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Leitsymptom chronischer Unterbauchschmerz der Frau pp 35–54Cite as

Endometriose: Pathogenese, Symptome und Diagnostik

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Zusammenfassung

Endometriose ist eine benigne, proliferative Erkrankung der Frau im reproduktivem Alter, bei der es zur Ansiedlung von Endometrium-artigem Gewebe außerhalb des Cavum uteri kommt. Die Prävalenz der Endometriose wird mit 2–20% aller Frauen im oben genannten Alter angegeben und stellt somit eine der häufigsten benignen gynäkologischen Erkrankungen dar. Die Leitsymptome Dysmenorrhoe, zyklische und/oder azyklische Unterbauchschmerzen (UBS), Dyspareunie, Dyschezie, sowie Dysurie und Fertilitätsbeeinträchtigung führen zu extremen menschlichen, klinischen und volkswirtschaftlichen Problemen. Äußerst problematisch ist, dass das Zeitintervall vom Auftreten der Symptome bis zur Diagnosestellung im Mittel 6–8 Jahre beträgt. Die häufig „unauffälligen“ körperlichen Untersuchungsbefunde erschweren die Diagnose. Daher ist die ausführliche Anamnese oftmals ausschlaggebend. Da ein Großteil der betroffenen Patientinnen über Schmerzen klagt, die die Lebensqualität signifikant einschränken, sind insbesondere Kenntnisse in diesem Bereich von essenzieller Bedeutung für die Diagnostik und die Therapie. Nach wie vor ist aber die Schmerzentstehung bei Endometriose ein in weiten Bereichen unverstandenes Gebiet. Die Symptome sind komplex, können isoliert oder in Kombination auftreten und scheinen multifaktoriell bedingt zu sein. In diesem Kapitel sind die wichtigsten klinischen Aspekte zusammengestellt, die insbesondere helfen sollen, die komplexe Problematik dieses Krankheitsbildes zu verstehen und hoffentlich dazu beitragen, dass Endometriose schneller erkannt wird.

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  1. Klinik für Gynäkologie, Charité Universitätsmedizin Berlin (Mitte), Charitéplatz 1, 10117, Berlin, Deutschland

    S. Mechsner

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  1. Praxisklinik am Rosengarten, Mannheim, Germany

    Martin Sillem

  2. Brustzentrum, Martin-Luther-Krankenhausbetrieb GmbH, Berlin-Grunewald, Germany

    Friederike Siedentopf

  3. Endometriosezentrum Charité, Klinik für Gynäkologie, Charite Universitätsmedizin, Berlin, Germany

    Sylvia Mechsner

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Mechsner, S. (2015). Endometriose: Pathogenese, Symptome und Diagnostik. In: Sillem, M., Siedentopf, F., Mechsner, S. (eds) Leitsymptom chronischer Unterbauchschmerz der Frau. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-43669-1_5

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