Interdisziplinäre Diagnostik und Therapie der tief infiltrierenden Endometriose

İbrahim Alkatout, I Alkatout, Jan‐Hendrik Egberts, J-H Egberts, Liselotte Mettler, L Mettler, M Doniec, T Wedel, Thilo Wedel, K-P Jünemann, K.-P. Jünemann, Thomas Becker, T Becker, W Jonat, T Schollmeyer, Thoralf Schollmeyer
Zentralblatt fur Chirurgie · 2015 · vol. 141(06) , pp. 630–638 · doi:10.1055/s-0034-1383272 · PMID:25723864 · W150221967
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⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

This review examines the interdisciplinary diagnosis and treatment of deep infiltrating endometriosis, emphasizing tailored therapy based on disease severity and fertility desires, and highlighting the need for specialized centers to optimize patient outcomes.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-07 ⓘ

This 2015 review article examines deep infiltrating endometriosis and describes an interdisciplinary diagnostic and treatment framework for managing the wide symptom range caused by endometrial glands and stroma outside the uterine cavity epithelium. It summarizes that about half of adolescents and up to 32% of reproductive-age women who undergo surgery for chronic pelvic pain or dysmenorrhea have endometriosis, and that the interval from first nonspecific symptoms to diagnosis can be around 7 years, attributed largely to non-specific symptomatology and insufficient awareness among initial care disciplines. The paper outlines treatment options including expectant management, analgesia, hormonal therapy, surgery, or combined approaches, emphasizing individualized decision-making based on disease burden and reproductive goals, with a reported recurrence rate among treated patients ranging from 5 to over 60% depending on integrated management and surgical quality, and noting that causal therapy remains impossible because pathogenesis is not fully understood. This paper is centrally about endometriosis — specifically deep infiltrating endometriosis and the interdisciplinary diagnostic and treatment strategy for it.

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Abstract

Endometriosis is the second most common benign female genital disease after uterine myoma. This review discusses the interdisciplinary approach to the treatment of deep infiltrating endometriosis. Endometriosis has been defined as the presence of endometrial glands and stroma outside the internal epithelial lining of the cavum uteri. As a consequence, endometriosis can cause a wide range of symptoms such as chronic pelvic pain, subfertility, dysmenorrhea, deep dyspareunia, cyclical bowel or bladder symptoms (e.g., dyschezia, bloating, constipation, rectal bleeding, diarrhoea and hematuria), abnormal menstrual bleeding, chronic fatigue or low back pain. Approx. 50 % of teenagers and up to 32 % of women of reproductive age, operated for chronic pelvic pain or dysmenorrhoea, suffer from endometriosis. The time interval between the first unspecific symptoms and the medical diagnosis of endometriosis is about 7 years. This is caused not only by the non-specific nature of the symptoms but also by the frequent lack of awareness on the part of the cooperating disciplines with which the patients have first contact. As the pathogenesis of endometriosis is not clearly understood, a causal treatment is still impossible. Treatment options include expectant management, analgesia, hormonal medical therapy, surgical intervention and the combination of medical treatment before and/or after surgery. The correct treatment for each patient should take into account the severity of the disease and whether the patient desires to have children. The treatment should be as radical as necessary and as minimal as possible. The recurrence rate among treated patients lies between 5 and > 60 % and is very much dependent on the integrated management and surgical skills of the respective hospital. Consequently, to optimise the individual patient's treatment, a high degree of interdisciplinary cooperation in diagnosis and treatment is crucial and should, especially in the case of deep infiltrating endometriosis, be undertaken in appropriate centres.

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Condition tags

endometriosisdie_deep_infiltratingchronic_pelvic_paindysmenorrheadyspareunia

MeSH descriptors

Endometriosis Endometriosis Interdisciplinary Communication Intersectoral Collaboration Endometriosis Endometriosis Endometriosis Female Humans Infertility, Female Infertility, Female Infertility, Female Infertility, Female Prognosis Recurrence Treatment Outcome

Citation neighborhood

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

References (38)

Cited by (9)

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