Operative Therapie der Endometriose und Fertilität

In: Gynäkologische Endokrinologie · 2017 · vol. 15(4) , pp. 273–280 · doi:10.1007/s10304-017-0154-y · W2752299677
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AI-generated summary by claude@2026-06+body, 2026-06-08

The aim of endometriosis surgery is complete removal to improve fertility, but residual endometriosis may be left if fertility is at risk.

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The paper discusses operative treatment for endometriosis, focusing on how surgical standards relate to fertility outcomes. It describes surgery’s main goal as complete removal of endometriosis to improve fertility, while noting that if protecting fertility is the overriding objective, surgeons may need to leave some residual disease. A stated caveat is that operative therapy is still not standardized. This paper is centrally about endometriosis — specifically, it reviews standard surgical techniques with emphasis on their implications for fertility, and it also mentions adenomyosis as part of its clinical scope.

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Abstract

Background Endometriosis is a widespread disease with many different appearances. There is still no standardized form of surgical treatment.

Objective

This article highlights the standard surgical techniques especially with respect to the impact on fertility.

Results

The aim of surgery is the complete removal of the endometriosis and therefore an improvement in fertility. If there is a risk of compromising the overriding aim of preserving fertility, it may be necessary to leave some residual endometriosis in place. Similar content being viewed by others Literatur Benagiano G, Brosens I (2006) History of adenomyosis. Best Pract Res Clin Obstet Gynaecol 20(4):449–463. https://doi.org/10.1016/j.bpobgyn.2006.01.007 Ulrich U, Buchweitz O, Greb R, Keckstein J, von Leffern I, Oppelt P, Renner SP, Sillem M, Stummvoll W, De Wilde RL, Schweppe KW, German and Austrian Societies for Obstetrics and Gynecology (2014) National German Guideline (S2k): Guideline for the Diagnosis and Treatment of Endometriosis (Leitlinie für die Diagnostik und Therapie der Endometriose). Geburtshilfe Frauenheilkd 74(12):1104–1118. https://doi.org/10.1055/s-0034-1383187 Freis A BM, Strowitzki T, Dietrich JE (2017) Relative kinetic data defining cleavage synchronicity are altered in Embryos from patients with and without endometriosis using time-lapse embryo assassment. World Congress on Endometriosis, Vancouver 17–20.05.2017, oral presentation, MS06-05 Ebert AD, Ulrich U, Keckstein J, Muller M, Schindler AE, Sillem M, Tinneberg HR, De Wilde RL, Schweppe KW, Endometriosis Research F, European Endometriosis L (2013) Implementation of certified endometriosis centers: 5‑year experience in German-speaking Europe. Gynecol Obstet Invest 76(1):4–9. https://doi.org/10.1159/000346457 Carfagna P, De Cicco Nardone C, De Cicco Nardone A, Testa AC, Scambia G, Marana R, De Cicco Nardone F (2017) The role of transvaginal ultrasound in the evaluation of ureteral involvement in deep Endometriosis. Ultrasound Obstet Gynecol. https://doi.org/10.1002/uog.17524 Schweppe KW, Ring D (2002) Peritoneal defects and the development of endometriosis in relation to the timing of endoscopic surgery during the menstrual cycle. Fertil Steril 78(4):763–766 American Society for Reproductive Medicine (1997) Revised American Society for Reproductive Medicine classification of endometriosis: 1996. Fertil Steril 67(5):817–821 Bühler K (1998) Diagnostik der Endometriose. Endometriose. Kohlhammer, Stuttgart Marcoux S, Maheux R, Berube S (1997) Laparoscopic surgery in infertile women with minimal or mild endometriosis. Canadian Collaborative Group on Endometriosis. N Engl J Med 337(4):217–222. https://doi.org/10.1056/NEJM199707243370401 Parazzini F (1999) Ablation of lesions or no treatment in minimal-mild endometriosis in infertile women: a randomized trial. Gruppo Italiano per lo Studio dell’Endometriosi. Hum Reprod 14(5):1332–1334 Jacobson TZ, Duffy JM, Barlow D, Farquhar C, Koninckx PR, Olive D (2010) Laparoscopic surgery for subfertility associated with endometriosis. Cochrane Database Syst Rev. https://doi.org/10.1002/14651858.CD001398.pub2 Opoien HK, Fedorcsak P, Byholm T, Tanbo T (2011) Complete surgical removal of minimal and mild endometriosis improves outcome of subsequent IVF/ICSI treatment. Reprod Biomed Online 23(3):389–395. https://doi.org/10.1016/j.rbmo.2011.06.002 Muzii L, Di Tucci C, Di Feliciantonio M, Marchetti C, Perniola G, Panici PB (2014) The effect of surgery for endometrioma on ovarian reserve evaluated by antral follicle count: a systematic review and meta-analysis. Hum Reprod 29(10):2190–2198. https://doi.org/10.1093/humrep/deu199 Yu HT, Huang HY, Lee CL, Soong YK, Wang CJ (2015) Side of ovarian endometrioma does not affect the outcome of in vitro fertilization/intracytoplasmic sperm injection in infertile women after laparoscopic cystectomy. J Obstet Gynaecol Res 41(5):717–721. https://doi.org/10.1111/jog.12633 Dunselman GA, Vermeulen N, Becker C, Calhaz-Jorge C, D’Hooghe T, De Bie B, Heikinheimo O, Horne AW, Kiesel L, Nap A, Prentice A, Saridogan E, Soriano D, Nelen W (2014) ESHRE guideline: management of women with endometriosis. Hum Reprod 29(3):400–412. https://doi.org/10.1093/humrep/det457 Yang XH, Ji F, AiLi A, TuerXun H, He Y, Ding Y (2014) Effects of laparoscopic ovarian endometriosis cystectomy combined with postoperative GnRH-a therapy on ovarian reserve, pregnancy, and outcome recurrence. Clin Exp Obstet Gynecol 41(3):272–275 Park H, Kim CH, Kim EY, Moon JW, Kim SH, Chae HD, Kang BM (2015) Effect of second-line surgery on in vitro fertilization outcome in infertile women with ovarian endometrioma recurrence after primary conservative surgery for moderate to severe endometriosis. Obstet Gynecol Sci 58(6):481–486. https://doi.org/10.5468/ogs.2015.58.6.481 Centini G, Afors K, Murtada R, Argay IM, Lazzeri L, Akladios CY, Zupi E, Petraglia F, Wattiez A (2016) Impact of laparoscopic surgical management of deep endometriosis on pregnancy rate. J Minim Invasive Gynecol 23(1):113–119. https://doi.org/10.1016/j.jmig.2015.09.015 Cohen J, Thomin A, Mathieu D’Argent E, Laas E, Canlorbe G, Zilberman S, Belghiti J, Thomassin-Naggara I, Bazot M, Ballester M, Darai E (2014) Fertility before and after surgery for deep infiltrating endometriosis with and without bowel involvement: a literature review. Minerva Ginecol 66(6):575–587 Schonman R, Dotan Z, Weintraub AY, Bibi G, Eisenberg VH, Seidman DS, Goldenberg M, Soriano D (2013) Deep endometriosis inflicting the bladder: long-term outcomes of surgical management. Arch Gynecol Obstet 288(6):1323–1328. https://doi.org/10.1007/s00404-013-2917-6 Tuttlies F, Keckstein J, Ulrich U, Possover M, Schweppe KW, Wustlich M, Buchweitz O, Greb R, Kandolf O, Mangold R, Masetti W, Neis K, Rauter G, Reeka N, Richter O, Schindler AE, Sillem M, Terruhn V, Tinneberg HR (2005) ENZIAN-score, a classification of deep infiltrating endometriosis. Zentralbl Gynakol 127(5):275–281. https://doi.org/10.1055/s-2005-836904 Iversen ML, Seyer-Hansen M, Forman A (2017) Does surgery for deep infiltrating bowel endometriosis improve fertility? A systematic review. Acta Obstet Gynecol Scand 96(6):688–693. https://doi.org/10.1111/aogs.13152 Stepniewska A, Pomini P, Bruni F, Mereu L, Ruffo G, Ceccaroni M, Scioscia M, Guerriero M, Minelli L (2009) Laparoscopic treatment of bowel endometriosis in infertile women. Hum Reprod 24(7):1619–1625. https://doi.org/10.1093/humrep/dep083 Ferrero S, Anserini P, Abbamonte LH, Ragni N, Camerini G, Remorgida V (2009) Fertility after bowel resection for endometriosis. Fertil Steril 92(1):41–46. https://doi.org/10.1016/j.fertnstert.2008.04.070 Osada H, Silber S, Kakinuma T, Nagaishi M, Kato K, Kato O (2011) Surgical procedure to conserve the uterus for future pregnancy in patients suffering from massive adenomyosis. Reprod Biomed Online 22(1):94–99. https://doi.org/10.1016/j.rbmo.2010.09.014 Grimbizis GF, Mikos T, Tarlatzis B (2014) Uterus-sparing operative treatment for adenomyosis. Fertil Steril 101(2):472–487. https://doi.org/10.1016/j.fertnstert.2013.10.025 Kishi Y, Yabuta M, Taniguchi F (2014) Who will benefit from uterus-sparing surgery in adenomyosis-associated subfertility? Fertil Steril 102(3):802–807 e801. https://doi.org/10.1016/j.fertnstert.2014.05.028 Martinez-Conejero JA, Morgan M, Montesinos M, Fortuno S, Meseguer M, Simon C, Horcajadas JA, Pellicer A (2011) Adenomyosis does not affect implantation, but is associated with miscarriage in patients undergoing oocyte donation. Fertil Steril 96(4):943–950. https://doi.org/10.1016/j.fertnstert.2011.07.1088 Dueholm M (2017) Uterine adenomyosis and infertility, review of reproductive outcome after in vitro fertilization and surgery. Acta Obstet Gynecol Scand 96(6):715–726. https://doi.org/10.1111/aogs.13158 Mijatovic V, Florijn E, Halim N, Schats R, Hompes P (2010) Adenomyosis has no adverse effects on IVF/ICSI outcomes in women with endometriosis treated with long-term pituitary down-regulation before IVF/ICSI. Eur J Obstet Gynecol Reprod Biol 151(1):62–65. https://doi.org/10.1016/j.ejogrb.2010.02.047 Author information Authors and Affiliations Corresponding author Ethics declarations Interessenkonflikt F. Neis, K. J. Neis und K. Bühler geben an, dass kein Interessenkonflikt besteht. Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren. Additional information Redaktion G. Griesinger, Lübeck Rights and permissions About this article Cite this article Neis, F., Neis, K.J. & Bühler, K. Operative Therapie der Endometriose und Fertilität. Gynäkologische Endokrinologie 15, 273–280 (2017). https://doi.org/10.1007/s10304-017-0154-y Published: Issue date: DOI: https://doi.org/10.1007/s10304-017-0154-y Schlüsselwörter - Peritoneale Endometriose - Ovarialendometriose - Endometriose der Blase - Adenomyose - Tiefinfiltrierende Endometriose

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