Therapie der Endometriose

In: Der Gynäkologe · 2014 · vol. 47(2) , pp. 124–127 · doi:10.1007/s00129-013-3300-1 · W2217502671
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AI-generated summary by claude@2026-06+body, 2026-06-28

This literature review discusses the pathogenesis and treatment of endometriosis-associated infertility, endometriosis and the appendix, and diagnostic methods for pelvic and bowel endometriosis.

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This paper is a German-language review article that surveys therapeutic approaches for endometriosis, drawing on a literature base that includes international guidelines and comparative trials of medical and surgical management. It outlines evidence on commonly discussed treatments (e.g., hormonal therapies and surgical options such as laparoscopic excision) and also touches on related topics like diagnosis and reproductive outcomes, including IVF/ICSI considerations and the role of ovarian reserve markers such as anti-Müllerian hormone in patients with ovarian endometrioma. A key limitation is that the contribution is not described as a primary study and reports no new experimental data, instead synthesizing previously published work and guideline documents. This paper is centrally about endometriosis — it reviews and discusses therapeutic strategies for endometriosis management.

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Literatur Macer ML, Taylor HS (2012) Endometriosis and infertility: a review of the pathogenesis and treatment of endometriosis-associated infertility. Obstet Gynecol Clin North Am 39:535–549 Gustofson RL, Kim N, Liu S, Stratton P (2006) Endometriosis and the appendix: a case series and comprehensive review of the literature. Fertil Steril 86:298–303 Jenkins S, Olive DL, Haney AF (1986) Endometriosis: pathogenetic implications of the anatomic distribution. Obstet Gynecol 67:335–338 Kennedy S, Bergqvist A, Chapron C et al (2005) ESHRE guideline for the diagnosis and treatment of endometriosis. Hum Reprod 20:2698–2704 Holland TK, Yazbek J, Cutner A et al (2010) Value of transvaginal ultrasound in assessing severity of pelvic endometriosis. Ultrasound Obstet Gynecol 36:241–248 Hudelist G, English J, Thomas AE et al (2011) Diagnostic accuracy of transvaginal ultrasound for non-invasive diagnosis of bowel endometriosis: systematic review and meta-analysis. Ultrasound Obstet Gynecol 37:257–263 Hudelist G, Tuttlies F, Rauter G et al (2009) Can transvaginal sonography predict infiltration depth in patients with deep infiltrating endometriosis of the rectum? Hum Reprod 24:1012–1017 Johnson NP, Hummelshoj L, World Endometriosis Society Montpellier Consortium (2013) Consensus on current management of endometriosis. Hum Reprod 28:1552–1568 o A (1997) Revised American Society for Reproductive Medicine classification of endometriosis: 1996. Fertil Steril 67:817–821 Tuttlies F, Keckstein J, Ulrich U et al (2008) ENZIAN-Klassifikation zur Diskussion gestellt: Eine neue differenzierte Klassifikation der tief infiltrierenden Endometriose. J Gynakol Endokrinol 18:7–13 Strowitzki T, Marr J, Gerlinger C et al (2012) Detailed analysis of a randomized, multicenter, comparative trial of dienogest versus leuprolide acetate in endometriosis. Int J Gynaecol Obstet 117:228–233 Brown J, Pan A, Hart RJ (2010) Gonadotrophin-releasing hormone analogues for pain associated with endometriosis. Cochrane Database Syst Rev CD008475 Sutton CJ, Ewen SP, Whitelaw N, Haines P (1994) Prospective, randomized, double-blind, controlled trial of laser laparoscopy in the treatment of pelvic pain associated with minimal, mild, and moderate endometriosis. Fertil Steril 62:696–700 Abbott J, Hawe J, Hunter D et al (2004) Laparoscopic excision of endometriosis: a randomized, placebo-controlled trial. Fertil Steril 82:878–884 Yap C, Furness S, Farquhar C (2004) Pre and post operative medical therapy for endometriosis surgery. Cochrane Database Syst Rev CD003678 Morelli M, Sacchinelli A, Venturella R et al (2013) Postoperative administration of dienogest plus estradiol valerate versus levonorgestrel-releasing intrauterine device for prevention of pain relapse and disease recurrence in endometriosis patients. J Obstet Gynaecol Res 39:985–990 Bulun SE (2009) Endometriosis. N Engl J Med 360:268–279 Gpta S, Goldberg JM, Aziz N et al (2008) Pathogenic mechanisms in endometriosis-associated infertility. Fertil Steril 90:247–257 Practice Committee of the American Society for Reproductive Medicine (2012) Endometriosis and infertility: a committee opinion. Fertil Steril 98:591–598 Kim JY, Jee BC, Suh CS, Kim SH (2013) Preoperative serum anti-mullerian hormone level in women with ovarian endometrioma and mature cystic teratoma. Yonsei Med J 54:921–926 Shebl O, Ebner T, Sommergruber M et al (2009) Anti muellerian hormone serum levels in women with endometriosis: a case-control study. Gynecol Endocrinol 25:713–716 Chang HJ, Han SH, Lee JR et al (2010) Impact of laparoscopic cystectomy on ovarian reserve: serial changes of serum anti-Müllerian hormone levels. Fertil Steril 94:343–349 Iwase A, Hirokawa W, Goto M et al (2010) Serum anti-Müllerian hormone level is a useful marker for evaluating the impact of laparoscopic cystectomy on ovarian reserve. Fertil Steril 94:2846–2849 Kitajima M, Khan KN, Hiraki K et al (2011) Changes in serum anti-Müllerian hormone levels may predict damage to residual normal ovarian tissue after laparoscopic surgery for women with ovarian endometrioma. Fertil Steril 95:2589–2591.e1 Streuli I, De Ziegler D, Gayet V et al (2012) In women with endometriosis anti-Müllerian hormone levels are decreased only in those with previous endometrioma surgery. Hum Reprod 27:3294–3303 Donnez J, Wyns C, Nisolle M (2001) Does ovarian surgery for endometriomas impair the ovarian response to gonadotropin? Fertil Steril 76:662–665 Barnhart K, Dunsmoor-Su R, Coutifaris C (2002) Effect of endometriosis on in vitro fertilization. Fertil Steril 77:1148–1155 Kuivasaari P, Hippeläinen M, Anttila M, Heinonen S (2005) Effect of endometriosis on IVF/ICSI outcome: stage III/IV endometriosis worsens cumulative pregnancy and live-born rates. Hum Reprod 20:3130–3135 Ballester M, Oppenheimer A, D’Argent EM et al (2012) Nomogram to predict pregnancy rate after ICSI-IVF cycle in patients with endometriosis. Hum Reprod 27:451–456 Crosignani PG, Vercellini P, Biffignandi F et al (1996) Laparoscopy versus laparotomy in conservative surgical treatment for severe endometriosis. Fertil Steril 66:706–711 Bianchi PHM, Pereira RMA, Zanatta A et al (2009) Extensive excision of deep infiltrative endometriosis before in vitro fertilization significantly improves pregnancy rates. J Minim Invasive Gynecol 16:174–180 Ebert AD (2002) Endometriose – Ein Wegweiser für die Praxis. De Gruyter, Berlin Einhaltung ethischer Richtlinien Interessenkonflikt. K. Hancke, P. Widschwendter, C. Wulff, K. Sterzik, F. Gagsteiger, R. Mangold und W. Janni geben an, dass kein Interessenkonflikt besteht. Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren. Author information Authors and Affiliations Corresponding author Rights and permissions About this article Cite this article Hancke, K., Widschwendter, P., Wulff, C. et al. Therapie der Endometriose. Gynäkologe 47, 124–127 (2014). https://doi.org/10.1007/s00129-013-3300-1 Published: Issue date: DOI: https://doi.org/10.1007/s00129-013-3300-1

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