Patientinnenzentrierte Aspekte der Endometriose

Zusammenfassung Die Endometriose ist eine häufige gutartige Erkrankung der Frau. Sie ist definiert durch das Auftreten endometriumartiger Zellverbände außerhalb der Gebärmutterhöhle. Zur Ätiologie und Pathogenese wurden zahlreiche Theorien entwickelt. Es wird ein breites Spektrum vom klinisch bedeutungslosen Zufallsbefund bis zu schweren Verläufen mit Organdestruktion beobachtet. Das Leitsymptom ist der zyklisch auftretende Unterbauchschmerz, nicht selten besteht eine Sterilität. Die Diagnose wird i. Allg. durch eine Laparoskopie gesichert. Die medikamentöse Behandlung besteht in der Unterdrückung der zyklischen ovariellen Aktivität, während die operative Therapie die Destruktion und Exzision von Endometrioseherden oder die Entfernung erkrankter Organe zum Ziel hat. Bei gleichzeitig bestehender Sterilität sollte diese vorrangig behandelt werden. Abstract Endometriosis is a frequent benign condition in women. It is defined as the occurrence of tissue complexes resembling endometrium outside the uterine cavity. Numerous theories regarding etiology and pathogenesis have been proposed. A broad spectrum ranging from clinically meaningless random findings to severe conditions involving organ destruction can be observed. The most important symptom is cyclical lower abdominal pain; coincident infertility is not infrequent. Diagnosis is commonly confirmed by laparoscopy. Medical therapies lead to the suppression of cyclical ovarian function while surgery aims at destruction or excision of endometriosis foci or the removal of affected organs. If infertility is present, this should be treated with priority. The paper will enable the reader to assess clinical findings, to consider possible differential diagnoses, and to recommend an individualized treatment. Literatur American Society for Reproductive Medicine (1997) Revised American Society for Reproductive Medicine classification of Endometriosis. 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