[Retroperitoneal endometriosis : When a rare form of endometriosis becomes a urological disease].

und Methoden Vergleich aktueller Therapieempfehlungen entsprechend der Leitlinien unter Berücksichtigung einzelner Studien und Grundlagenarbeiten; Auswertung von Arbeiten und deren Interpretation mit dem Hintergrund, eine Hinführung zu dem Thema mit einer Therapieempfehlung zu erstellen. Ergebnisse Die retroperitoneale Endometriose als benigne Erkrankung betrifft aus urologischer Perspektive einen Befall der Harnleiter und der Harnblase. Führt ein Befall der Harnleiter zu einer Hydronephrose, besteht eine absolute Therapieindikation. Auch eine rezidivierende Makrohämaturie bei Befall der Harnblase kann eine Behandlung erforderlich machen. Dieses beinhaltet ist in erster Linie eine operative Entfernung der Endometrioseherde. Verschiedene operative Verfahren und Zugangswege stehen hierfür zur Verfügung, wenn möglich minimal-invasiv. Eine medikamentöse Therapie ist sekundär ebenfalls möglich. Schlussfolgerung Die operative Entfernung eines klinisch relevanten Endometrioseherds ist der Goldstandard in der Therapie. Die Behandlung sollte an spezialisierten Zentren im interdisziplinären Konsens erfolgen. Da es sich um eine primär benigne Erkrankung handelt, ist eine Aufklärung der Patientin über Nutzen und Risiken der Therapie streng erforderlich. Ein individuelles Therapiekonzept unter Berücksichtigung von Faktoren wie dem Leidensdruck und der spezifischen klinischen Relevanz ist in enger Rücksprache mit der Betroffenen zu entwickeln.

Background Retroperitoneal endometriosis is a common benign disease, which requires an interdisciplinary approach. In the clinical practice diagnosis is often delayed for years after onset of the unspecific symptoms so that increased awareness is necessary for detection of the presence of the disease.

This article provides a description of the disease including the symptoms and pathogenesis, an introduction to the complexity of diagnostic investigations and the current therapy recommendations.

Comparison of current therapy recommendations according to the guidelines under consideration of individual studies and background research. Assessment of studies and the accompanying interpretations with the intention of presenting an introduction to the topic with therapy recommendations.

From a urological point of view retroperitoneal endometriosis is a benign disease affecting the ureters and urinary bladder. Involvement of the ureters leading to hydronephrosis caused by ureteral compression represents an absolute indication for therapy. Recurrent macrohematuria can also necessitate treatment. Treatment includes surgical excision of the focal point of endometriosis as the first line therapy. Various operative procedures and access routes are available but when possible a minimally invasive procedure should be used. A second line drug therapy is also possible.

Surgical excision of a clinically significant focus of endometriosis is the gold standard for therapy. This procedure should take place in a specialized center within an interdisciplinary consensus. Due to the fact that endometriosis is primarily a benign disease, medical clarification for the patient concerning the benefits and risks of therapy is absolutely necessary. An individual therapy concept under consideration of factors, such as the specific clinical relevance and psychological stress is recommended and in close cooperation with the patient. Similar content being viewed by others Literatur Bassi MA, Podgaec S, Dias JA Jr (2011) Quality of life after segmental resection of the rectosigmoid by laparoscopy in patients with deep infiltrating endometriosis with bowel involvement. 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Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren. Rights and permissions About this article Cite this article Waegner, R.H., Schmid, M., Trojan, L. et al. Retroperitoneale Endometriose. Urologe 55, 756–762 (2016). https://doi.org/10.1007/s00120-016-0119-0 Published: Issue date: DOI: https://doi.org/10.1007/s00120-016-0119-0 Schlüsselwörter - Endometriose, retroperitoneal - Endometriose, periureteral - ENZIAN-Klassifikation - Hydronephrose - Makrohämaturie