DeCherney A H
Department of Obstetrics and Gynecology, Tufts University School of Medicine, Boston, Massachusetts.
Clin Ther. 1992 Nov-Dec;14(6):766-72; discussion 765.
Endometriosis, a condition in which endometrial tissue sheds and becomes attached to extrauterine sites, appears to be a progressive or recurrent disease. Although there are a variety of treatment options, the only cure for endometriosis is total abdominal hysterectomy with bilateral oophorectomy. For women who wish to preserve fertility, however, this is not a desirable choice. Because the symptoms of endometriosis suggest a hormonal relationship, pharmacologic management entails inducing anovulation. A concern of both physicians and patients is recurrence of endometriosis after initial response to therapy. Whether symptoms represent recurrent disease or progression of preexisting implants is still unknown. A repeat course of therapy with danazol, a synthetic androgen, may be tried for retreatment of endometriosis. Another option is the progestins. Conservative surgery (ie, laparoscopy) is also an option, but often must be repeated for pain control; combination pharmacologic/surgical therapy, although in widespread use, is not without disadvantages and requires further investigation.
子宫内膜异位症是一种子宫内膜组织脱落并附着于子宫外部位的病症，似乎是一种进行性或复发性疾病。尽管有多种治疗选择，但子宫内膜异位症的唯一治愈方法是全腹子宫切除术加双侧卵巢切除术。然而，对于希望保留生育能力的女性来说，这不是一个理想的选择。由于子宫内膜异位症的症状表明存在激素关系，药物治疗需要诱导无排卵。医生和患者都担心的一个问题是，在对治疗产生初始反应后子宫内膜异位症会复发。症状是代表复发性疾病还是先前存在的植入物进展尚不清楚。可以尝试用合成雄激素达那唑进行重复疗程治疗子宫内膜异位症。另一种选择是孕激素。保守手术（即腹腔镜检查）也是一种选择，但通常必须重复进行以控制疼痛；药物/手术联合治疗虽然广泛使用，但并非没有缺点，需要进一步研究。
