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Medikamentöse und konservative Therapie

  • Chapter
Endometriose

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.

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Authors and Affiliations

  1. Klinik für Frauenheilkunde und Geburtshilfe Universitätsklinikum Schleswig-Holstein Campus Lübeck, Ratzeburger Allee 160, D-23538, Lübeck

    Dominique Finas & Klaus Diedrich

  2. Direktor der Frauenklinik des Zentralkrankenhauses Bremen-Nord Hammerbecker, Straße 228, D-28755, Bremen

    Wolfgang Küpker

  3. Stellvertretender Direktor der Klinik für Frauenheilkunde und Geburtshilfe Universitätsklinikum Schleswig-Holstein Campus Lübeck, Ratzeburger Allee 160, D-23538, Lübeck

    Ricardo Felberbaum

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  1. Dominique Finas
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  2. Wolfgang Küpker
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  3. Klaus Diedrich
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  4. Ricardo Felberbaum
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© 2004 Springer-Verlag Wien

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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

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  • 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

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