Fertilitätserhaltende Operationen bei Uterus myomatosus und Endometriose

und Methode Mithilfe einer Pubmed-Suche wurde die aktuelle Literatur auf Relevanz geprüft, ebenso wurden die einschlägigen Leitlinien der Fachgesellschaften konsultiert. Ergebnisse Die Laparoskopie konnte die Therapie dieser Erkrankungen sowohl in Hinsicht auf die Symptomkontrolle als auch auf die Fertilität weiter verbessern. Schlussfolgerung Durch die flächendeckende Einführung laparoskopischer Behandlungsansätze in der Myom- und Endometriosetherapie kann einer Vielzahl von Patientinnen, die einen oft langen Leidensweg hinter sich haben, nicht nur effizient, sondern auch schonend und nicht zuletzt mit dem optimalen kosmetischen Ergebnis geholfen werden.

Background Uterine leiomyoma and endometriosis are among the most common benign diseases in gynecological practice. Both are currently subject to laparoscopic treatment. Aim The aim of this article was to summarize the current importance of fertility-preserving and minimally invasive surgery for treatment of uterine leiomyoma and endometriosis and to assess the evidence for laparoscopic treatment.

A search of the current literature was carried out in PubMed and the articles were examined for relevance. Furthermore, guidelines of medical societies were taken into account.

Laparoscopic approaches can further improve the therapy of these diseases in terms of symptom relief and also in terms of fertility.

The comprehensive implementation of laparoscopic procedures for the treatment of uterine leiomyoma and endometriosis means that many patients who have often endured a great deal of suffering can now be helped not only efficiently but also protectively and last but not least with an optimal cosmetic result. Similar content being viewed by others Literatur Baird DD, Dunson DB, Hill MC et al (2003) High cumulative incidence of uterine leiomyoma in black and white women: ultrasound evidence. Am J Obstet Gynecol 188:100–107 Cramer SF, Patel A (1990) The frequency of uterine leiomyomas. Am J Clin Pathol 94:435–438 Benecke C, Kruger TF, Siebert TI et al (2005) Effect of fibroids on fertility in patients undergoing assisted reproduction. A structured literature review. Gynecol Obstet Invest 59:225–230 Buttram VC, Reiter RC (1981) Uterine leiomyomata: etiology, symptomatology, and management. Fertil Steril 36:433–445 Somigliana E, Vercellini P, Daguati R et al (2007) Fibroids and female reproduction: a critical analysis of the evidence. Hum Reprod Update 13:465–476 Eldar-Geva T, Meagher S, Healy DL et al (1998) Effect of intramural, subserosal, and submucosal uterine fibroids on the outcome of assisted reproductive technology treatment. Fertil Steril 70:687–691 Bulletti C, De Ziegler D, Polli V, Flamigni C (1999) The role of leiomyomas in infertility. J Am Assoc Gynecol Laparosc 6:441–445 Sizzi O, Rossetti A, Malzoni M et al (2007) Italian multicenter study on complications of laparoscopic myomectomy. J Minim Invasive Gynecol 14:453–462 Metwally M, Cheong V, Horne A (2012) Surgical treatment of fibroids for subfertility. Cochrane Database Syst Rev 11:CD003857 Seracchioli R, Rossi S, Govoni F et al (2000) Fertility and obstetric outcome after laparoscopic myomectomy of large myomata: a randomized comparison with abdominal myomectomy. Hum Reprod 15:2663–2668 Mais V, Ajossa S, Guerriero S et al (1996) Laparoscopic versus abdominal myomectomy: a prospective, randomized trial to evaluate benefits in early outcome. Am J Obstet Gynecol 174:654–658 Lethaby A, Vollenhoven B, Sowter M (2001) Pre-operative GnRH analogue therapy before hysterectomy or myomectomy for uterine fibroids (Review). Cochrane Database Syst Rev 2:CD000547 Dubuisson J.-B (2001) Laparoscopic myomectomy: predicting the risk of conversion to an open procedure. Hum Reprod 16:1726–1731 Rossetti A (2001) Long-term results of laparoscopic myomectomy: recurrence rate in comparison with abdominal myomectomy. Hum Reprod 16:770–774 Nahum G, Pham K (2010) Uterine rupture in pregnancy. http://emedicine.medscape.com/article/275854-overview. Zugegriffen 19 Jan. 2014 Parker WH, Einarsson J, Istre O, Dubuisson J.-B (2010) Risk factors for uterine rupture after laparoscopic myomectomy. J Minim Invasive Gynecol 17:551–554 Pistofidis G, Makrakis E, Balinakos P et al (2012) Report of 7 uterine rupture cases after laparoscopic myomectomy: update of the literature. J Minim Invasive Gynecol 19:762–767 Landon MB, Lynch CD (2011) Optimal timing and mode of delivery after cesarean with previous classical incision or myomectomy: a review of the data. Semin Perinatol 35:257–261 Verkauf BS (1992) Myomectomy for fertility enhancement and preservation. Fertil Steril 58:1–15 Parker WH, Fu YS, Berek JS (1994) Uterine sarcoma in patients operated on for presumed leiomyoma and rapidly growing leiomyoma. Obstet Gynecol 83:414–418 Nnoaham KE, Hummelshoj L, Webster P et al (2011) Impact of endometriosis on quality of life and work productivity: a multicenter study across ten countries. Fertil Steril 96:366–373.e8 Vercellini P, Fedele L, Aimi G et al (2007) Association between endometriosis stage, lesion type, patient characteristics and severity of pelvic pain symptoms: a multivariate analysis of over 1000 patients. Hum Reprod 22:266–271 Jacobson TZ, Duffy JM, Barlow D et al (2009) Laparoscopic surgery for pelvic pain associated with endometriosis. Cochrane Database Syst Rev 4:CD001300 Jacobson TZ, Duffy JM, Barlow D et al (2010) Laparoscopic surgery for subfertility associated with endometriosis. Cochrane Database Syst Rev1:CD001398 Mandai M, Suzuki A, Matsumura N et al (2012) Clinical management of ovarian endometriotic cyst (chocolate cyst): diagnosis, medical treatment, and minimally invasive surgery. Curr Obstet Gynecol Rep 1:16–24 Kondo W, Ribeiro R, Trippia C, Zomer M (2013) Laparoscopic treatment of deep infiltrating endometriosis affecting the rectosigmoid colon: nodulectomy or segmental resection? Gynecol Obstet S3(001):1–5 Fleisch MC, Xafis D, De Bruyne F et al (2005) Radical resection of invasive endometriosis with bowel or bladder involvement–long-term results. Eur J Obstet Gynecol Reprod Biol 123:224–229 Endometriosis Guideline Development Group (2013) Management of women with endometriosis – ESHRE guideline on endometriosis 2013. http://www.eshre.eu/~/media/Files/ESHRE guideline on endometriosis 2013 v1.pdf. Zugegriffen: 01. Dez. 2013 Yap C, Furness S, Farquhar C (2004) Pre and post operative medical therapy for endometriosis surgery. Cochrane Database Syst Rev 3: CD003678 Bayoglu Tekin Y, Dilbaz B, Altinbas SK, Dilbaz S (2011) Postoperative medical treatment of chronic pelvic pain related to severe endometriosis: levonorgestrel-releasing intrauterine system versus gonadotropin-releasing hormone analogue. Fertil Steril 95:492–496 Einhaltung ethischer Richtlinien Interessenkonflikt. P. Hepp, T. Fehm und M. Fleisch geben an, dass kein Interessenkonflikt besteht. Der Beitrag enthält keine Studien an Menschen oder Tieren. Author information Authors and Affiliations Corresponding author Rights and permissions About this article Cite this article Hepp, P., Fehm, T. & Fleisch, M. Fertilitätserhaltende Operationen bei Uterus myomatosus und Endometriose. Gynäkologe 47, 172–178 (2014). https://doi.org/10.1007/s00129-013-3278-8 Published: Issue date: DOI: https://doi.org/10.1007/s00129-013-3278-8