Endometriose

T. Pottek
In: Facharztwissen Urologie · 2014 · pp. 517–519 · doi:10.1007/978-3-662-45739-9_49 · W4240301636
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Endometriosis outside the uterus, often affecting the bladder in 10-20% of women, can cause cyclical symptoms or none, and is treated with hormonal therapy and reconstructive surgery.

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The chapter explains endometriosis as the presence of endometrial epithelium outside the uterus and describes how urogenital involvement affects symptoms in women of reproductive age, noting that 10–20% are affected (most often the bladder), with many remaining asymptomatic. It outlines cycle-dependent urinary symptoms such as macrohematuria and ureteral or renal colic depending on lesion location, while also describing possible non–cycle-dependent urinary retention, pollakisuria, and pelvic pain, and emphasizes that “typical” dysmenorrhea is not required. It summarizes diagnostic evaluation using imaging and histology, with the caveat that lesions can be destroyed during diagnosis, and then describes a treatment sequence beginning with hormonal therapy (gestagens, danazol, or LHRH analogs) followed by possible reconstructive procedures. This paper is centrally about endometriosis — it specifically focuses on urogenital complications and diagnostic and treatment approaches for urinary tract involvement.

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Zusammenfassung Als Endometriose wird das Vorhandensein von Endometriumepithel außerhalb des Uterus bezeichnet, was zyklusabhängige Beschwerden verursacht. Eine urogenitale Endometriose weisen 10–20% der gebärfähigen Frauen auf, wobei meist die Blase betroffen ist. Bei vielen dieser Frauen jedoch treten keine Symptome auf. Zyklusabhängig kommt es bei Beschwerden je nach Lokalisation der Endometriose zu Makrohämaturie, Harnleiter-/Nierenkolik; „typische“ Symptome, wie Dysmenorrhö, sind nicht obligat. Unabhängig vom Zyklus können Harnstauung, Pollakisurie, Beckenschmerzen usw. auftreten. Nach bildgebender und histologischer Diagnostik, während der zugleich die Herde destruiert werden können, erfolgt zunächst eine hormonelle Therapie mit Gestagenen, Danazol oder LHRH-Analoga, später dann ggf. die Rekonstruktion betroffener Organe. Access this chapter Tax calculation will be finalised at checkout Purchases are for personal use only Similar content being viewed by others Literatur Balasch J, Creus M, Fábregues F, Carmona F, Ordi J, Martinez-Roman S, Vanrell JA (1996) Visible and non-visible endometriosis at laparoscopy infertile and infertile women and in patients with chronic pelvic pain: a prospective study. Hum Reprod 11: 387–391 Carl PE (2003) Urologische Komplikationen der Endometriose. Urologe A 42(2): 255–62 Kuntz RM, Eichenauer R, Grosse G (1992) Diagnostik und Therapie der Endometriose des Ureters. Akt Urol 23: 186–192 Nezhat CR, Nezhat FR, Green B (1992) Laparoscopic treatment of obstructed ureter due to endometriosis by resection and ureteroureterostomy: a case report. J Urol 148: 865–868 Pinkert TC, Catlow CE, Straus R (1979) Endometriosis of urinary bladder in a man with prostatic carcinoma. Cancer 43: 1562 Shook TE, Nyberg LM (1988) Endometriosis of the urinary tract. Urology 31: 1–6 Umaria N, Olliff JF (2000) MRI appearances of bladder endometriosis. Br J Radiol 73: 733–736 Westney OL, Amundsen CL, Mc Guire EJ (2000) Bladder endometriosis: Conservative management. J Urol 163: 1814–1817 Yates-Bell AJ, Molland EA, Pryor JP (1972) Endometriosis of the ureter. Br J Urol 44: 58–67 Author information Authors and Affiliations Editor information Editors and Affiliations Rights and permissions Copyright information © 2014 Springer-Verlag Berlin Heidelberg About this chapter Cite this chapter Pottek, T. (2014). Endometriose. In: Schmelz, HU., Sparwasser, C., Weidner, W. (eds) Facharztwissen Urologie. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-44942-0_49 Download citation DOI: https://doi.org/10.1007/978-3-642-44942-0_49 Published: Publisher Name: Springer, Berlin, Heidelberg Print ISBN: 978-3-642-44941-3 Online ISBN: 978-3-642-44942-0 eBook Packages: Medicine (German Language)

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