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Endometriose

Atiologie, Diagnostik, Therapie

Endometriosis

Etiology, diagnostics, treatment

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Gynäkologische Endokrinologie Aims and scope

Zusammenfassung

Die Endometriose zählt zu den häufigsten gutartigen Erkrankungen der geschlechtsreifen Frau. Trotz des charakteristischen Symptoms der Dysmenorrhö – häufig in Kombination mit Begleitsymptomen wie chronischen Unterbauchschmerzen, Dyschezie, Dysurie und Dyspareunie – dauert es immer noch zu lange, bis die Diagnose gestellt wird. Einfache Methoden der rektovaginalen Untersuchung sind hinweisend. Die Laparoskopie sollte zur Diagnosesicherung frühzeitig angestrebt werden. Eine postoperative Rezidivprophylaxe kann – bei fehlendem Kinderwunsch – sinnvoll sein. In der Rezidivsituation gilt es, individuell und im Konsens mit der Patientin das optimale Behandlungskonzept zu finden. Neben Rezidivoperationen kommen medikamentöse Maßnahmen zum Einsatz: neben Schmerzmedikamenten Gestagene, orale Kontrazeptiva im Langzyklus sowie Gonadotropin-releasing-Hormon(GnRH)-Analoga.

Abstract

Endometriosis is one of the most common benign diseases of the mature woman. In spite of characteristic symptoms like dysmenorrhea—often in combination with accompanying symptoms such as chronic pelvic pain, dyschezia, dysuria and dyspareunia—it still takes too long for the correct diagnosis to be made. Simple methods like rectovaginal exam are indicative. Laparoscopy to confirm the diagnosis should be sought at an early stage. Postoperative recurrence prevention can—if there is no desire for children—make sense. In recurrent endometriosis, therapy must be individually made in consensus with the patient to find the optimal treatment plan. Besides recurrence operations, pharmacological treatment is often used. In addition to pain medications, progestins, oral contraceptives in long-cycle and gonadotropin-releasing hormone (GnRH) analogues are used.

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Authors and Affiliations

  1. Universitätsfrauenklinik und Endometriosezentrum (Stufe III), Universitätsklinikum Erlangen, Universitätsstr. 21–23, 91054, Erlangen, Deutschland

    S.P. Renner MBA, S. Burghaus & J. Hackl

  2. Zentrum für Minimal Invasive Gynäkologie, Endometriose und Reproduktionsmedizin Baden-Baden – Rastatt, Rastatt, Deutschland

    P.G. Hartmann, M.A. Knoll & W. Küpker

Authors
  1. S.P. Renner MBA
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  2. S. Burghaus
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  3. J. Hackl
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  4. P.G. Hartmann
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  5. M.A. Knoll
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  6. W. Küpker
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Correspondence to S.P. Renner MBA.

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Renner, S., Burghaus, S., Hackl, J. et al. Endometriose. Gynäkologische Endokrinologie 11, 115–128 (2013). https://doi.org/10.1007/s10304-013-0556-4

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  • DOI: https://doi.org/10.1007/s10304-013-0556-4

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