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Erschienen in: Die Gynäkologie 10/2020

21.08.2020 | Infertilität | Leitthema

Operative Therapie der Endometriose und ihre Risiken

verfasst von: Dr. med. Sebastian D. Schäfer

Erschienen in: Die Gynäkologie | Ausgabe 10/2020

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Zusammenfassung

Die operative Therapie stellt eine der Hauptsäulen der Endometriosebehandlung dar. Operationen werden insbesondere bei Schmerzen und Sterilität durchgeführt und führen zu Schmerzlinderung, teilweise auch zu erhöhter Fertilität. Erläutert wird die operative Therapie bei Adenomyosis, peritonealer Endometriose, tief infiltrierender Endometriose und ovarieller Endometriose. Dabei werden die Effekte der Operation auf Schmerzen und Fertilität sowie Rezidive und Risiken diskutiert. Bei Adenomyosis kommen organerhaltende Verfahren und die Hysterektomie zum Einsatz. Bei peritonealer Endometriose wird die Komplettresektion angestrebt, bei tief infiltrierender Endometriose symptomorientierte Komplettresektion. Hierfür kommen zum Teil hochkomplexe Eingriffe mit erhöhtem Komplikationspotenzial zum Einsatz. Bei der ovariellen Endometriose wird die komplette Zystektomie angestrebt. Dabei sind ovarielle Funktion und Kinderwunsch zusätzlich zu beachten. Endometrioseoperationen sind zumindest kurz- bis mittelfristig effektiv hinsichtlich von Schmerzsymptomen. Sie erhöhen die Wahrscheinlichkeit einer Spontankonzeption. Ihre Rolle im Rahmen der assistierten Reproduktion ist noch unklar. Die Indikationsstellung zur Operation sollte daher stets individuell erfolgen. Die Behandlung sollte insbesondere bei tief infiltrierender Endometriose in spezialisierten Zentren erfolgen.
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Metadaten
Titel
Operative Therapie der Endometriose und ihre Risiken
verfasst von
Dr. med. Sebastian D. Schäfer
Publikationsdatum
21.08.2020
Verlag
Springer Medizin
Erschienen in
Die Gynäkologie / Ausgabe 10/2020
Print ISSN: 2731-7102
Elektronische ISSN: 2731-7110
DOI
https://doi.org/10.1007/s00129-020-04646-8

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