Endometriose – mehr als „nur“ Dysmenorrhö!

In: Die Gynäkologie · 2023 · vol. 56(7) , pp. 445–453 · doi:10.1007/s00129-023-05101-0 · W4379513915
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Endometriosis, a frequent benign condition in reproductive-aged women, causes pain and sterility, often affecting adolescents with significant suffering, and requires thorough history and examination for diagnosis and treatment planning.

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The paper is a narrative discussion of endometriosis as a common benign disease in women of reproductive age, addressing its clinical presentation across specialties, with emphasis on pain and infertility and the frequent under-recognition of adolescent cases. It reviews the diagnostic pathway at a high level, stating that targeted history taking and thorough examination allow estimation of the extent and lesion location, forming the basis for individualized, sustainable treatment planning. A key limitation is that it does not present original research data, instead focusing on clinical overview and implications, as reflected by its role as a practice-oriented article. This paper is centrally about endometriosis — it emphasizes that endometriosis is more than “just” dysmenorrhea, including underdiagnosed adolescent presentations and the need for careful assessment.

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Zusammenfassung Das Krankheitsbild der Endometriose zählt zu den häufigsten benignen Erkrankungen der Frau in der reproduktiven Phase und konfrontiert im Arbeitsalltag nahezu alle gynäkologischen Praxen und Kliniken in unterschiedlicher Häufigkeit und Intensität. Aber auch die benachbarten Fachdisziplinen haben regelmäßig direkten oder indirekten Kontakt mit Krankheitsformationen der Endometriose oder ihren Folgen. Die Erkrankung ist geprägt durch Schmerzsymptome und Sterilität. Der Tatsache, dass Endometriose auch Adoleszente betrifft, wird häufig zu wenig Beachtung geschenkt. Doch auch in diesem Alter ist die Erkrankung oftmals mit hohem Leidensdruck verbunden. Bis eine adäquate Diagnostik und Therapie erfolgt, vergehen oft viele Jahre. Die gezielte Anamnese und gründliche Untersuchung ermöglichen eine Einschätzung bezüglich des Ausmaßes und der Lokalisation der Endometrioseläsionen und bilden die Basis für eine individuelle, nachhaltige Therapieplanung. Abstract Endometriosis is one of the most frequent benign diseases in women of reproductive age. In the clinical routine, nearly all practicing gynecologists and gynecological clinics are confronted with this condition at diverse rates and in various degrees of severity. In addition to gynecology, neighboring medical specialties also have to regularly deal, either directly or indirectly, with various forms of endometriosis and its sequelae. The disease is marked by pain and sterility. Too little attention is frequently paid to the fact that endometriosis also affects adolescents; nevertheless, even in patients of this age group it is associated with a significant level of suffering. Many years can elapse before the disease is diagnosed and appropriately treated. A targeted taking of the medical history and thorough examination enable an accurate assessment with respect to the extent and location of endometriosis lesions and constitute the basis of an individualized sustainable treatment planning. Similar content being viewed by others Literatur ACOG Committee Opinion No. 760 (2018) Dysmenorrhea and endometriosis in the adolescent. Obstet Gynecol 132(6):e249–e258. https://doi.org/10.1097/AOG.0000000000002978 Alkatout I, Wedel T, Pape J, Possover M, Dhanawat J (2021) Review: pelvic nerves—from anatomy and physiology to clinical applications. Transl Neurosci 12(1):362–378. https://doi.org/10.1515/tnsci-2020-0184 Alkatout I, Wedel T, Maass N (2018) Kombinierte Therapie der Endometriose: Radikal und schonend zugleich [Combined treatment of endometriosis: radical yet gentle]. Aktuelle Urol 49(1):60–72 Ballard K, Seaman HE, de Vries CS et al (2008) Can symptomatology help in the diagnosis of endometriosis? 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Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien. Additional information Redaktion Barbara Schmalfeldt, Hamburg Nicolai Maass, Kiel QR-Code scannen & Beitrag online lesen Rights and permissions About this article Cite this article Willer, D., Peters, G., Tesch, K. et al. Endometriose – mehr als „nur“ Dysmenorrhö!. Gynäkologie 56, 445–453 (2023). https://doi.org/10.1007/s00129-023-05101-0 Accepted: Published: Version of record: Issue date: DOI: https://doi.org/10.1007/s00129-023-05101-0

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