Skip to main content
SpringerLink
Log in

Endometriose

  • Chapter
  • First Online:
Klinische Endokrinologie für Frauenärzte

  • 208 Accesses

Zusammenfassung

Patientinnen mit Endometriose präsentieren sich in der täglichen Praxis mit vielfältigen Symptomen. Die Erkrankung kann asymptomatisch bestehen oder mit starken Beschwerden assoziiert sein, oft stehen die Dysmenorrhö und der chronischer Unterbauchschmerz im Vordergrund. Die genaue Prävalenz ist unbekannt, dürfte aber bis zu 30 % betragen. Leider wird die Erkrankung trotz starker Beschwerden von nicht oder spät erkannt. Dabei wäre häufig ein „Drandenken“ ausreichend, um der Diagnose näher zu kommen. Die Definition von Risikofaktoren ist schwierig, einige scheinen aber zu bestehen und werden genannt. Auch die Entstehung von Endometriose ist nicht eindeutig geklärt, verschiedene Theorien existieren, werden weiterentwickelt und ergänzen sich gegenseitig. Die Diagnostik liegt mit einfachen Mitteln und Möglichkeiten eindeutig in den Händen der Gynäkologen, hierzu sind unsere Standarduntersuchungsverfahren meist ausreichend. Im Vordergrund stehen Anamnese, klinische Untersuchung mittels Spekulum, rektovaginale Untersuchung und die Sonografie. Selten werden Zusatzuntersuchungsverfahren nötig sein, sollten aber nicht ganz aus dem diagnostischen Repertoire verbannt werden. Insbesondere die Therapie ist von der Lebenssituation der Patientin abhängig und erfordert speziell bei Kinderwunschpatientinnen die Ausarbeitung eines Gesamtkonzepts unter Berücksichtigung aller Parameter.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 149.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 199.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Literatur

  • Adamson GD, Pasta DJ (2010) Endometriosis fertility index: the new, validated endometriosis staging system. Fertil Steril 94:1609–1615

    Article  PubMed  Google Scholar 

  • Aghaey Meibody F et al (2011) Diagnosis of endometrial nerve fibers in women with endometriosis. Arch Gynecol Obstet 284:1157–1162

    Article  PubMed  Google Scholar 

  • Alhamdan D et al (2010) Mirena intra-uterine system: does it improve long term symptoms in women with chronic pelvic pain and/or endometriosis after laparoscopy? A multicentre randomized controlled trial. Rev Recent Clin Trials 5:143–146

    Article  PubMed  Google Scholar 

  • Al-Jefout M et al (2009) Diagnosis of endometriosis by detection of nerve fibres in an endometrial biopsy: a double-blind study. Hum Reprod 24:3019–3024

    Article  CAS  PubMed  Google Scholar 

  • Barcena de Arellano ML et al (2011) Influence of nerve growth factor in endometriosis-associated symptoms. Reprod Sci 18:1202–1210

    Article  CAS  PubMed  Google Scholar 

  • Brosens I, Brosens JJ, Benagiano G (2012) The eutopic endometrium in endometriosis: are the changes of clinical significance? Reprod Biomed Online 24:496–502

    Article  PubMed  Google Scholar 

  • Burghaus SKP, Fasching PA, Engel A et al (2012) Risk factors for endometriosis in a German Case-Control Study. Geburtsh Frauenheilkd 71:1073–1079

    Google Scholar 

  • Cahill DJ (2002) What is the optimal medical management of infertility and minor endometriosis? Analysis and future prospects. Hum Reprod 17:1135–1140

    Article  CAS  PubMed  Google Scholar 

  • Cahill DJ et al (1997) Ovarian dysfunction in endometriosis-associated and unexplained infertility. J Assist Reprod Genet 14:554–557

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Candiani GB et al (1991) Reproductive and menstrual factors and risk of peritoneal and ovarian endometriosis. Fertil Steril 56:230–234

    Article  CAS  PubMed  Google Scholar 

  • Chapron C et al (2011) Oral contraceptives and endometriosis: the past use of oral contraceptives for treating severe primary dysmenorrhea is associated with endometriosis, especially deep infiltrating endometriosis. Hum Reprod 26:2028–2035

    Article  CAS  PubMed  Google Scholar 

  • D’Hooghe TM, Xiao L, Hill JA (2001) Cytokine profiles in autologous peritoneal fluid and peripheral blood of women with deep and superficial endometriosis. Arch Gynecol Obstet 265:40–44

    Article  PubMed  Google Scholar 

  • Diagnosis and therapy of endometriosis. Guideline of the DGGG, SGGG and OEGGG (S2k-Level, AWMF Registry No. 045/015, August 2020). http://www.awmf.org/leitlinien/detail/ll/015-045.html

  • Donnez J, Taylor HS, Stewart EA, Bradley L, Marsh E, Archer D, Al-Hendy A, Petraglia F, Watts N, Gotteland JP, Bestel E, Terrill P, Loumaye E, Humberstone A, Garner E (2022) Lancet 17;400(10356):896–907

    Google Scholar 

  • Doody MC, Gibbons WE, Buttram VC Jr (1988) Linear regression analysis of ultrasound follicular growth series: evidence for an abnormality of follicular growth in endometriosis patients. Fertil Steril 49:47–51

    Article  CAS  PubMed  Google Scholar 

  • Giudice LC et al (2022) Once daily oral relugolix combination therapy versus placebo in patients with endometriosis-associated pain: two replicate phase 3, randomised, double-blind, studies (SPIRIT 1 and 2). Lancet 399(10343):2267–2279 and Supplementary Appendix

    Google Scholar 

  • Hassa H et al (2009) Cytokine and immune cell levels in peritoneal fluid and peripheral blood of women with early- and late-staged endometriosis. Arch Gynecol Obstet 279:891–895

    Article  CAS  PubMed  Google Scholar 

  • Hudelist G, Fritzer N, Thomas A et al (2012) Diagnostic delay for endometriosis in Austria and Germany: causes and possible consequences. Hum Reprod 27:3412–3416

    Article  CAS  PubMed  Google Scholar 

  • Keckstein J et al (2021) The #Enzian classification: a comprehensive non-invasive and surgical description system for endometriosis. Acta Obstet Gynecol Scand 100(7):1165–1175

    Article  PubMed  Google Scholar 

  • Kennedy S et al (2005) ESHRE guideline for the diagnosis and treatment of endometriosis. Hum Reprod 20:2698–2704

    Article  PubMed  Google Scholar 

  • Khorram O et al (1993) Peritoneal fluid concentrations of the cytokine RANTES correlate with the severity of endometriosis. Am J Obstet Gynecol 169:1545–1549

    Article  CAS  PubMed  Google Scholar 

  • Knapp VJ (1999) How old is endometriosis? Late 17th- and 18th-century European descriptions of the disease. Fertil Steril 72:10–14

    CAS  PubMed  Google Scholar 

  • Kohler G et al (2010) A dose-ranging study to determine the efficacy and safety of 1, 2, and 4mg of dienogest daily for endometriosis. Int J Gynaecol Obstet 108:21–25

    Article  PubMed  Google Scholar 

  • Kunz G et al (2000) Structural abnormalities of the uterine wall in women with endometriosis and infertility visualized by vaginal sonography and magnetic resonance imaging. Hum Reprod 15:76–82

    Article  CAS  PubMed  Google Scholar 

  • Leslie C, Ma T, McElhinney B et al (2013) Is the detection of endometrial nerve fibers useful in the diagnosis of endometriosis? Int J Gynecol Pathol 32:149–155

    Article  CAS  PubMed  Google Scholar 

  • Leyendecker G et al (1996) Uterine hyperperistalsis and dysperistalsis as dysfunctions of the mechanism of rapid sperm transport in patients with endometriosis and infertility. Hum Reprod 11:1542–1551

    Article  CAS  PubMed  Google Scholar 

  • Leyendecker G et al (1998) Endometriosis: a dysfunction and disease of the archimetra. Hum Reprod Update 4:752–762

    Article  CAS  PubMed  Google Scholar 

  • Leyendecker G et al (2002) Endometriosis results from the dislocation of basal endometrium. Hum Reprod 17:2725–2736

    Article  CAS  PubMed  Google Scholar 

  • Leyendecker G et al (2004) Uterine peristaltic activity and the development of endometriosis. Ann N Y Acad Sci 1034:338–355

    Article  PubMed  Google Scholar 

  • Mahmood TA, Templeton A (1991) Prevalence and genesis of endometriosis. Hum Reprod 6:544–549

    Article  CAS  PubMed  Google Scholar 

  • Mathur S, Garza DE, Smith LF (1990) Endometrial autoantigens eliciting immunoglobulin (Ig)G, IgA, and IgM responses in endometriosis. Fertil Steril 54:56–63

    Article  CAS  PubMed  Google Scholar 

  • McLeod BS, Retzloff MG (2010) Epidemiology of endometriosis: an assessment of risk factors. Clin Obstet Gynecol 53:389–396

    Article  PubMed  Google Scholar 

  • Meyer R (1919) Über den Stand der Frage der Adenomyositis, Adenomyome im Allgemeinen und insbesondere über Adenomyositis seroepithelialis und Adenomyometritis sarcomatosa. Zentralbl Gynäkol 36:745–750

    Google Scholar 

  • Moen MH, Schei B (1997) Epidemiology of endometriosis in a Norwegian county. Acta Obstet Gynecol Scand 76:559–562

    Article  CAS  PubMed  Google Scholar 

  • Nyholt DR et al (2012) Genome-wide association meta-analysis identifies new endometriosis risk loci. Nat Genet 44:1355–1359

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Painter JN et al (2011) Genome-wide association study identifies a locus at 7p15.2 associated with endometriosis. Nat Genet 43:51–54

    Article  CAS  PubMed  Google Scholar 

  • Petta CA, Ferriani RA, Abrao MS, Hassan D, Rosa E, Silva JC, Podgaec S, Bahamondes L (2005) Hum Reprod 20(7):1993–1998

    Google Scholar 

  • Rousset-Jablonski C et al (2011) Catamenial pneumothorax and endometriosis-related pneumothorax: clinical features and risk factors. Hum Reprod 26:2322–2329

    Article  PubMed  Google Scholar 

  • Sampson JA (1927) Metastatic or embolic endometriosis, due to the menstrual dissemination of endometrial tissue into the venous circulation. Am J Pathol 3:93–110

    CAS  PubMed  PubMed Central  Google Scholar 

  • Schweppe KW (2003) Endometriose – Eine Erkrankung ohne Lobby. Zentralbl Gynäkol 125:233

    PubMed  Google Scholar 

  • Simon C et al (1994) Outcome of patients with endometriosis in assisted reproduction: results from in-vitro fertilization and oocyte donation. Hum Reprod 9:725–729

    Article  CAS  PubMed  Google Scholar 

  • Sokolov DI et al (2005) Study of cytokine profile and angiogenic potential of peritoneal fluid in patients with external genital endometriosis. Bull Exp Biol Med 140:541–544

    Article  CAS  PubMed  Google Scholar 

  • Strowitzki T et al (2010a) Dienogest in the treatment of endometriosis-associated pelvic pain: a 12-week, randomized, double-blind, placebo-controlled study. Eur J Obstet Gynecol Reprod Biol 151:193–198

    Article  CAS  PubMed  Google Scholar 

  • Strowitzki T et al (2010b) Dienogest is as effective as leuprolide acetate in treating the painful symptoms of endometriosis: a 24-week, randomized, multicentre, open-label trial. Hum Reprod 25:633–641

    Article  CAS  PubMed  Google Scholar 

  • Strowitzki T et al (2012) Detailed analysis of a randomized, multicenter, comparative trial of dienogest versus leuprolide acetate in endometriosis. Int J Gynaecol Obstet 117:228–233

    Article  CAS  PubMed  Google Scholar 

  • Sukhikh GT et al (2004) Cytokine production by immunocompetent cells of peritoneal fluid in women with external genital endometriosis. Bull Exp Biol Med 137:568–571

    Article  CAS  PubMed  Google Scholar 

  • Sundqvist J et al (2013) Replication of endometriosis-associated single-nucleotide polymorphisms from genome-wide association studies in a Caucasian population. Hum Reprod 28:835–839

    Article  CAS  PubMed  Google Scholar 

  • Treloar SA et al (2005) Genomewide linkage study in 1,176 affected sister pair families identifies a significant susceptibility locus for endometriosis on chromosome 10q26. Am J Hum Genet 77:365–376

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Tummon IS et al (1988) Occult ovulatory dysfunction in women with minimal endometriosis or unexplained infertility. Fertil Steril 50:716–720

    Article  CAS  PubMed  Google Scholar 

  • Uno S et al (2010) A genome-wide association study identifies genetic variants in the CDKN2BAS locus associated with endometriosis in Japanese. Nat Genet 42:707–710

    Article  CAS  PubMed  Google Scholar 

  • Vigano P et al (2004) Endometriosis: epidemiology and aetiological factors. Best Pract Res Clin Obstet Gynaecol 18:177–200

    Article  PubMed  Google Scholar 

  • Wei DM et al (2011) [Relationship between endometriosis fertility index and pregnancies after laparoscopic surgery in endometriosis-associated infertility]. Zhonghua Fu Chan Ke Za Zhi 46:806–808

    Google Scholar 

  • Xin L et al (2023) Efficacy and safety of oral gonadotropin-releasing hormone antagonists in moderate-to-severe endometriosis-associated pain: a systematic review and network meta-analysis. Arch Gynecol Obstet 2023 Jan 19

    Google Scholar 

  • Xu H, Zhang MGC et al (2013) Vascular endothelial growth factor C is increased in endometrium and promotes endothelial functions, vascular permeability and angiogenesis and growth of endometriosis. Angiogenesis 16:541–551

    Article  CAS  PubMed  Google Scholar 

  • Yin X et al (2012) Increased activation of the PI3K/AKT pathway compromises decidualization of stromal cells from endometriosis. J Clin Endocrinol Metab 97:E35–E43

    Article  CAS  PubMed  Google Scholar 

  • Zafrakas M et al (2008) Genome-wide microarray gene expression, array-CGH analysis, and telomerase activity in advanced ovarian endometriosis: a high degree of differenziation rather than malignant potential. Int J Mol Med 21:335–344

    CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Frauenklinik, Kliniken Böblingen, Klinikum Sindelfingen-Böblingen, Böblingen, Deutschland

    S. P. Renner

  2. Frauenklinik, Städtisches Klinikum Karlsruhe, Karlsruhe, Deutschland

    A. Müller

Authors
  1. S. P. Renner
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. A. Müller
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to S. P. Renner .

Editor information

Editors and Affiliations

  1. Abt. Gynäkologische Endokrinologie und Fertilitätsstörungen, Universitäts-Frauenklinik Heidelberg, Heidelberg, Deutschland

    Thomas Strowitzki

  2. Universitätsfrauenklinik Regensburg, Regensburg, Deutschland

    Olaf Ortmann

Rights and permissions

Reprints and permissions

Copyright information

© 2024 Der/die Autor(en), exklusiv lizenziert an Springer-Verlag GmbH, DE, ein Teil von Springer Nature

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Renner, S.P., Müller, A. (2024). Endometriose. In: Strowitzki, T., Ortmann, O. (eds) Klinische Endokrinologie für Frauenärzte. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-65517-7_12

Download citation

  • DOI: https://doi.org/10.1007/978-3-662-65517-7_12

  • Published:

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-662-65516-0

  • Online ISBN: 978-3-662-65517-7

  • eBook Packages: Medicine (German Language)

Publish with us

Policies and ethics

Search

Navigation