Download PDF
Frauenheilkunde up2date 2007; 1(1): 15-33
DOI: 10.1055/s-2006-955231
Allgemeine Gynäkologie und gynäkologische Onkologie

© Georg Thieme Verlag KG Stuttgart · New York 2007

Endometriose

Stefan P. Renner1 , Peter Oppelt1 , Helge Binder1 , Matthias W. Beckmann1
  • 1Frauenklinik, Universität Erlangen
Further Information

Publication History

Publication Date:
28 February 2007 (online)

Also available at
    Permissions and Reprints All articles of this category

Einführung

Hintergrund. Obwohl die Endometriose erstmals bereits im späten 17. Jahrhundert beschrieben wurde, wird diese Erkrankung bis heute aufgrund des leider weitgehend fehlenden wissenschaftlichem und klinischem Interesses häufig als „forgotten disease” bezeichnet [1].

Selbst in aktuellen Abhandlungen über Erkrankungen des Menschen (Encyclopedia of Medical History, 1985 und The Cambridge World History of Human disease, 1993) sucht man vergebens nach einem Hinweis auf Endometriose [2] [3].

Aufgrund der hohen Prävalenz der Erkrankung erscheint dies verwunderlich. Ein Grund liegt sicherlich in der weitgehend unverstandenen Ätiologie sowie der schwierigen Diagnostik und Therapie dieser rätselhaften Erkrankung. Dieser Beitrag soll eine kurze, sicherlich nicht allumfassende Darstellung der Erkrankung geben, um die Erkrankung Endometriose vermehrt in den Mittelpunkt des klinischen und basiswissenschaftlichen Interesses zu rücken. Dies scheint aufgrund des hohen Leidensdruckes der Patientinnen sowie nicht zuletzt auch der hohen volkswirtschaftlichen Bedeutung dieser Erkrankung durch Arbeitsausfall und medizinischen Aufwand mehr als überfällig zu sein.

Literatur

  • 1 Knapp V J. How old is endometriosis? Late 17th- and 18th-century European descriptions of the disease.  Fertil Steril. 1999;  72 10-14
    CrossrefGoogle Scholar
  • 2 Kiple K. The Cambridge world history of human disease. Cambridge University Press, Cambridge 1993
    Google Scholar
  • 3 McGrew R. Encyclopedia of medical history. McGraw-Hill, New York 1985
    Google Scholar
  • 4 Mahmood T A, Templeton A. Prevalence and genesis of endometriosis.  Hum Reprod. 1991;  6 544-549
    CrossrefGoogle Scholar
  • 5 Moen M H, Schei B. Epidemiology of endometriosis in a Norwegian county.  Acta Obstet Gynecol Scand. 1997;  76 559-562
    CrossrefPubMedGoogle Scholar
  • 6 Vigano P, Parazzini F, Somigliana E, Vercellini P. Endometriosis: epidemiology and aetiological factors.  Best Pract Res Clin Obstet Gynaecol. 2004;  18 177-200
    CrossrefPubMedGoogle Scholar
  • 7 Witz C A, Burns W N. Endometriosis and infertility: is there a cause and effect relationship?.  Gynecol Obstet Invest. 2002;  53 Suppl 1 2-11
    CrossrefGoogle Scholar
  • 8 Simpson J L, Elias S, Malinak L R, Buttram V CJr. Heritable aspects of endometriosis. I. Genetic studies.  Am J Obstet Gynecol. 1980;  137 327-331
    CrossrefPubMedGoogle Scholar
  • 9 Meyer R. Über den Stand der Frage der Adenomyositis, Adenomyome im Allgemeinen und insbesondere über Adenomyositis seroepithelialis und Adenomyometritis sarcomatosa.  Zentralbl Gynäkol. 1919;  36 745-750
    Google Scholar
  • 10 Sampson J. Peritoneal endometriosis due to menstrual dissemination of endometrial tissue into the peritoneal cavity.  Am J Obst Gynecol. 1927;  14 442-469
    Google Scholar
  • 11 D'Hooghe T M, Bambra C S, Raeymaekers B M. et al . Intrapelvic injection of menstrual endometrium causes endometriosis in baboons (Papio cynocephalus and Papio anubis).  Am J Obstet Gynecol. 1995;  173 125-134
    CrossrefGoogle Scholar
  • 12 Sharpe-Timms K L. Using rats as a research model for the study of endometriosis.  Ann N Y Acad Sci. 2002;  955 318-327 , discussion 340-312, 396-406
    CrossrefGoogle Scholar
  • 13 American Society for Reproductive Medicine . Revised American Society for Reproductive Medicine classification of endometriosis: 1996.  Fertil Steril. 1997;  67 817-821
    CrossrefGoogle Scholar
  • 14 Tuttlies F, Keckstein J, Ulrich U. et al . ENZIAN-score, a classification of deep infiltrating endometriosis.  Zentralbl Gynäkol. 2005;  127 275-281
    Article in Thieme ConnectPubMedGoogle Scholar
  • 15 Schweppe K W. Endometriosis - a disease that has no lobby.  Zentralbl Gynäkol. 2003;  125 233
    Article in Thieme ConnectGoogle Scholar
  • 16 Renner S P, Strick R, Oppelt P. et al . Evaluation of clinical parameters and estrogen receptor alpha gene polymorphisms for patients with endometriosis.  Reproduction. 2006;  131 153-161
    CrossrefGoogle Scholar
  • 17 Sallam H, Garcia-Velasco J, Dias S, Arici A. Long-term pituitary down-regulation before in vitro fertilization (IVF) for women with endometriosis. Cochrane Database Syst Rev: CD004635, 2006
    Google Scholar
  • 18 Alborzi S, Momtahan M, Parsanezhad M E. et al . A prospective, randomized study comparing laparoscopic ovarian cystectomy versus fenestration and coagulation in patients with endometriomas.  Fertil Steril. 2004;  82 1633-1637
    CrossrefPubMedGoogle Scholar
  • 19 Saleh A, Tulandi T. Reoperation after laparoscopic treatment of ovarian endometriomas by excision and by fenestration.  Fertil Steril. 1999;  72 322-324
    CrossrefPubMedGoogle Scholar
  • 20 Hart R, Hickey M, Maouris P. et al .Excisional surgery versus ablative surgery for ovarian endometriomata. The Cochrane Database Syst Rev 2005, Issue 3. Art. No.: CD004992. DOI: 10.1002/14651858.CD004992.pub2, 2005
    Google Scholar
  • 21 Mueller A, Thiel F, Binder H. et al . GebFra Refresher Myome - Teil 1.  Geburtsh Frauenheilk. 2004;  64 R229-R244
    Article in Thieme ConnectGoogle Scholar
  • 22 Mueller A, Oppelt P, Ackermann S. et al . The Hohl instrument for optimizing total laparoscopic hysterectomy procedures.  J Minim Invasive Gynecol. 2005;  12 432-435
    CrossrefGoogle Scholar
  • 23 Mueller A, Thiel F, Binder H. et al . GebFra Refresher Myome - Teil 2.  Geburtsh Frauenheilk. 2004;  64 R245-R260
    Article in Thieme ConnectGoogle Scholar
  • 24 Schweppe K W. Guidelines for the use of GnRH-analogues in the treatment of endometriosis.  Zentralbl Gynäkol. 2005;  127 308-313
    Article in Thieme ConnectGoogle Scholar
  • 25 Zupi E, Marconi D, Sbracia M. et al . Add-back therapy in the treatment of endometriosis-associated pain.  Fertil Steril. 2004;  82 1303-1308
    CrossrefGoogle Scholar
  • 26 Busacca M, Somigliana E, Bianchi S. et al . Post-operative GnRH analogue treatment after conservative surgery for symptomatic endometriosis stage III-IV: a randomized controlled trial.  Hum Reprod. 2001;  16 2399-2402
    CrossrefGoogle Scholar
  • 27 Hornstein M D, Yuzpe A A, Burry K A. et al . Prospective randomized double-blind trial of 3 versus 6 months of nafarelin therapy for endometriosis associated pelvic pain.  Fertil Steril. 1995;  63 955-962
    CrossrefPubMedGoogle Scholar
  • 28 Vercellini P, Crosignani P G, Fadini R. et al . A gonadotrophin-releasing hormone agonist compared with expectant management after conservative surgery for symptomatic endometriosis.  Br J Obstet Gynaecol. 1999;  106 672-677
    CrossrefGoogle Scholar
  • 29 Hornstein M D, Hemmings R, Yuzpe A A, Heinrichs W L. Use of nafarelin versus placebo after reductive laparoscopic surgery for endometriosis.  Fertil Steril. 1997;  68 860-864
    CrossrefGoogle Scholar
  • 30 Hornstein M D, Surrey E S, Weisberg G W, Casino L A. Leuprolide acetate depot and hormonal add-back in endometriosis: a 12-month study. Lupron Add-Back Study Group.  Obstet Gynecol. 1998;  91 16-24
    CrossrefPubMedGoogle Scholar
  • 31 Moore J, Kennedy S, Prentice A. Modern combined oral contraceptives for pain associated with endometriosis. Cochrane Database Syst Rev: CD001019, 2000
    Google Scholar
  • 32 Fedele L, Berlanda N. Emerging drugs for endometriosis.  Expert Opin Emerg Drugs. 2004;  9 167-177
    CrossrefGoogle Scholar
  • 33 Goretzlehner G. Menstrual bleeding - must that be? Extended use of oral hormonal contraceptives.  Zentralbl Gynäkol. 2005;  127 302-307
    Article in Thieme ConnectGoogle Scholar
  • 34 Anderson F D, Hait H. A multicenter, randomized study of an extended cycle oral contraceptive.  Contraception. 2003;  68 89-96
    CrossrefGoogle Scholar
  • 35 Mahutte N G, Arici A. Medical management of endometriosis-associated pain.  Obstet Gynecol Clin North Am. 2003;  30 133-150
    CrossrefGoogle Scholar
  • 36 Prentice A, Deary A J, Bland E. Progestagens and anti-progestagens for pain associated with endometriosis. Cochrane Database Syst Rev: CD002122, 2000
    Google Scholar
  • 37 Regidor P A, Regidor M, Schmidt M. et al . Prospective randomized study comparing the GnRH-agonist leuprorelin acetate and the gestagen lynestrenol in the treatment of severe endometriosis.  Gynecol Endocrinol. 2001;  15 202-209
    CrossrefPubMedGoogle Scholar
  • 38 Vercellini P, Fedele L, Pietropaolo G. et al . Progestogens for endometriosis: forward to the past.  Hum Reprod Update. 2003;  9 387-396
    CrossrefGoogle Scholar
  • 39 Vercellini P, Vigano P, Somigliana E. The role of the levonorgestrel-releasing intrauterine device in the management of symptomatic endometriosis.  Curr Opin Obstet Gynecol. 2005;  17 359-365
    CrossrefGoogle Scholar
  • 40 Petta C A, Ferriani R A, Abrao M S. et al . Randomized clinical trial of a levonorgestrel-releasing intrauterine system and a depot GnRH analogue for the treatment of chronic pelvic pain in women with endometriosis.  Hum Reprod. 2005;  20 1993-1998
    CrossrefPubMedGoogle Scholar
  • 41 Allen C, Hopewell S, Prentice A, Allen C. Non-steroidal anti-inflammatory drugs for pain in women with endometriosis. Cochrane Database Syst Rev: CD004753, 2005
    Google Scholar
  • 42 Sagsveen M, Farmer J E, Prentice A, Breeze A. Gonadotrophin-releasing hormone analogues for endometriosis: bone mineral density. Cochrane Database Syst Rev: CD001297, 2003
    Google Scholar
  • 43 Attar E, Bulun S E. Aromatase and other steroidogenic genes in endometriosis: translational aspects.  Hum Reprod Update. 2005;  12 49-56
    CrossrefGoogle Scholar
  • 44 Ebert A D, Bartley J, David M. Aromatase inhibitors and cyclooxygenase-2 (COX-2) inhibitors in endometriosis: new questions - old answers?.  Eur J Obstet Gynecol Reprod Biol. 2005;  122 144-150
    CrossrefGoogle Scholar
  • 45 Pritts E A, Taylor R N. An evidence-based evaluation of endometriosis-associated infertility.  Endocrinol Metab Clin North Am. 2003;  32 653-667
    CrossrefGoogle Scholar
  • 46 Omland A K, Tanbo T, Dale P O, Abyholm T. Artificial insemination by husband in unexplained infertility compared with infertility associated with peritoneal endometriosis.  Hum Reprod. 1998;  13 2602-2605
    CrossrefGoogle Scholar
  • 47 Wu M Y, Ho H N. The role of cytokines in endometriosis.  Am J Reprod Immunol. 2003;  49 285-296
    CrossrefGoogle Scholar
  • 48 Kissler S, Hamscho N, Zangos S. et al . Diminished pregnancy rates in endometriosis due to impaired uterotubal transport assessed by hysterosalpingoscintigraphy.  Brit J Obstet Gynaecol. 2005;  112 1391-1396
    Google Scholar
  • 49 Garrido N, Navarro J, Garcia-Velasco J. et al . The endometrium versus embryonic quality in endometriosis-related infertility.  Hum Reprod Update. 2002;  8 95-103
    CrossrefPubMedGoogle Scholar
  • 50 Garcia-Velasco J A, Mahutte N G, Corona J. et al . Removal of endometriomas before in vitro fertilization does not improve fertility outcomes: a matched, case-control study.  Fertil Steril. 2004;  81 1194-1197
    CrossrefGoogle Scholar
  • 51 Simon C, Gutierrez A, Vidal A. et al . Outcome of patients with endometriosis in assisted reproduction: results from in-vitro fertilization and oocyte donation.  Hum Reprod. 1994;  9 725-729
    Google Scholar
  • 52 Barnhart K, Dunsmoor-Su R, Coutifaris C. Effect of endometriosis on in vitro fertilization.  Fertil Steril. 2002;  77 1148-1155
    CrossrefPubMedGoogle Scholar
  • 53 Yap C, Furness S, Farquhar C. Pre and post operative medical therapy for endometriosis surgery. Cochrane Database Syst Rev 2000, Issue 2. Art. No.: CD003678. DOI: 10.1002/14651858.CD003678, 2000
    Google Scholar
  • 54 Hughes E, Fedorkow D, Collins J, Vandekerckhove P. Ovulation suppression for endometriosis. Cochrane Database Syst Rev 2003, Issue 3. Art. No.: CD000155. DOI: 10.1002/14651858.CD000155, 2003
    Google Scholar
  • 55 Rickes D, Nickel I, Kropf S, Kleinstein J. Increased pregnancy rates after ultralong postoperative therapy with gonadotropin-releasing hormone analogs in patients with endometriosis.  Fertil Steril. 2002;  78 757-762
    CrossrefGoogle Scholar
  • 56 Hughes E G, Fedorkow D M, Collins J A. A quantitative overview of controlled trials in endometriosis-associated infertility.  Fertil Steril. 1993;  59 963-970
    Google Scholar
  • 57 Jacobson T, Barlow D, Koninckx P. et al .Laparoscopic surgery for subfertility associated with endometriosis. Cochrane Database Syst Rev 2002, Issue 4. Art. No.: CD001398. DOI: 10.1002/14651858.CD001398, 2002
    Google Scholar
  • 58 Strowitzki T. Infertility treatment and endometriosis - risk and benefit of assisted reproductive techniques.  Zentralbl Gynäkol. 2005;  127 314-319
    Article in Thieme ConnectGoogle Scholar
  • 59 Deaton J L, Gibson M, Blackmer K M. et al . A randomized, controlled trial of clomiphene citrate and intrauterine insemination in couples with unexplained infertility or surgically corrected endometriosis.  Fertil Steril. 1990;  54 1083-1088
    Google Scholar
  • 60 Tummon I S, Asher L J, Martin J S, Tulandi T. Randomized controlled trial of superovulation and insemination for infertility associated with minimal or mild endometriosis.  Fertil Steril. 1997;  68 8-12
    CrossrefPubMedGoogle Scholar
  • 61 Jansen R P. Relative infertility: modeling clinical paradoxes.  Fertil Steril. 1993;  59 1041-1045
    Google Scholar
  • 62 Somigliana E, Vercellini P, Vigano P. et al . Should endometriomas be treated before IVF-ICSI cycles?.  Hum Reprod Update. 2005;  12 57-64
    CrossrefGoogle Scholar

Dr. med. S. P. Renner

Frauenklinik · Universität Erlangen

Universitätsstraße 21-23

91054 Erlangen

Email: Stefan.Renner@gyn.imed.uni-erlangen.de

      >