Juhasz-Böss I, Laschke M W, Müller F, Rosenbaum P, Baum S, Solomayer E F, Ulrich U
Klinik für Frauenheilkunde, Geburtshilfe und Reproduktionsmedizin, Universitätsklinikum des Saarlandes, Homburg/Saar.
Institut für Klinisch-Experimentelle Chirurgie, Universität des Saarlandes, Homburg.
Geburtshilfe Frauenheilkd. 2014 Aug;74(8):733-742. doi: 10.1055/s-0034-1382884.
Endometriosis is one of the most frequent benign diseases in women of child-bearing age. The main symptoms are chronic upper abdominal pain and infertility. However, the aetiology and pathogenesis of endometriosis are as yet insufficiently clarified. Thus, therapy is mainly symptomatic with laparoscopic surgery being the gold standard. The aim of drug therapy is to achieve a hypo-oestrogenic condition. In cases of severe endometriosis and a desire to have children there is often an indication for assisted reproduction. The present article illustrates almost all current aspects on the diagnosis of and therapy of endometriosis. From the clinical viewpoint, emphasis is placed on the rare cases of deeply infiltrating endometriosis that are, however, accompanied with a high morbidity. Current therapeutic options in cases of infertility are also presented in more detail. Furthermore, special attention is paid to the latest research results from both clinical and basic research fields in order to demonstrate our current knowledge on the pathogenesis and, where possible, potentially related therapeutic options.
子宫内膜异位症是育龄期女性最常见的良性疾病之一。主要症状为慢性上腹部疼痛和不孕。然而,子宫内膜异位症的病因和发病机制尚未完全阐明。因此,治疗主要是对症治疗,腹腔镜手术是金标准。药物治疗的目的是达到低雌激素状态。在重度子宫内膜异位症且有生育意愿的情况下,通常需要辅助生殖。本文阐述了子宫内膜异位症诊断和治疗的几乎所有当前方面。从临床角度来看,重点关注深度浸润性子宫内膜异位症的罕见病例,然而这些病例伴随着高发病率。还更详细地介绍了不孕情况下的当前治疗选择。此外,特别关注临床和基础研究领域的最新研究成果,以展示我们目前对发病机制的认识,并在可能的情况下展示潜在相关的治疗选择。