Operative Therapie der Endometriose: radikal und schonend zugleich

Background Endometriosis is the second most common benign female genital disease after uterine leiomyoma.

This review discusses the individual management for each patient which should take into account the severity of the disease and whether the patient desires to have children. Endometriosis is defined as the presence of endometrial glands and stroma outside the internal epithelial lining of the cavity of the uterus. 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, diarrhea and hematuria), abnormal menstrual bleeding, chronic fatigue and low back pain.

Approximately 50 % of teenage women and up to 32 % of women of reproductive age operated on for chronic pelvic pain or dysmenorrhea, suffer from endometriosis. The time interval between the first unspecific symptoms and the medical diagnosis of endometriosis is approximately 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 not possible. Treatment options include watchful waiting, analgesia, hormonal medical therapy, surgical intervention and the combination of medical treatment before and/or after surgery. 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.

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Author information Authors and Affiliations Corresponding author Zusatzmaterial online Video 1: Ureterolyse bei tief infiltrierender Endometriose der Sakrouterinligamente (WMV 46KB) Video 2: Partielle Resektion eines die Harnblase infiltrierenden Endometrioseknotens (AVI 26KB) Video 3: End-zu-End Anastomose nach laparoskopischer anteriorer Rektumresektion eines transmural gewachsenen Endometrioseknotens (AVI 22KB) Rights and permissions About this article Cite this article Alkatout, I., Meinhold-Heerlein, I., von Leffern, I. et al. Operative Therapie der Endometriose: radikal und schonend zugleich. Gynäkologe 48, 228–236 (2015). https://doi.org/10.1007/s00129-014-3419-8 Published: Issue date: DOI: https://doi.org/10.1007/s00129-014-3419-8