Endometriosis: Survey of Current Diagnostic and Therapeutic Options and Latest Research Work

Abstract

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.

Zusammenfassung

Die Endometriose ist eine der häufigsten gutartigen Erkrankungen der Frau im reproduktionsfähigen Alter. Hauptsymptome sind chronische Unterbauchschmerzen und Infertilität. Ätiologie und Pathogenese der Endometriose sind jedoch bisher unzulänglich geklärt. Es erfolgt daher eine vornehmlich symptomatische Therapie, wobei die laparoskopische Entfernung als operativer „Goldstandard“ gilt. Ziel der medikamentösen Therapie ist das Erreichen eines hypoöstrogenen Zustands. Bei schwerer Endometriose und Kinderwunsch ergibt sich häufig die Indikation für eine assistierte Reproduktion. Die vorliegende Arbeit fasst alle aktuellen Aspekte zur Diagnostik und Therapie der Endometriose zusammen. Dabei wird klinisch ein Schwerpunkt auch auf die zwar seltenere, jedoch mit hoher Morbidität verbundene tief infiltrierende Endometriose gesetzt. Auch zeitgemäße Therapieoptionen bei Infertilität werden näher dargestellt. Zudem wird ein Schwerpunkt auf neueste Forschungsansätze gelegt, um sowohl Klinikern als auch Wissenschaftlern aktuelle Erkenntnisse zur Pathogenese und ggf. daraus resultierenden Therapieoptionen darzustellen.

Key words

endometriosis - infertility - dyspareunia

Schlüsselwörter

Endometriose - Infertilität - Dyspareunie

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