Medikamentöse und konservative Therapie

Zusammenfassung Ziel der Behandlung einer Endometriose ist die Beseitigung bestehender bzw. die Verhinderung des Auftretens neuer Endometrioseherde. Zumindest sollte die Behandlung zu einer längerfristigen Besserung von Symptomen oder/und Erfüllung eines bestehenden Kinderwunsches führen. Die Therapie der Endometriose stützt sich erfahrungsgemäß auf ein Dreistufenkonzept (Tabelle 1): 1. Primäroperation mit Laparoskopie zur definitiven histologischen Diagnose der Endometriose durch Biopsie, Adhäsiolyse und Koagulation makroskopisch erkennbarer Endometrioseherde und suspekter Areale, ggf. ist auch die Durchführung einer Laparotomie zur Sanierung ausgedehnter Endometriosebefunde erforderlich. 2. Nach primär operativem Vorgehen, kann sich eine medikamentöse Nachbehandlung z.B. mit gonadotropin releasing hormon (GnRH)-Agonisten über 3–6 Monate anschließ en (Dmowski et al. 1990, Buttram 1993). 3. Zwei Monate nach Abschluss der Medikationsphase kann eine second look Operation mit der Möglichkeit der Anwendung mikrochirurgischer, rekonstruktiver Verfahren erfolgen. Bei primär ausgedehnten Befunden sollte nun die Sanierung und ggf. Resektion von Restbefunden erfolgen. Dies kann auch die Resektion betroffener Darm- oder Blasenabschnitte beinhalten. Bei Kinderwunsch ist ein primär organerhaltendes Vorgehen zu wählen. Preview Unable to display preview. Download preview PDF. Similar content being viewed by others Literatur Adamson GD (1997) Treatment of endometriosis-associated infertility. Semin Reprod Endocrinol 15: 263–271 Adamson GD, Pasta DJ (1994) Surgical treatment of endometriosis-associated infertility: meta-analysis compared with survival analysis. 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Fertil Steril 72: 961–969 Author information Authors and Affiliations Rights and permissions Copyright information © 2004 Springer-Verlag Wien About this chapter Cite this chapter Finas, D., Küpker, W., Diedrich, K., Felberbaum, R. (2004). Medikamentöse und konservative Therapie. In: Endometriose. Springer, Vienna. https://doi.org/10.1007/978-3-7091-0574-0_6 Download citation DOI: https://doi.org/10.1007/978-3-7091-0574-0_6 Publisher Name: Springer, Vienna Print ISBN: 978-3-7091-7196-7 Online ISBN: 978-3-7091-0574-0 eBook Packages: Springer Book Archive