see a doctor. After consultations and examinations with two different doctors, I was told that it would heal with medication, but my pain did not decrease at all.

After three difficult months, I met Prof. Dr. Fatih Şendağ, and I’m so glad I did. I was examined by him, and with his valuable insights and extensive experience, he informed me about the surgery. On December 21, my laparoscopic (minimally invasive) surgery was performed at a private hospital.

It’s been exactly a week since my surgery, and I came to the clinic with a smile on my face. As always, Ms. Selda greeted me cheerfully. I wanted to share this process briefly because I cannot thank Dr. Fatih Şendağ and his team enough.

Although I had surgery, after three painful months, thanks to Dr. Fatih Şendağ, I returned to my comfortable and happy life before the pain.

Many thanks to the whole team.

Burcu Korkmaz

Hello, I’m Burcu.
To briefly summarize how my path crossed with Prof. Dr. Fatih Şendağ — it all began two years ago with a cyst diagnosis. I visited many different doctors in Aydın, but my persistent pain gradually started to affect my daily life. I later learned that what I had wasn’t just a cyst, but endometriosis. After countless medications, antibiotics, and treatments, one doctor finally told me, “You should see Fatih Şendağ.”

I had previously undergone open surgery and thought everything was over with the diagnosis of endometriosis — but in fact, it was just the beginning. When I met Dr. Şendağ, he explained everything so clearly, positively, and reassuringly during my first examination that I immediately understood the process.

He recommended a laparoscopic (minimally invasive) surgery, but due to my previous experiences, I was very afraid. However, the whole process went far better than I imagined — it wasn’t scary at all. My doctor, the nurses, and the entire team were incredibly supportive and caring.

I’m writing this just one week after my surgery, and thankfully, I have no pain or discomfort at all. Previously, fear and pain kept me away from doctors — but now I’ve learned that trust is what matters most.

I trust Prof. Dr. Fatih Şendağ with my eyes closed, and I’m endlessly thankful to him and his amazing team for everything.

What is Endometriosis?

The membrane layer lining the inside of the uterus is called the endometrium. Endometriosis is defined as the placement of the endometrium, which is found in the inner layer of the uterus and sheds out in the form of menstruation every month, in a place outside the uterus in the body.

Where in the body can endometriosis appear?

Endometrial tissue outside the uterus reacts to monthly changes in hormones, as does endometrial tissue inside the uterus. It causes shedding and bleeding. This bleeding can cause pain, especially during the menstrual period. The shedding and bleeding of this tissue every month can cause scar tissue called adhesions. Sometimes adhesions can bind organs together. Adhesions can also cause pain. If blood is stuck in the ovary due to adhesion, it can form an endometrioma. (chocolate cyst)

The cause of endometriosis is unknown. One theory is that during the menstrual period, blood flows backwards, transporting the tissue inside the uterus to the fallopian tubes. Later, this tissue comes out of the tubes and settles elsewhere. According to another theory; endometrial tissues are transported through blood and lymph vessels.

In the United States, 7% of women of childbearing age have endometriosis. It is a very common condition in women aged 30-40, but it can be encountered in any period in any woman who has a menstrual period. Endometriosis is more common in women who have never given birth. It is more common in women whose mother, sister or daughter has endometriosis.

Endometriosis symptoms worsen over time. It develops in more than half of untreated women and in 20% of treated women.

Symptoms of Endometriosis

The most prominent of the symptoms of endometriosis is pelvic pain. This type of pain can also occur during sexual intercourse, bowel movements or urination, or before menstruation. Endometriosis can also lead to spotting or infertility.

While these symptoms may be indicative of endometriosis, they may also be indicative of other diseases. If you have any of these symptoms, consult your doctor as soon as possible.

The amount of pain does not tell you the severity of your condition. For example, women with little pain are in serious condition; The condition of women with a lot of pain may be mild.

Some women with endometriosis may have no symptoms at all. There are also women who find out that they have endometriosis even when they go to the doctor because they cannot get pregnant. One third of women with infertility problems have endometriosis.

Endometriosis symptoms ease during pregnancy. In fact, most products used to alleviate endometriosis are based on the hormonal effects of pregnancy. Among the main symptoms of endomeriosis, we can count the following items;

Diagnosing Endometriosis

For the diagnosis of endometriosis, your doctor checks the abnormalities in your body and asks about your complaints, thus suspecting endometriosis. In order to make the correct diagnosis, advanced examinations are required. These examinations;

INFORMATION FORM

Endometriosis (Chocolate Cyst) Treatment

Treatment of endometriosis depends on your symptoms and whether you want to have children. It can be treated with medication, surgery, or both. There is no permanent treatment for endometriosis due to individual differences and the 2-year recurrence rate of endometriosis is around 20%. The aim of drug and surgical treatments is to relieve severe pain, increase life comfort and infertility treatment, if any.

 

Hormone therapy can be used to reduce pain. Hormones can help slow the growth of endometrial tissue. Among the most used hormone treatments; birth control pills, gonadotropin-releasing hormone (GnRH) agonists, progestin and danazol. However, many women cannot get rid of their pain with medication; because drugs do not remove adhesions or scar tissue that cause pain.

Medication is not suitable for every woman. Many drugs also have some side effects related to hormone therapy. Still, some women prefer pain relief to the side effects of medications.

Birth Control Pills:
Birth control pills are often prescribed for the symptoms of endometriosis. The hormone present in these pills regulates the regularity of the menstrual cycle; It provides painless and short time. There is no evidence that birth control pills shrink endometriosis or increase fertility.

GnRH Agonists:
GnRH is a hormone that helps keep the menstrual cycle under control. GnRH agonists are drugs that are similar in nature to human GnRH but are often stronger than natural ingredients. GnRH agonists deactivate the ovaries, lowering estrogen levels. This procedure creates a temporary process similar to menopause.

GnRH agonists can be given by needle, by an implant, or by nasal spray. Usually, the endometriosis patches shrink and the pain is relieved. GnRH also helps relieve pain during sexual intercourse. Women using GnRH may experience hot flashes, headaches and vaginal dryness.

Treatment with GnRH usually takes around 6 months. You will start menstruating again 6 to 10 weeks after you stop using GnRH. Endometriosis symptoms may recur in half of women who have used GnRH, especially if their symptoms are severe.

Progestin:
The hormone progestin is also used to shrink patches of endometriosis. Progestin fights the effects of estrogen on tissue. Menstruation does not occur while using progestin. Progestin can be taken in the form of injections or pills.

Danazol:
Danazol is a synthetic hormone that shrinks endometrial tissue. It is taken in pill form and prevents you from menstruating.

Danazol works very well in reducing pelvic pain and pain during sexual intercourse. Endometriosis symptoms usually return within 6 weeks after you stop taking the medication. Side effects of danazol include weight gain, acne, voice changes and hair growth.

Danazol treatment is not suitable for everyone. Women with liver, kidney and heart problems cannot use danazol.

Endometriosis surgery is recommended for patients with a diagnosis of infertility, those with bilateral chocolate cysts, adolescents, patients with low ovarian reserve, and patients who have had previous recurrent operations. Endometriosis is a disease that seriously reduces the patient's comfort of life. If the pain is very intense and affects his daily life, surgical treatment and drug treatment may be recommended together. Surgery is the most effective treatment in terms of reducing pain and increasing life comfort.

Surgery can be done to remove Endometriosis and surrounding scar tissue. Healthy ovaries and normal fallopian tubes are left inside to increase the chances of a possible pregnancy.

The operation is successful in terms of both pain relief and infertility treatment, but the symptoms may return over time. Many patients are treated with both surgery and medication to prevent recurrence of the disease. One third of women who have had an operation may need another operation within 5 years. If the patient's pain is very severe and does not go away, if he does not want to have children, the doctor may recommend removal of the uterus, tubes and ovaries. After this operation, the patient does not menstruate again and cannot become pregnant.

Endometriosis Surgery can be performed openly by lapatomy, or it can be performed laparoscopically with a closed method. However, with the developing technology and treatments, Robotic Surgery is the gold standard in Endometriosis surgery.

Do not damage the ovarian reserve: Endometriosis surgery is often applied for the treatment of infertility. The surgeon's experience is very important in endometriosis surgery. In endometriosis surgery, the ovarian tissue outside the cyst wall should not be damaged. One of the most important reasons why robotic surgery is the gold standard in endometriosis surgery is that it causes minimal damage to the surrounding tissue due to small incisions, 3-dimensional vision and the ability of the arms to move like a human wrist inside. If the ovarian tissue is damaged, the eggs found here may be damaged and the patient may face early menopause and infertility problems in the future. Avoiding damage to the ovaries, tubes and uterine tissue is the most important point in chocolate cyst surgery.

Opening adhesions: Chocolate cyst is not as sweet as its name, but unfortunately it is sticky like chocolate. Pain is related to intense adhesions. The opening and correction of these adhesions during surgery is of great importance for pregnancy treatment and reduction of pain.

Removal of deeply located endometriosis nodules:  Endometriosis does not occur only in the uterus. Deep endometriosis is a condition that spreads between the vagina and the rectum to the uterine ligaments, intestines, urethra, or deep into the abdomen. In this condition, which is defined as Deep Infiltrative Endometriosis, it is a surgery that requires a multidisciplinary approach, not only in gynecological diseases but also in general surgery urology units.

The experience of the doctor is of great importance in the surgery of “deep infiltrative endometriosis”. During the surgery, it is necessary to free the area between the uterus and the intestine and the ureter. In the treatment of deep endometriosis that causes severe inguinal abdominal pain, removal of chocolate cyst and ovarian cysts will not be sufficient, but deep infiltative endometriosis nodules should also be removed. It is very important not to damage the surrounding tissue, nerves and organs in deep endometriosis surgery. Therefore, deep endometriosis surgery should be performed by experienced doctors. Robotic surgery as a surgical treatment minimizes the risk. However, the same treatment can be applied by performing laparoscopic surgery with an experienced doctor.

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Chocolate Cyst (Endometriosis)